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SAj 12 Days of Holiday Cheer! Day 7: 5th Most Viewed

Dec 19, 2019 by AMERSA

12 Days of Holiday Cheer – Celebrating Some of Our Best!

Day 7: 5th Most Read/Viewed:

Implications of Marijuana Legalization for Adolescent Substance Use

Abstract: Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of tetrahydrocannabinol (THC) compared with previous generations of users due to higher potencies. Although previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts, as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol.

SAj 12 Days of Holiday Cheer! Day 6: 6th Most Viewed

Dec 18, 2019 by AMERSA

12 Days of Holiday Cheer – Celebrating Some of Our Best!

Day 6: 6th Most Read/Viewed:

Project ECHO (Extension for Community Healthcare Outcomes): A new model for educating primary care providers about treatment of substance use disorders

Miriam Komaromy, MD; Dan Duhigg, MBA, DO; Adam Metcalf, LISW; Cristina Carlson, PMHCNS-BC; Summers Kalishman, PhD; Leslie Hayes, MD; Tom Burke, BS; Karla Thornton, MPH, MD; & Sanjeev Arora, MD

Abstract: Background: Project ECHO (Extension for Community Healthcare Outcomes) trains and mentors primary care providers (PCPs) in the care of patients with complex conditions. ECHO is a distance education model that connects specialists with numerous PCPs via simultaneous video link for the purpose of facilitating case-based learning. This article describes a teleECHO clinic based at the University of New Mexico Health Sciences Center that is focused on treatment of substance use disorders (SUDs) and behavioral health disorders. Methods: Since 2005, specialists in treatment of SUDs and behavioral health disorders at Project ECHO have offered a weekly 2-hour Integrated Addictions and Psychiatry (IAP) TeleECHO Clinic focused on supporting PCP evaluation and treatment of SUDs and behavioral health disorders. We tabulate the number of teleECHO clinic sessions, participants, and CME/CEU (continuing medical education/continuing education unit) credits provided annually. This teleECHO clinic has also been used to recruit physicians to participate in DATA-2000 buprenorphine waiver trainings. Using a database of the practice location of physicians who received the buprenorphine waiver since 2002, the number of waivered physicians per capita in US states was calculated. The increase in waivered physicians practicing in underserved areas in New Mexico was evaluated and compared with the rest of the United States. Results: Since 2008, approximately 950 patient cases have been presented during the teleECHO clinic, and more than 9000 hours of CME/CEU have been awarded. Opioids are the substances discussed most commonly (31%), followed by alcohol (21%) and cannabis (12%). New Mexico is near the top among US states in DATA-2000 buprenorphine-waivered physicians per capita, and it has had much more rapid growth in waivered physicians practicing in traditionally underserved areas compared with the rest of the United States since the initiation of the teleECHO clinic focused on SUDs in 2005. Conclusion: The ECHO model provides an opportunity to promote expansion of access to treatment for opioid use disorder and other SUDs, particularly in underserved areas.

SAj 12 Days of Holiday Cheer! Day 5: 7th Most Viewed

Dec 17, 2019 by AMERSA

12 Days of Holiday Cheer – Celebrating Some of Our Best!

Day 5: 7th Most Read/Viewed:

From risk reduction to implementation: Addressing the opioid epidemic and continued challenges to our field

Ingrid A. Binswange, MD, MPH, MS & Adam J. Gordon, MD, MPH

This editorial features SAj Editor in Chief, Adam J. Gordon! Read it now!

SAj 12 Days of Holiday Cheer! Day 4: 8th Most Viewed

Dec 16, 2019 by AMERSA

12 Days of Holiday Cheer – Celebrating Some of Our Best!

Day 4: 8th Most Read/Viewed:

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

Thomas F. Babor PhD, MPH; Bonnie G. McRee MPH; Patricia A. Kassebaum MA; Paul L. Grimaldi PhD; Kazi Ahmed PhD; & Jeremy Bray PhD

SAj Volume 28, Issue 3

Abstract: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to the delivery of early intervention and treatment services through universal screening for persons with substance use disorders and those at risk. This paper describes research on the components of SBIRT conducted during the past 25 years, including the development of screening tests, clinical trials of brief interventions and implementation research. Beginning in the 1980s, concerted efforts were made in the US and at the World Health Organization to provide an evidence base for alcohol screening and brief intervention in primary health care settings. With the development of reliable and accurate screening tests for alcohol, more than a hundred clinical trials were conducted to evaluate the efficacy and cost effectiveness of alcohol screening and brief intervention in primary care, emergency departments and trauma centers. With the accumulation of positive evidence, implementation research on alcohol SBI was begun in the 1990s, followed by trials of similar methods for other substances (e.g., illicit drugs, tobacco, prescription drugs) and by national demonstration programs in the US and other countries. The results of these efforts demonstrate the cumulative benefit of translational research on health care delivery systems and substance abuse policy. That SBIRT yields short-term improvements in individuals’ health is irrefutable; long-term effects on population health have not yet been demonstrated, but simulation models suggest that the benefits could be substantial.

SAj 12 Days of Holiday Cheer! Day 3: 9th Most Viewed

Dec 15, 2019 by AMERSA

12 Days of Holiday Cheer – Celebrating Some of Our Best!

Day 3: 9th Most Read/Viewed:

Advanced Practice Nurses: Increasing Access to Opioid Treatment by Expanding the Pool of Qualified Buprenorphine Prescribers

Matthew Tierney, MS, PMHNP-BC; Deborah S. Finnell, DNS, PMHNP-BC, CARN-AP, FAAN; Madeline A. Naegle, PhD, CNS-PMH, BC, FAAN; Colleen LaBelle, BSN, RN-BC, CARN; & Adam J. Gordon, MD, MPH

SAj Volume 36, Issue 4

Abstract: This editorial is an appeal for all advanced practice nurses with appropriate prescriptive privileges and DEA licenses to be allowed to join physicians in prescribing buprenorphine to increase access to opioid agonist treatment and to reduce the harms associated with the opioid epidemic. Constituting a large proportion of US health care providers, advanced practice nurses can help stop this epidemic.