Opioid Response Symposium

Monday, September 28: Current State of the Opioid Crisis in the District

Health Disparities Among the Opioid Use Disorder Population

This session will set the stage for the Opioid Response Symposium by providing a historical context to the opioid crisis in DC and how it is been addressed in the health care system. We will discuss, in depth, the history of opioids and health care in Washington, DC, understand the context and costs to DC communities, address the impact of opioid abuse on marginalized populations, and discuss current policy implications.
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Presenters: Dr. Robert Cosby, Ph.D., MSW, MPhil, Assistant Dean of Administration, an Associate Professor, and Director of the Howard University School of Social Work Multidisciplinary Gerontology Center, Howard University; Janice Berry Edwards, PhD, LICSW, LCSW-C, ACSW, BCD, Associate Professor Howard University School of Social Work; Mark S. Johnson, MD, MPH, Professor and Chair of the Department of Community and Family Medicine, Howard University.

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Opioids in the District: Trends, Testing, and Composition 

In this session, experts from DC Health and the Department of Forensic Sciences will discuss opioid trends, testing, and composition in the District. The speakers will estimate the scope of the District’s opioid epidemic evidenced by data on overdoses, hospital transports, Narcan administration, and deaths, recognize key demographics of individuals who have overdosed on opioids, describe trends in opioid composition, including fentanyl levels, and outline methods the District uses for overdose and opioid surveillance.

Presenters: Kenan Zamore, MPH, Senior Research Epidemiologist, District of Columbia Department of Health; Jenifer Smith, PhD, Director of the Department of Forensic Sciences; Luke Short, PhD, Chemistry Section Chief, DC Public Health Laboratory, Department of Forensic Sciences

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Spotlight: Impact of Opioid and Substance Use Disorder on Adolescents and Families

This session will place a spotlight on the impact of opioid and substance use disorder on adolescents and families.  It will address the current data on adolescent opioid use, define features associated with substance abuse in adolescents, and illustrate a clinical approach to treating substance abusing adolescents and their families. Participants will receive a list of providers in the District that offer support services for adolescents and families impacted by opioid and substance use disorder.


Presenter: Meghan Schott, DO, FAPA, Medical Director of Psychiatric Emergency Services, Department of Psychiatry and Behavioral Sciences, Children’s National Hospital, Assistant Professor in Psychiatry, Pediatrics, and Emergency Medicine, George Washington University, School of Medicine

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Tuesday, September 29: Opioid Use Disorder Clinical Landscape - New Frontiers

Opioid Use Disorders: Trajectory of the Problem, Use of Medications and the Impact of COVID-19 

The opioid epidemic in our country has understandably been given much attention. Here we discuss the prevalence of opiate use/addiction in population, present how the opioid crisis came about in the country, what’s helped address this problem and why this problem isn’t going away. This session will review how treatment that includes medications can help individuals with opioid use disorder in varying ways, from harm reduction benefits (decreased NIV/HEP C transmission) to decreased cravings and stable living.  We will review the 3 primary medications for treating opioid use disorder: methadone, buprenorphine (Suboxone/Subutex) and naltrexone (Vivitrol), and the medication for treating opioid overdose (naloxone).  Each has different uses, goals, and benefits. In this session, for each medication, we will describe the background, purpose, mechanisms of action, and “real world” experience implementing these medications in assisted treatment. We will review educational points that will show treatment providers who only believe in “the abstinence model” why we should use medications in our treatment of OUD. The session will also discuss how the COVID Pandemic has impacted the opioid problem including increases in overdose rates, changes in our providers and patients as well as the treatment system.

Presenter: Deni Carise, Ph.D., Chief Science Officer, Recovery Centers of America and Adjunct Asst. Professor, University of Pennsylvania Perelman School of Medicine

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Behavioral Pain Medicine: Alternatives to Opioids

Learn about Behavioral Medicine (psychology) interventions for pain management. Beyond treating associated anxiety and depression, Behavioral Pain Medicine (BPM) teaches patients coping strategies that can dial down the intensity of pain, increase daily functioning, and improve patient’s pain-coping self-efficacy. This intervention strategy empowers patients to take control of their pain and improves quality of life. Acupuncture is one of the oldest techniques for providing analgesia still in use today. Despite the accumulation of 2 millennia’s worth of experience throughout the world, its application remains fairly underutilized in a variety of clinical settings although the past 50 years has seen the emergence of more widespread adoption throughout the US. We will discuss some of the theory behind acupuncture, as well as take a look at situations where acupuncture may help with symptoms, and then identify 3 easy-to-locate acupressure points that can be used for pain.

Presenters: Laura S. Gray, PhD, Pediatric Psychologist, Children’s National Hospital; Dr. Sarah Reece-Stremtan, Associate Professor of Pediatrics and Anesthesiology, The George Washington University

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Integrating Peer Support Workers to Enhance SUD Services

In this session, the presenters will focus on defining the role of a peer support worker, highlighting the importance of the role, and how it differs from a clinical staff role. In addition, the presentation will discuss how peer workers are involved in all sectors of the substance use disorder continuum, and provide case examples of DC peer support programs. Finally, the presenters will provide “next steps” in integrating peers into services, providing key components essential to supporting and employing peers successfully.

Presenters: Shea Davis, M.Ed., Special Populations Coordinator, DC Department of Health; Raphaelle Richardson, Director, Consumer and Family Affairs Administration, Department of Behavioral Health; William Ellis, Overdose Survivor Outreach Program Coach, Howard University Hospital; Corrine Simons, MHS, Overdose Survivor Outreach Program Coach, The George Washington University Hospital

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Wednesday, September 30: Broadening Care to Meet Distinct Needs

Trauma-Informed Care 

Innumerable people struggle with substance abuse, mental illnesses, and debilitating conditions daily. Health care is shifting from attributing these conditions to genetic abnormalities, birth defects, and high-risk behaviors to exploring and ascertaining their origins. It has been determined that adverse childhood experiences (ACEs) are the primary variable in some forms of disabilities, mental illnesses, and addictive behavior. Adverse childhood experiences include parental neglect, sexual abuse, and other trauma, and are unfortunately extremely common among children. In this context, exposure to adverse childhood experiences can aggravate mental illnesses, disabilities, and addiction. ACE screening and therapy should, therefore, be incorporated into therapy and rehabilitation programs. This session will shed light on which ACEs are correlated with each condition and the ensuing implications for their treatment.

Presenter: Jami Freeman, M. Psych, ICPRS-T, Culturally Responsive Speaker/Advocate/Disability Awareness Consultant/Bio-Psycho-Social-Spiritual Educator/Internationally Certified Recovery Coach & Trainer, Psychiatric Institute of Washington

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Opioids and Maternal Health: Screening and Stigma, Treatment and Trauma

In this session Dr. Terplan will review the opioid crisis through the lens of maternal health with particular emphasis on hospital-based opportunities for intervention. Screening will be reviewed in detail as will labor analgesia management. Specific attention will be placed on the postpartum period and how hospitals can work to reduce inequities in care many of which are grounded in stigma and discrimination.

Presenter: Mishka Terplan, MD, MPH, FACOG, DFASAM, Associate Medical Director, Friends Research Institute, Adjunct Faculty, Department of Family and Community Medicine, University of California, San Francisco, Addiction Medicine Specialist, Virginia Medicaid

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Impact of COVID-19 on Opioid Use Patients

This session will discuss the impact of COVID-19 on Opioid Use Patients. Presenters from MedStar Washington Hospital Center will describe the components, function, and goals of the Emergency Department Medication-Assisted Treatment and Overdose Survivor Outreach Programs using the Screening, Brief Intervention, Referral to Treatment (SBIRT) model, compare recent hospital data on Emergency Department encounters and SBIRT screenings from before COVID-19 to during the COVID-19 response and summarize frontline provider experiences and flexibilities necessary for meeting the needs of patients with opioid use disorder during COVID-19.

Presenters: Lourdes Griffin, PhD, Assistant Vice President, Behavioral Health Service Line, MedStar Washington Hospital Center; Samantha Brannigan, MSN, Patient Care Manager, Emergency Department, MedStar Washington Hospital Center; Keith Martin, Overdose Survivor’s Outreach Program Coach, MedStar Washington Hospital Center; Christina Blake, Peer Recovery Coach, MedStar Washington Hospital Center

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Prescribing MAT: Physician Perspective and Booster Training

In this session, physician and national expert Dr. Michael Fingerhood will discuss the opioid epidemic and the evidence behind medication-assisted treatment. He will also address common barriers to prescribing MAT and share best practices for overcoming them.

 

Presenter: Michael Fingerhood, MD, Associate Professor of Medicine and Public Health, Johns Hopkins University

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