Addiction Medicine: Beyond the Abstract

In this episode, Dr. Mishka Terplan discusses initiation of MAUD for pregnant patients, and the findings from his recent article Medications for Alcohol Use Disorder Among Birthing People With an Alcohol-related Diagnosis.
 
Dr. Mishka Terplan  is board certified in both obstetrics and gynecology and in addiction medicine. His primary clinical, research, public health, and advocacy interests lie along the intersections of reproductive and behavioral health. He is Medical Director at Friends Research Institute and adjunct faculty at the University of California, San Francisco where he is a Substance Use Warmline clinician. He is Co-Founder and Co-Director of Doing Right By Birth, a non-profit that seeks to flip the script from drug exposure to early childhood development. Dr. Terplan has spoken at local high schools and before the United States Congress and is internationally recognized as an expert in the care of pregnant and parenting people who use drugs.
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Article Link: Medications for Alcohol Use Disorder Among Birthing People With an Alcohol-related Diagnosis

In this episode, Dr. Ryan Alexander joins the show to discuss findings from his new study Withdrawal Signs and Symptoms Among Patients Positive for Fentanyl With and Without Xylazine. 
 
Dr. Ryan Alexander is an addiction medicine specialist and is currently the medical director for substance use services at McNabb Center in Knoxville, TN and is an assistant professor at the University of Tennessee Graduate School of Medicine. He completed medical school at the DeBusk College of Osteopathic Medicine in East Tennessee, his residency in preventive medicine and public health at Griffin Hospital/Yale School of Medicine, and a fellowship in addiction medicine at Yale University School of Medicine. In addition, he completed a Masters of Public Health at Yale School of Public Health. In addition to treating patients, Dr. Alexander conducts clinical research and has published multiple articles related to addiction medicine. He also regularly teaches medical students, residents, and other medical professionals about treating substance use disorders, reducing community stigma toward individuals with substance use disorders, and expanding access to medication treatments.
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Article link: Withdrawal Signs and Symptoms Among Patients Positive for Fentanyl With and Without Xylazine

In this episode, Dr. Ekaterina Pivovarova joins host Shawn McNeil to discuss the findings from her new article Collaborating With Jails to Provide Community-based Medication for Opioid Use Disorder: Qualitative Perspectives From MOUD Treatment Providers. Dr. Pivovarova is a licensed clinical psychologist and an associate professor in the Department of Family Medicine and Community Health at the University of Massachusetts Chan Medical School.
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Article link: Collaborating With Jails to Provide Community-based Medication for Opioid Use Disorder: Qualitative Perspectives From MOUD Treatment Providers

In this episode, Dr. Christine Neeb sits down to discuss integrated treatment programs and how this model could potentially be adapted to other populations with SUD. Dr. Neeb is a Visiting Associate Professor and the Director of Integrated Primary Care and Addiction in the Division of General Internal Medicine at the University of Colorado Anschutz. She is board certified in Family Medicine and Addiction Medicine and focuses on novel strategies to expand access to treatment of substance use disorders, including methadone maintenance therapy, in underserved populations and in the primary care setting.
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Integration of a Community Opioid Treatment Program Into a Federally Qualified Health Center

Podcast host Shawn McNiel, MD, is joined by Michael Incze, MD, MSEd to discuss his new article Expert Panel Consensus of the Effectiveness and Implementation of Models to Support Posthospitalization Care Transitions for People With Substance Use Disorders which aimed to establish a hierarchy of existing SUD care transition models in 2 categories-effectiveness and implementation-using an expert consensus approach.
Dr. Michael Incze is a primary care physician in the Division of General Internal Medicine who is board certified in internal medicine and addiction medicine. His clinical interests include patient education, high value care, and caring for vulnerable populations including people experiencing homelessness and people with substance use disorders. He regularly volunteers at the Fourth Street Clinic, a federally qualified health center that specialized in providing care to people experiencing homelessness. He is a volunteer physician at the Rosebud Indian Health Service hospital in South Dakota. He also founded a clinic that focuses on providing primary care-based addiction treatment at Sugarhouse Health Center.

In this episode of Beyond The Abstract, Dr. Joji Suzuki stops by the show to discuss his recent co-authored review on GLP-1 agonists and their potential role in addiction treatment. Dr. Suzuki is the founding Director of the Division of Addiction Psychiatry in the Department of Psychiatry, Brigham and Women’s Hospital (BWH), and an Associate Professor of Psychiatry at Harvard Medical School (HMS). He is board certified in both Addiction Psychiatry and Addiction Medicine, and has continued to maintain his clinical role as an inpatient addiction consultant at BWH. He has received NIH funding continuously since 2017, having completed a K23 Career Development Award to receive training in conducting clinical trials with an emphasis on research to improve the care of hospitalized patients. He is now a principal investigator on multiple NIH funded trials to evaluate novel pharmacologic and psychosocial treatments for substance use disorders.
 
The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients: A Scoping Review
 
Journal of Addiction Medicine 18(5):p 488-498, 9/10 2024
 
Sept-Oct 2024

Host Shawn McNeil, MD, is joined by Michelle Lofwall, MD, DFAPA, DFASAM,  a professor in the Department of Behavioral Science and Psychiatry at the University of Kentucky and Medical Director of UK’s Robert Straus and First Bridge Clinics, which provide comprehensive OUD treatment within the UK Center on Drug and Alcohol Research. Dr. Lofwall and  her co-authors examined the relationship between the dose in the early stages of treatment and the subsequent risk of death and found some surprising results.
 
Higher First 30-Day Dose of Buprenorphine for Opioid Use Disorder Treatment Is Associated With Decreased Mortality
 
Journal of Addiction Medicine 18(3):p 319-326, 5/6 2024
May-June 2024

Podcast host Shawn McNiel, MD, is joined by Noa Krawczyk, PhD, an assistant professor in the Department of Population Health at NYU Grossman School of Medicine, and an author of Initiatives to Support the Transition of Patients With Substance Use Disorders From Acute Care to Community-based Services Among a National Sample of Nonprofit Hospitals. Dr. Krawczyk discusses the gap in transition of acute care to community care services among most US hospitals, efforts to increase acute care interventions, and how clinicians providing SUD treatment can help hospitals identify and implement best practices to support continuity of care.
 
Follow Dr. Krawczyk on Twitter @noakrawczyk
 
 
Article, Authors, and Links:
Initiatives to Support the Transition of Patients With Substance Use Disorders From Acute Care to Community-based Services Among a National Sample of Nonprofit Hospitals.
Krawczyk, Noa PhD; Rivera, Bianca D. MPH; Chang, Ji E. PhD; Lindenfeld, Zoe MPH; Franz, Berkeley PhD
Journal of Addiction Medicine 18(2):p 115-121, 3/4 2024

Xylazine Use Among People Who Inject Drugs, Philadelphia 2022
 
Host Shawn McNiel, MD,  is joined by Marissa Tan, DO, an Epidemiology Intelligence Service (EIS) Fellow for the Center of Disease Control and Prevention through the Philadelphia Department of Public Health. Dr. Tan and her co-authors sought to help clinicians better identify individuals at risk and inform patients and clinicians about xylazine risk factors.
Dr. Tan discusses their findings from National HIV Behavioral Surveillance Survey among persons who inject drugs data and offers recommendations for clinicians and public health professionals. 
 
Show Links:
Xylazine Use Among People Who Inject Drugs, Philadelphia 2022
Journal of Addiction Medicine, 18(2):p 194-200, 3/4 2024.
March-April 2024

Podcast host Shawn McNeil, MD, is joined by Joshua Sharfstein, MD, and Sara Whaley, MPH, from Johns Hopkins Bloomberg School of Public Health who delve into the strategic allocation of $56 billion from opioid litigation settlements. As they discuss the principles for effective fund utilization, they highlight opportunities for addiction medicine specialists to play a pivotal role in guiding state and local governments to spend these resources wisely to save lives.
 
Journal of Addiction Medicine, November-December 2023
Opioid Settlements: The Role for Addiction Medicine in Guiding Effective Spending
 
Also of Interest
Principles for the Use of Funds From the Opioid Litigation
Developed by a coalition of organizations across the spectrum of the substance use field including physicians, addiction medicine specialists, recovery, treatment, and harm reduction.