| 7:00 am - 8:00 am | Mutual Help
Room 214, Second Floor |
| 7:00 am - 8:00 am | Continental Breakfast - Exhibit Hall
Galleria Exhibit Hall, Lower Level |
7:00 am - 4:15 pm
| ASAM Exhibit Hall Open
Galleria Exhibit Hall, Lower Level |
7:00 am - 5:00 pm
| Registration Desk Open
2nd Floor Pre-Function Foyer, Second Floor |
8:00 am - 9:30 am
Policy Plenary - Grand Ballroom East - Ballroom AB, Second Floor
Addressing Prescription Drug Abuse: Role of the Physician in Counteracting Diversion, Misuse & Addiction
Council Chair: Herbert Malinoff, MD, FACP, FASAM
Committee Co-Chairs: Mark Kraus, MD, FASAM; Scott Teitelbaum, MD, FASAM
Legislative Advocacy Committee Co-Chairs: A. Kenison Roy, III, MD, FASAM; Kelly Clark, MD, MBA
Plenary Keynote Speaker:
Ileana Arias, PhD
Deputy Director, Centers for Disease Control and Prevention
Dr. Arias will speak about the public health impact of prescription drug abuse and overdose. She will present information on current trends in prescription drug abuse and overdose, highlight populations at greatest risk, and present CDC’s public health policy recommendations to addressing the prescription drug overdose epidemic.
Plenary Panelists: Mark Kraus, MD, FASAM; Scott Teitelbaum, MD, FASAM; A. Kenison Roy, III, MD, FASAM; Kelly Clark, MD, MBA
Plenary Description: The last two decades have seen dramatic increases in the use of and addiction to potentially addictive pharmaceuticals. Although the non-medical use of prescription drugs is not a new phenomenon, increases in cases of diversion, misuse, and overdose deaths have been striking and have drawn the attention of public health officials, regulatory agencies, and public policy makers on the state and national level. This plenary will explore the role of the physician in counteracting prescription drug misuse and addiction. In particular, the plenary will discuss ways that physicians can work with federal partners like the Centers for Disease Control and Prevention to stem the rising tide of prescription drug abuse in our country.
Educational Objectives:
At the end of the plenary, attendees will:
- Understand federal and state public policies that affect the research, education, prevention and treatment efforts of addiction medicine practitioners.
- Gain a more intimate understanding of the practical implications of these policies on their work and on the lives of their colleagues, patients, and students.
| 9:00 am - 10:00 am | Ohio and New Jersey Chapter Meeting
Room 201, Second Floor |
| 9:30 am - 10:00 am | Refreshment Break - Exhibit Hall
Galleria Exhibit Hall, Lower Level |
10:00 am - 12 noon - Concurrent Sessions
Symposium 4 - Grand Salon West - Salon D, Second Floor
An International Perspective on Combined Addiction and Mental Illness
Co-Sponsored by: International Society of Addiction Medicine (ISAM) and the National Institute on Drug Abuse (NIDA)
Organizers: Marc Galanter, MD, FASAM; Jag Khalsa, PhD.; Petros Levounis, MD, MA, FASAM
Speakers: Marc Galanter, MD, FASAM; Jag Khalsa, PhD; Steven W. Gust, PhD; Miguel Casas, MD; Giuseppe Carra, MD, PhD; Haim Mell, MD
Symposium Description: In recent years, there has been remarkable growth internationally in innovative approaches to understand and treat substance use disorders. Some of this relates to new modalities of treatment for the very same problems and disorders confronting American clinicians in the addiction field. Other research studies have dealt with problems different from our own, but ones that shed light on the issues confronted in the American treatment community.
Educational Objectives:
At the end of the symposium, attendees will:
- Have an enhanced appreciation of the breadth of dual diagnosis issues found internationally, and
- Understand more about how they are manifest in three different national settings.
Symposium 5 - Grand Salon East - Salon C, Second Floor
The Epidemic of Accidental/Inadvertent Overdoses on Prescription Drugs
Sponsored by: the National Institute on Drug Abuse (NIDA)
Organizers:
Wilson Compton, MD, MPE; Richard D. Ries, MD, FASAM
Speakers:
Jody Rich, MD, MPH;
Leonard J. Paulozzi, MD, MPH; Richard D. Ries, MD, FASAM
Description: There are now more persons dying by overdose on prescription drugs than auto accidents in many stated, chiefly prescription opiated, often combined with other medications such as benzodiazepines.
Educational Objectives:
At the end of this symposium, attendees will:
- Describe the epidemiology of this phenomenon.
- Identify interventional public health strategies to increase survival rates.
Symposium 6 - Grand Salon East - Salon A, Second Floor
Buprenorphine: Enhancing Access While Preventing Diversion
Sponsored by: The Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (CSAT/SAMHSA)
Organizer and Chair:
Sandrine Pirard, MD, PhD, MPH - Welcome and Overview
Speakers:
Richard C. Dart, MD, PhD - Trends in Buprenorphine Diversion
Michelle R. Lofwall, MD - Clinical Strategies for Enhancing Access While Preventing Diversion
Jody Rich, MD, MPH - Motives for Diversion of Buprenorphine
Description: This session discusses national trends, explores underlying motivation of users, reviews the national and international literature on Buprenorphine diversion, and explores associated risk factors, and provide recommendations to Buprenorphine providers.
Educational Objectives:
At the conclusion of this session, the attendee will:
Understand the implications of trend data and the published literature on Buprenorphine diversion
- Discuss motives associated with Buprenorphine diversion and assess patient risk factors for such nonmedical use.
- Adopt strategies to minimize diversion while enhancing medically appropriate access to Buprenorphine.
Course 6 - Rooms 206-207, Second Floor
Biology, Buddha and the Big Book
Speakers: Charles Morgan, MD, FASAM, FAAFP; Stephanie Loebs, RN, BSN
Description: Biopsychosocial aspects of the disease of addiction based on tennents, philosophy and science will be explored. Recent advances in science have supported basic principles that have been documented more recently in the original 12 step literature, as well as in ancient philosophical writings and some of those found in religious and spiritual writings. In order to recover, the paths are many, but the truth is one. The presenters will demonstrate how the science of addiction is confirming ancient beliefs and time tested principles of recovery. Specific examples include such things as PET scan changes during anticipatory reward which correlates with the principle of avoiding people places and things; or new anatomical evidence for generation of new neuronal pathways correlating with the statement, "You can't think your way into sober living; you have to live your way into sober thinking." Numerous other such correlations will be explored. Corresponding treatment for these symptoms will be correlated with the findings of basic science.
Educational Objectives:
At the end of this course, attendees will:
- Be able to delineate basic scientific principles that support the principles of recovery that are found in 12 step programs and other spiritual programs.
- Have a vocabulary that they can use with both their colleagues and with their patients to discuss both spiritual principles of recovery and the scientific basis for those principles.
- Be able to describe certain characteristics of the disease of addiction, that lay people have long described (such as relapse occurs before use) and how this relates to science (for example anticipatory reward and corresponding changes in brain chemistry).
- Have a skill set to help patients and their families embrace long term recovery.
- Have an understanding of how to help themselves and their staff members to be more enlightened practitioners and to help their patients be more self-actualized.
Component Session 5 - Grand Salon West - Salon E, Second Floor
State Medicaid Limitations on Buprenorphine: How to Fight Back
Speakers: Mark Publicker, MD, FASAM; Mark Kraus, MD, FASAM; Eric Goplerud, PhD, MA; A. Thomas McLellan, PhD
Description: Buprenorphine is an essential medication for the treatment of opiate addiction. Increasingly, state Medicaid programs are setting limitations on its use. An important role of state ASAM Chapters is to oppose these limitations. This component session will provide attendees with strategies for fighting limitations based on the Maine experience. Participants will receive documents used in the Maine, including important letters from ABAM, ASAM and Joint, as well as a review of the pertinent literature.
Educational Objectives:
At the end of this session, attendees will:
- Understand the essential elements of treatment advocacy, including the role of leadership and perseverance in public policy committees, coordination with ASAM’s government relations department, the role of lobbyists and grassroots work by patients and families.
Workshop 3 - Grand Salon East - Salon B, Second Floor
Making 12-Step Programs Meaningful for Adolescents and Young Adults
Speakers: Steven Jaffe, MD; Clint Stonebraker, CADC, CAC-2, CCS; Matthew Meyer, CADC, CAC, CCS
Description: Making 12-Step Treatment developmentally meaningful for adolescents and young adults is an extremely important but challenging problem for all clinicians who work with this population. There is significant evidence of the effectiveness of adolescent participation in 12-Step groups which will be reviewed. Two approaches to solving this challenge will be presented. Modifying how the Steps are worked, using a Workbook format which is then presented at a group and the monitored assertive linking to 12-Step programs will be discussed. Conceptual and practical issues of a program of "enthusiastic sobriety" where participation is fun and exciting will be presented. Dealing with the difficult issue of spirituality will be included in these approaches.
Educational Objectives:
At the end of the workshop, participants will:
- Learn the research evidence for the effectiveness of adolescent participation in 12-Step Groups.
- Learn the use of a workbook format for adolescents to work their First and then next Four Steps.
- Learn the components involved in a 12-Step based treatment program which makes participation fun and exciting.
- Share their experience and approaches to these clinical problems.
12:15 pm - 2:00 pm
2012 Awards Luncheon
(Ticketed event - $65 per person, please purchase online or at the registration desk)
Grand Ballroom East - Ballroom AB, Second Floor
Awardees:
Distinguished Scientist Lecture Award: Richard Saitz, MD, MPH, FACP, FASAM
The John P. McGovern Award: David R. Gastfriend, MD
Public Policy Award: A. Thomas McLellan, PhD
Medical-Scientific Program Committee Award: J. Aaron Johnson, PhD
ASAM Media Award: Bill & Judith Moyers
Young Investigator Award: Anne Neumann, PhD, MA
Annual Award: Elizabeth F. Howell, MD, DFAPA, FASAM
Annual Award: Gerald D. Shulman, MA, MAC, FACATA
Presidential Award:Bonnie B. Wilford, MS
Ruth Fox Scholarship: Dustin DeYoung, MD; Brian Harahan, MD, PhD; Karsten Lunze, MD, MPH; Chinyere Ogbonna, MD, MPH; Joan M. Striebel, MD; Christen Tibbs, MD
SAMHSA Science and Service Award: Marc Fishman, MD; Patricia Pade, MD; Joseph O. Merrill MD, MPH; Amanda Wilson, MD
2:00 pm - 4:00 pm - Concurrent Sessions
Symposium 7 - Grand Salon East - Salon A, Second Floor
Review of Treatment of Co-occurring Disorders in Depression, Bipolar Disorder, and Schizophrenic Disorders - The ASAM Clinician's Role
Sponsored by: National Institute on Drug Abuse (NIDA)
Organizers: Richard D.Ries, MD, FASAM; Wilson Compton, MD, MPE,
Speakers: Edward V. Nunes, Jr, MD; Kevin P. Hill, MD, MHS; Richard Ries, MD, FASAM; Joan Ellen Zweben, PhD
Description: Rate of substance disorders are increased two to five times in depression, bipolar and schizophrenic disorders, and such patients present challenges around diagnosis, psychosocial and medication strategies. This review will focus on the unique role which the ASAM clinician may have in these areas.
Educational Objectives:
At the end of this symposium, attendees will:
- Understand and be able to apply screening criteria to assess for Depression, Bipolar, and Schizophrenic disorders in their clinical addiction treatment populations.
- Understand and be able to integrate psychosocial and medication treatments for patients with the above COD's in addiction treatment.
- Understand and be able to prescribe appropriate medications to patients who have the above COD's with regards to both addictions treatments and addictions treatment medications.
Symposium 8 - Grand Salon East - Salon C, Second Floor
Medical Conditions and Opiates Agonist Treatment
Organizers:
Judith Martin, MD, FASAM; Daniel P. Alford, MD, MPH, FACP, FASAM
Speakers:
Shehzad Basaria, MD; Mori J. Krantz, MD, FACC, FACP; Karen Miotto, MD; Diana Sylvestre, MD; Alexander Walley, MD, MSc
Symposium Description: Opioid addiction and opioid agonist treatment can be associated with medical conditions related to needle use, and medical conditions related to long-term opioid treatment. This Symposium presents current clinical information related to some of these medical issues.
Shehzad Basaria, MD: Opioid-induced Hypogonadism
Mori J. Krantz, MD, FACC, FACP: ECG Screening and Cardiac Risk Mitigation in an Urban OTP
Karen Miotto, MD Sleep Apnea in Opioid Agonist Treatment
Diana Sylvestre, MD: Update on Hepatitis C Treatment
Alexander Walley, MD, MSc: Update on HIV/AIDS: Prevention and Treatment in Patients on Opioid Agonist Treatment.
Educational Objectives:
At the end of this symposium, attendees will:
- Use current knowledge about hepatitis C and HIV in screening and treatment decisions.
- Learn the infrastructure requirements for starting an ECG screening program in an urban OTP
- Develop ways to address hypogonadism in OAT patients.
- Be informed on current research on sleep apnea and opioids.
Symposium 9 - Grand Salon West - Salon E, Second Floor
Screening and Brief Interventions of Adolescents and Young Adults in General Medical Settings: Scientific Updates and Clinical Implications
Sponsored by: National Institute on Drug Abuse (NIDA)
Organizers: Geetha Subramanian, MD; Norman W. Wetterau, MD, FAAP, FASAM
Speakers: John Knight, MD; Constance Weisner, DrPH, MSW; Fredric Blow, PhD, Mary Larimer, PhD
Description: Epidemiologic research evidence shows that the use of substances such as tobacco, alcohol, marijuana and misuse of prescription medications among adolescents and young adults are high and in some cases rising. Early onset of abuse of these substances leads to persistent and worsening of substance use disorders in adulthood which supports early identification and intervention of problem use. Empirical evidence for the efficacy and tools for Screening and Brief intervention and Referral to Treatment (SBIRT) for youth presenting at medical settings is now emerging.
Educational Objectives:
At the end of this symposium, attendees will:
- Understand the outcomes from behavioral medicine specialists in pediatric primary care providing adolescents brief interventions and referral to treatment.
- Understand the impact of computerized screening, brief intervention, and referral to treatment for substance use and abuse among adolescents treated in low-income primary care settings, including Federally Qualified Health Centers.
- Be able to begin using evidence based methods to identify and help their adolescent patients overcome substance use problems.
Symposium 10 - Grand Salon West - Salon D, Second Floor
Prenatal Care and Neonatal Withdrawal Approaches in Opiate Dependence
Organizers: Alfonso Paredes, MD; Jag Khalsa, PhD
Speakers: Karol Kaltenbach, PhD; Martha Velez, PhD; Sara Heil, PhD
Description: Currently methadone maintenance is considered to be the treatment of choice for heroin-addicted women. Such approach is believed to facilitate compliance with prenatal care, reportedly it leads to better infant outcomes, helps to reduce the risk of HIV infection and makes possible to prepare the mother for the assumption of parenting responsibilities.
Recent trends in the epidemiology of opiate use require attention given to the increasingly large group of opiate dependent women who are addicted to prescription opiates like oxycodone, hydrocodone and codeine. These medications have become the fastest rising category of abused drugs. Many pregnant women may be consuming these substances increasing the numbers of expecting mothers who carry a significant amount of opiates in their system.
Current clinical practices seem to imply that prolonged exposure of opioids to the unborn is relatively safe and that the risks to the neonate are relatively minor. However, it should also be considered that this exposure occurs during critical periods of neural development.
Throughout the intrauterine period brain cells in the fetus are evolving from stem cell precursors some differentiating to neurons and neuroglia development is taking place. Immature neurons are migrating from initial locations to final positions. At the same time there is a remarkable outgrowth of axons and dendrites.
Does the presence of opiates or, for that matter the presence of other drugs of abuse and their metabolites as well as therapeutic drugs such as antidepressants lead to morphological and functional vulnerabilities that may become apparent during later states of development? It has been claimed that babies exposed to opiates in uterus have a “slightly higher rate of birth defects including, congenital heart defects, and glaucoma and spine bifida.” Although the confounding effects of smoking, alcohol and poverty have not been ruled out, these issues deserve attention. It is known that exposure to alcohol in the mother’s internal environment is not harmless; may this be the case with other substances including several of the psychiatric medications? Resent research has raised some concern regarding antidepressant use during pregnancy.
From the perspective of clinical experience, neonatal opiate withdrawal syndromes are often observed among the neonates of mothers receiving opiates. The usual medical approaches to manage these syndromes require review and perhaps update. The empirical validation of safety and effectiveness also deserves close attention. The type of opiates to which the unborn is exposed may be predictive of risk. There are short acting and long acting opiates, some are agonist/antagonist. The newborn from mothers on buprenorphine have been reported to require significantly less medication after delivery and spend less time in the hospital than babies whose mother was on methadone.
Educational Objectives:
At the end of this Symposium, attendees will:
- Review practices and guiding principles if the prenatal care of opiate dependent women who are receiving substitution therapy opiates.
- What are the criteria that should be applied to consider permissible breastfeeding.
Course 7 - Rooms 204-205, Second Floor
Setting Up an Addiction Medicine Fellowship
Speakers: Petros Levounis, MD, MA, FASAM; Paul Rinaldi, PhD; Abigail J. Herron, DO; Launette Rieb, MSc, MD, CCFP, FCFP
Description: With the founding of the American Board of Addiction Medicine in 2007 and the accreditation of the first 10 fellowships in Addiction Medicine in 2011, the question of how to best prepare our fellow physicians who are not psychiatrists for the challenges and rewards of a career in addiction medicine has come to the forefront of graduate medical education. This workshop will focus on (a) logistics of setting up a fellowship in Addiction Medicine (funding, recruiting, rotations, didactics, documentation), and (b) best practices in the clinical training of general physicians who want to specialize in Addiction Medicine.
Educational Objectives:
At the end of this course, attendees will:
- Organize an Addiction Medicine fellowship.
- Recognize training opportunities, challenges, and limitations in the current landscape of organized addiction psychiatry and addiction medicine.
- Critically evaluate different options for the addiction training of non-psychiatric physicians
Course 8 - Rooms 206-207, Second Floor
Adolescent Substance Use: Addressing America's #1 Public Health Problem
Speakers: Emily Feinstein, JD; Sharon Levy, MD, MPH; Martha Wunsch, MD, FAAP, FASAM; Eric Goplerud, PhD, MA, BA
Description: Adolescent substance use is the largest preventable and most costly health problem in America: 46.1 percent of high school students are current users of addictive substances and 11.9 percent of high school students have a clinical substance use disorder which often co-occurs with other health problems. Adolescent substance use can be addressed with evidence-based interventions that prevent use or interrupt the progression from risky use to addiction, and adolescent addictive disorders can be treated and managed effectively. These interventions, however, are not part of routine medical practice and only about 6 percent of those who need treatment receive it. Barriers health care providers face in addressing adolescent substance use include a lack of: 1) knowledge about adolescent substance use and addictive disorders; 2) knowledge of tools for screening and brief interventions, and uncertainty of what to do upon a positive screen; 3) familiarity with reimbursement options for coverage; 4) time given current reimbursement policies; and 5) quality specialty care. This session will fill these gaps in knowledge and discuss barriers to expanded attention to adolescent substance use in medical practice and how these barriers can be overcome. Experts in substance use research, pediatrics, medical education and health care financing will demonstrate how substance use can be managed in health care practice in the same manner as other adolescent health conditions. The workshop will equip participants with tools for substance use prevention and early intervention and help them understand how developments in medical education and health insurance can facilitate positive change.
Educational Objectives:
At the end of this course, participants will:
- Understand the critical importance of addressing adolescent substance use in medical practice.
- Know how to access tools to address adolescent substance use as part of routine care.
- Identify resources for expanded education and training on the topic.
- Know how to take advantage of insurance provisions and billing codes to obtain reimbursement for services.
Workshop 4 - Grand Salon East - Salon B, Second Floor
Prescription Drug Monitoring Programs and Substance Abuse Treatment: What Healthcare Providers Need to Know
Speakers: Jinhee J. Lee, PharmD; Sandrine Pirard, MD, PhD, MPH
Description: Prescription Drug Monitoring Programs (PDMPs) are statewide programs that collect data on various controlled substance prescriptions and enable prescribers, pharmacists, regulatory boards and law enforcement agencies (under certain restrictions) to access this information pursuant to applicable State guidelines. Additionally, PDMPs may aid the care of those patients with chronic, untreated pain or chemical dependency and help to identify patients engaged in prescription drug abuse and diversion. To date, forty-eight states and one US territory have enacted PDMP legislation. Thirty-six states have operational PDMPs and some are planning on becoming operational in 2011.
Educational Objectives:
At the end of this workshop, attendees will:
- Provide an overview of PDMPs.
- Present PDMPs as an additional tool in the management of patients with substance-related disorders.
- Help healthcare providers take advantage of this tool while understanding the limitations of the current system and confidentiality restrictions.
| 3:30 pm - 5:00 pm | Physicians Health Committee
Room 209, Second Floor |
4:00 pm - 6:00 pm - Concurrent Sessions Component Session 6 - Rooms 206-207, Second Floor
What is Tested on the American Board of Addiction Medicine (ABAM) Certification Exam: How the Core Content of Addiction Medicine will be Reflected in the Examination Blueprint
Speakers: Michael Weaver, MD, FASAM; Martha Wunsch, MD, FAAP, FASAM; Patrick O' Connor, MD, MPH; Christina Delos Reyes, MD; Margaret A. E. Jarvis, MD, Terri Silver, MA
Description: The format will be interactive: brief presentations on ABAM certification, eligibility requirements to sit for the examination, and changes that will be reflected in the examination blueprint, with time in each segment for participants to pose questions on issues that are important to them.
Educational Objectives:
At the end of this session, attendees will:
ABAM is revising the Examination Blueprint for 2012 based on the Scope of Practice, Core Content, and Compendium of Educational Objectives. ABAM also continues to expand the processes for certifying and maintaining certification for addiction medicine specialists. Component Session participants will learn about recent developments and future plans for the Examination Blueprint, and how these affect current and future certified physicians. Component Session participants will gain an understanding of the History of Certification in Addiction Medicine.
- Understand the ABAM Certification Eligibility Requirements, and Application process.
- Understand the impact of the Scope of Practice, Core Content, and Compendium
- Understand the Educational Objectives on the Examination Blueprint.
- Understand Preparation and Review for the Examination.
| 4:15 pm | Exhibit Hall Closes
Galleria Exhibit Hall, Lower Level |
| 4:15 pm - 5:15 pm | Primary Care Interest Group Meeting
Room 208, Second Floor |
| 5:00 pm - 6:00 pm | Ruth Fox Endowment Scholarship Meeting
Room 214, Second Floor |
| 6:00 pm - 7:00 pm | Massachusetts Chapter Meeting
Room 201, Second Floor |
| 10:00 pm - 11:00 pm | Mutual Help
Room 214, Second Floor |