Society of Addiction Specialists Oppose Issue 1

News Release
DATE: October 9, 2018

Members Call on Legislature to Properly Address Substance Use Disorder

The Ohio Society of Addiction Medicine (OHSAM), an association of physicians dedicated to addiction treatment and prevention, strongly believe that non-violent individuals with a substance use disorder are best served when provided proper clinical options.
While on its surface State Issue 1 appears focused on reducing addiction by favoring treatment over incarceration, a closer look at this proposed constitutional amendment reveals that it is not likely to fully achieve this intended mark. Stipulating any specific amount of illicit drugs an individual may possess before triggering a felonious offense, as Issue 1 proposes, is likely to inadvertently worsen the addiction problem in our communities.

For this reason, the members of OHSAM are opposed to State Issue 1 and urge Ohioans to vote ‘no’ on November 6. While we do not believe Issue 1 is the right approach, the proposal’s subject matter is ripe for attention.

We urge the General Assembly to adopt the overall spirit of this measure and immediately propose and quickly approve appropriate legislation that ushers in much-needed reform in the area of treatment and recovery options for the addicted. A new approach that brings balance to a complex dilemma while reducing the over-reliance on incarceration, especially for marginalized populations who are over-represented in Ohio’s prisons, is urgently needed.

ABOUT US: Ohio Society of Addiction Medicine (OHSAM) is a group of addiction specialists and other providers focused on caring for patients with substance use disorder. OHSAM is dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addiction. OHSAM is affiliated with the American Society of Addiction Medicine. Learn more at: http://www.OHSAM.org.

CONTACT: Reginald Fields, MA
Executive Director
614-527-6726 / info@OHSAM.org

Senate Passes Multi-Pronged Legislation to Battle Nation’s Opioid Crisis

WASHINGTON – The Senate easily passed bipartisan legislation Wednesday to combat the nation’s opioid crisis by bolstering programs to treat addiction, more closely monitoring of prescriptions and updating information on alternative treatments to addictive drugs and updating information on alternative treatments to addictive drugs.

The bill passed 98 to one – Sen. Mike Lee, R-Utah was the lone “no” vote and Sen. Ted Cruz, R-Texas, was absent. The House passed the measure 393 to eight. It now goes to President Donald Trump for a signature, which is likely.

The National Institute of Drug Abuse reported that more than 115 people a day die from opioid overdose and 21 percent to 29 percent of patients prescribed opioids for chronic pain misuse them.

Before the vote Sen. Joe Donnelly, D-Ind., said that drug overdoses killed more than 72,000 Americans in 2017, including nearly 30,000 from opioid overdose.

“That’s heartbreaking — heartbreaking, as each person is someone’s loved one and someone’s family member,” Donnelly said.

The legislation would require the Centers for Medicare and Medicaid Services to implement programs for prevention and treatment, including drug management for at-risk beneficiaries to avoid over-prescribing opioids, medical assistance for incarcerated juveniles who need substance abuse treatment, and limits on e-prescribing prescription drugs that are controlled substances.

The Food and Drug Administration would be required to update information on nonaddictive treatments for chronic pain and addiction. In January, the FDA released its strategic policy roadmap, which included bolstering efforts to prevent and treat opioid addiction.

Last month, the Senate passed another bill addressing the opioid crisis 99-1. The bill creates grant programs, including funding to help doctors get waivers for drugs that are especially good at treating opioid addiction, to help communities create addiction treatment centers and expands the use of naloxone, which can reverse opioid overdoses, to more first responders.

Republican Sen. Lamar Alexander, chairman of the Senate health committee and author of the measure, said Congress has allocated $8.5 million for opioid treatment since March. Wednesday’s vote “is an important step toward dealing with the most serious public health epidemic in any of our communities,” Sen. Alexander said.

Sen. Shelley Moore Capito, R-W.Va., emphasized how bipartisan efforts have helped curb overdose rates in West Virginia and nationwide.

“There’s no one silver bullet when it comes to the epidemic of opioids, but one thing is for certain, I and we will keep fighting,” Capito said. “We will fight back against those who are bringing deadly drugs into our communities.”

Beverly Banks, Medill News Service

Original article here.

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ASAM Applauds Inclusion of Key Provisions in Historic Opioid Legislative Package

The American Society of Addiction Medicine (ASAM) today applauds US House and Senate leaders for announcing a bipartisan agreement on an opioid legislative package that includes key provisions to bolster the country’s addiction treatment workforce, help provide standardized evidence-based treatment for individuals with a substance use disorder (SUD), and help ensure coverage and payment models facilitate comprehensive, coordinated care for patients seeking treatment for a SUD.

“On behalf of America’s addiction medicine physicians and other clinicians on the frontlines of this crisis, ASAM applauds our Congressional leaders for working together to include key provisions that will help close the current treatment gap, bolster the addiction medicine workforce, and save more lives,” said Kelly J. Clark, MD, MBA, DFASAM, president of ASAM.  “Reversing course on the deadly opioid overdose crisis requires bold policy solutions that help teach, standardize, and cover addiction medicine so more patients benefit from evidence-based treatment. The agreement reached last night is an important step toward realizing this critical goal.”

Key provisions in the legislative package to teach, standardize, and cover evidence-based addiction medicine include:

  • Making permanent buprenorphine prescribing authority for physician assistants and nurse practitioners and allowing waivered practitioners to treat immediately up to 100 patients at a time (in lieu of 30) if the practitioner is board certified in addiction medicine or addiction psychiatry; or if the practitioner provides medication assisted treatment (MAT) in a qualified practice setting. Certain qualified physicians would also be allowed to treat up to 275 patients at a time with buprenorphine, codifying an existing rule;
  •  Allowing physicians who have recently graduated in good standing from an accredited school of allopathic or osteopathic medicine, and who meet the other training requirements during school to prescribe MAT, to obtain a waiver to prescribe MAT;
  •  Providing loan repayment relief to addiction treatment professionals who practice in high-need areas;
  •  Creating a Medicare demonstration program to increase access to evidence-based outpatient treatment for beneficiaries with opioid use disorder that includes medication as well as psychosocial supports, care management, and treatment planning;
  •  Partially repealing the Institutions for Mental Diseases (IMD) exclusion and allowing state Medicaid programs to cover care in certain IMDs that can deliver services consistent with certain requirements, including evidence-based assessments and levels of care;
  •  Directing the Departments of Justice and Health and Human Services to finalize special registration regulations concerning the prescribing of medications for addiction via telemedicine within one year of enactment;
  •  Expanding Medicare coverage to include payment for Opioid Treatment Programs through bundled payments for wholistic services;
  •  Convening a stakeholder group to produce a report of best practices for states to consider in health care related transitions for inmates of public correctional facilities; and
  •  Requiring the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide information to SAMHSA grantees to encourage the implementation and replication of evidence-based practices.

“Substance use disorder is both treatable and preventable – but from where we stand today, delivering high-quality care to the millions of Americans who live with the disease of addiction will require significant investments in our workforce, coverage, and payment models that facilitate coordinated and comprehensive care, and structural changes that incentivize the use of evidence-based approaches,” said Clark. “And while we celebrate this bipartisan announcement today, ASAM knows there is still much more work to be done to ensure all Americans living with a substance use disorder get the treatment they need. ASAM will continue to advocate for building an addiction treatment system that fully integrates mental health, substance use disorder, and primary care services in order to produce the best patient outcomes. This includes supporting final passage of legislation that would more closely align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act.”

Media Contact: Rebecca Reid P: 410-212-3843 E: rreid@schmidtpa.com

Link to original article here.

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Dr. Ryan, Immediate Past President of OHSAM to be on Panel in Washington D.C. – Live Webcast Thursday

Despite rising rates of Americans suffering from opioid addiction, millions of Americans still lack access to quality, evidence-based treatment for opioid use disorder (OUD).  Although there is no “one size fits all” approach to treatment, there is strong evidence demonstrating the effectiveness of FDA-approved medications, including buprenorphine, methadone, and naltrexone, for OUD treatment. Supporting development, access, and adoption of medication-assisted treatment for OUD is a key priority of the U.S. Food and Drug Administration (FDA) as part of its response to the opioid crisis. However, substantial challenges remain in patient access and provider utilization of medications for OUD treatment.

The objective for this public workshop is to generate an active discussion with providers and health system stakeholders on the armamentarium of therapies to treat opioid use disorder, current barriers to appropriate use of these medications, and opportunities to further reduce stigma and expand access to effective pharmacotherapies as part of an evidence-based approach to OUD treatment.

While this project is supported through a cooperative agreement with FDA, the views expressed in the accompanying documents are those of the participants in attendance, and do not necessarily reflect the official positions and policies of the Department of Health and Human Services, or imply endorsements by the U.S. Government or other organizations.

To view the live webcast and participate in event discussion click the picture below:

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Event date/time:

September 20, 2018 –

9:00 am to 4:15 pm

 

Location:

529 14th Street NW, Floor 13 Washington, DC 20045

Contact Info

518-796-8992
sarah.supsiri@duke.edu

Schedule of events can be found here.

Click the Register button below to register for this event.

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It’s Time to Measure Addiction Recovery Rates, Not Just Addiction Rates

Lost among the headlines of opioid addiction and overdose deaths are the many quiet stories of recovery. An estimated 22 million Americans— that includes the three of us — are in recovery from opioid and other addictions. We say “estimated” because states and the federal government don’t track recovery like they track addiction rates or overdoses.

Oregon, recently ranked last in providing mental health and addiction treatment services by Mental Health America, and almost last in terms of adults needing but not receiving treatment for substance use disorders, is about to change that. We urge other states to follow.

In the midst of a serious addiction crisis, in which 72,000 people died from overdoses in 2017, it can be easy to forget that recovery is not only possible but is the reality for nearly 10 percent of U.S. adults. Losing sight of that can skew public policy and funding priorities to narrowly focus on preventing deaths instead of aiming more broadly to both reduce unnecessary deaths and promote long-term wellness among the 20 million Americans who have a substance use disorder — barely 4 million of whom receive treatment.

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Since 1971, the Substance Abuse and Mental Health Services Administration (SAMHSA) has tracked the rates of substance use disorder in all 50 states and the District of Columbia. The tool it uses, the National Survey on Drug Use and Health, is invaluable for measuring tobacco, alcohol, and drug use, as well as mental health and other health-related issues. But it has never included questions related to the most positive outcome of having a substance use disorder — recovery from it.

Filling this gap has been left to researchers like Harvard University’s John F. Kelly, who directs the Recovery Research Institute, with work like the National Recovery Study. Kelly’s study has one critical limitation though: It provides recovery rates only at the national level and leaves out regional and local estimates.

That’s what makes state reporting so important. More accurate numbers about recovery could provide information on the success of expanding treatment for opioid use disorder and help state policymakers decide where to direct increasing federal aid for addressing the opioid epidemic. These state-specific rates could also be used to help monitor the success of new policies like Good Samaritan and naloxone access laws. Regularly collecting statistics on recovery could also give us a sense of accomplishment compared to the ever-increasing overdose rates since 2000.

Thanks to advocacy by Oregon Recovers and an executive order recently signed by Kate Brown, Oregon’s governor, that declared addiction to be a public health crisis in Oregon, a new effort aims to lower the state’s addiction rate and increase its recovery rate. The first goal of this strategic initiative is easily measurable, since the annual National Survey on Drug Use and Health provides state-by-state data on addiction rates. But measuring progress on improving recovery wasn’t possible — until now.

The state’s Public Health Division, in partnership with Oregon Recovers, plans to pilot a biannual measurement of recovery rates through the Adult Behavioral Risk Survey, to be done in collaboration with the Centers for Disease Control and Prevention.

The pilot will add three questions to the digital version of the survey, which is performed once in the fall and once in the spring. It will ask a sample of Oregonians 1) if they once had a drug or alcohol problem but no longer do; 2) if they identify as a person in recovery; and 3) what supports or resources they use to assist their recovery.

This kind of information will help state authorities, policymakers, treatment providers, and recovery community organizations better understand what is working (including large-scale investments in statewide addiction treatment systems via funds from the Comprehensive Addiction and Recovery Act and 21st Century Cures Act), what is not working, and how individuals with addictions and those in recovery can better be served.

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States such as Pennsylvania, South Carolina, Florida, Nevada, and Wisconsin are beginning to explore similar initiatives, but many more states need to follow Oregon’s lead.

Given the logistics of trying to develop state-by-state initiatives to measure recovery rates, a more efficient approach would be for SAMHSA to modify the National Survey on Drug Use and Health so it can measure recovery nationally and deliver this information to states. That means the same things would be measured in the same ways in all states, ensuring that results about addiction and recovery are comparable across states.

As individuals in long-term recovery, we believe it is essential that federal, state, and local authorities begin shifting their focus from the problem of addiction to the solution of recovery by tracking recovery rates among individuals with substance use disorders. By following Oregon’s example and collecting this valuable information, communities hit hard by this crisis will have a more complete and nuanced picture of the effects local programs are having. That will help them achieve higher rates of success in treating substance use disorders and promoting long-term recovery — which should be held up as the norm and expected outcome for the millions of Americans living with active addictions.

Robert D. Ashford is a recovery researcher pursuing a Ph.D. in health policy at the University of the Sciences in Philadelphia. Olivia Pennelle is a recovery journalist and owner of Liv’s Recovery Kitchen. Brent Canode is co-founder and chair of Oregon Recovers, a statewide recovery advocacy organization serving all Oregonians.

By ROBERT D. ASHFORDOLIVIA PENNELLEand BRENT CANODE

AUGUST 30, 2018

Original article here on statnews.com.

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Cures Act – Prescriber MAT Training

Data 2000 Prescriber Training for Medication-Assisted-Treatment

The 21st Century Cures Act enacted by Congress in December 2016 recognized that states need significant help to combat the opioid epidemic. Ohio is receiving federal funds over two years to focus on developing a skilled workforce that can prescribe buprenorphine for medication assisted treatment (MAT). MAT has been recognized as a critical component in the treatment of people with opioid use disorder. Currently, buprenorphine availability is limited in Ohio because it is the only form of MAT that requires prescribers (i.e., physicians, physician assistants or advanced nurse practitioners) to have a unique DEA license (aka, DATA 2000 waiver). Prescribers must obtain additional training to obtain this license through one eight-hour course and then apply for a DATA 2000 waiver through the Substance Abuse and Mental Health Services Administration (SAMHSA). OhioMHAS’ has designed a training agenda that will allow any medical professional with prescribing privileges to freely obtain the DATA 2000 waiver to meet the growing need of Ohio’s patients with opioid use disorder.

Who can be trained?

Physicians, physician assistants and advanced nurse practitioners who are licensed in the state of Ohio may participate in the free training. See the specific requirements below.

What does the training entail?

The Drug Abuse Treatment Act of 2000 (DATA 2000) specifies training is necessary for prescribers to obtain a waiver to engage in office‐based treatment of opioid use disorders using Schedule III drugs approved by the FDA. The American Society of Addiction Medicine will host the eight-hour day of training to meet federal requirements for the DATA 2000 Waiver. This will be followed by a half-day of training from Ohio experts who will discuss topics including low-dose prescribing according to federal and state guidelines, and referral to behavioral health treatment facilities.

Training events are available live and online

Training events will occur several times each month across the state. Click the calendar image to view dates and locations. Please check back if there is not yet a training posted in your area, as additional dates will be added. Physicians who do not have time for the live course may take an online module at their own pace. ASAM is offering the full eight-hour training to meet federal requirements for the DATA 2000 Waiver.

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Click the above calendar image to view dates and locations and click here for link to original website.

Here’s How to Support Someone Experiencing a Relapse

Headlines about Demi Lovato’s recent hospitalization have sparked a new public discussion about addiction, overdoses, and relapses. Unfortunately, some of that discussion has reinforced harmful stereotypes and misinformation about how to treat a loved one who struggles with addiction.

If you have someone in your life who is dealing with a relapse, don’t panic. There’s no need to cut that person off with “tough love,” or to max out your credit card shipping them off to a destination rehab. We talked to medical experts, plus people with lived experience of recovery, to get the facts on relapse and how to support someone through it.

First, understand what relapse is.

Here’s what happens medically when someone relapses—and why it can be so dangerous.

It has to do with tolerance, says Dr. Shawn Ryan, founder of BrightView Health and president of the Ohio chapter of the American Society of Addiction Medicine (ASAM). When a person stops using their drug of choice, “their tolerance drops and puts them at risk for more medical consequences if they relapse.” For example, “if a patient has stayed abstinent from opioids for a while (whether on medication-assisted treatment or not), their tolerance for fast-acting opioids such as heroin substantially declines; this is why patients are at such high risk of overdose if they go back to using their old dosages.”

Relapse is a part of addiction, and addiction is a medical illness.

“Once an individual becomes addicted, the brain rewires,” says Nikki Litvak, MA, LPCC-S, LICDC, the Associate Director of Counseling at BrightView. “Relapse is not a choice, but a potential part of the disorder.”

It’s really not about willpower.

“Most people wouldn’t yell at a loved one who forgot their inhaler at home, and then had an allergic reaction as a result of their medical condition,” Litvak continued. “So we shouldn’t do that when someone we’re close to experiences a relapse.”

As someone with addiction progresses toward recovery, relapse can happen—just as symptoms can flare up during treatment for any other chronic disease, like diabetes or hypertension. But a relapse doesn’t mean someone has failed, or didn’t try hard enough.

Next, learn how to best support someone experiencing a relapse.

Be there to offer “empathy, empathy, empathy.”

Laura Silverman, a Shatterproof ambassador and founder of the Sobriety Collective, has been in recovery for 11 years. Her advice for supporting a loved one through a relapse? “Empathy, empathy, empathy. Remove shame, don’t blame, and show love.”

It shouldn’t be that strange of a concept. “Do we shame someone with a recurrence of cancer?” Silverman asks. “No. Then why do we shame people with a recurrence of substance use?”

Litvak agrees with this approach. “There is no shame in connection and being a person,” she says. “We all need help sometimes and the best help anyone can get is genuine, compassionate and trustworthy connection from another person. The best thing to do is love them, support them, encourage treatment, and be understanding to their struggle.”

Remember to take care of yourself, too.

“Love can come with boundaries,” Silverman also says. “Caregivers or loved ones can show the person of concern that they care, that they’re there to support and love them—while still maintaining healthy boundaries and their own self-care.”

Be prepared for an emergency.

If your loved one is addicted to opioids, be sure to keep a naloxone kit on-hand at all times. This safe, FDA-approved, easy-to-use medication can reverse an opioid overdose in minutes. Naloxone is now available in pharmacies in most states without a prescription. Learn about how naloxone works, how you can get it, and how to use it.

Encourage high-quality treatment.

There’s so much misinformation surrounding what’s best to treat addiction. 12 steps? In-patient rehab? What about medications?

Two things matter most: Local resources and an individualized plan.

“The most effective treatment for someone suffering from substance use disorder is based on the individual’s needs. Each person suffering from substance use disorder should recognize their priorities which may include religious affiliation, insurance costs (or lack thereof), medication, privacy, and many other factors,” says Litvak. “You should begin looking for treatment within your insurance provider, primary care, and local recovery support systems.”

ASAM’s physician locator and the American Board of Preventative Medicine (ABPM)’s search tool are great places to find medical professionals in your area who are certified to provide addiction treatment.

Educate yourself on what good treatment looks like.

To know what to look for in legitimate addiction treatment, read up on Shatterproof’s National Principles of Care. They’re a set of eight core concepts for addiction treatment, crafted by experts and backed by decades of research. These Principles remove some of that confusion from the addiction treatment process, and show the path toward sustained recovery for patients dealing with addiction.

Original article here written by Shatterproof.org.

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Video for Patients and Families With Questions About MAT

Dr. Hillary Kunins, a PCSS Clinical expert, dispels the notion that treating an addiction patient with medication is simply exchanging one drug with another. Learn how physical dependence is not the same as addiction. A good video to share with patients and their families who have questions about MAT.

Dr. Kunins is an Assistant Commissioner at the New York City Department of Health and Mental Hygiene where she leads the Department’s Bureau of Alcohol and Drug Use – Prevention, Care and Treatment.

Link to original video here.

View more videos at www.pcssNOW.org.

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Opioid Management Congress Aug 13-14 in Nashville

Join Dr. Shawn Ryan, president of OHSAM, who will be speaking at the Opioid Management Congress August 13-14 in Nashville, TN. This is the top destination for executives from hospitals, health plans, community health centers and treatment facilities to:

  • Implement strategies for prevention, monitoring, and treatment across the continuum
  • Network with like-minded executives from various health care sectors to better collaborate and respond to the opioid epidemic
  • Improve your day-to-day operations to target efforts toward pain management, stigma reduction, education, addiction treatment, and more

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Click on the image below to register.

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Click here for event home page.

New Clinician Screening Tool Available for Substance Use

The National Institute on Drug Abuse (NIDA) Clinical Trials Network has unveiled a new scientifically validated, online screening tool designed to assess a patient’s risk for substance misuse and substance use disorder, and assist the health care provider with prevention and treatment strategies. The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Tool is available on the NIDAMED Web Portal and consists of a comprehensive screening component followed by a brief assessment for those who screen positive. NIDAMED disseminates science-based resources to health professionals on the causes and consequences of drug use and addiction, and advances in pain management. NIDA is part of the National Institutes of Health.

The TAPS tool may either be self-administered by an adult patient (under medical supervision) or conducted as an interview by a health professional, but not intended to guide self-assessment or take the place of a health care provider’s clinical judgment. TAPS is one of several tools on the NIDAMED portal that can help providers quickly and easily introduce brief, evidence-based substance use screenings into their clinical practices. Clinicians can survey the tools available to determine which one best fits their practice.taps-image-web

For more information about the TAPS tool, go to: TAPS: Tobacco, Alcohol, prescription medication and other Substance Use Tool or https://www.drugabuse.gov/taps/#/.

For a more comprehensive list of evidence based screening tools, go to: Chart of Evidence-Based Screening Tools for Adults and Adolescents.

For more information on the NIDAMED initiative, go to: NIDAMED: Medical & Health Professionals

For more information, contact the NIDA press office at media@nida.nih.gov or 301-443-6245. Follow NIDA on Twitter and Facebook.