AATOD Conference Photos

AATODThe American Association for the Treatment of Opioid Addiction has posted photos from their November 2013 National Conference in Philadelphia on their website. Photos include:

http://www.aatod.org/national-conference/2013-aatod-conference-philadelphia/2013-conference-photos/

Source: American Association for the Treatment of Opioid Addiction – February 26, 2014

Message from AATOD Regarding the Death of Philip Seymour Hoffman

AATOD“Philip Seymour Hoffman’s death has attracted national media attention as most celebrity deaths do, especially when they relate to a drug overdose. We have seen this phenomenon shortly after the deaths of Anna Nicole Smith and Michael Jackson. There was an immediate flurry of media attention, and then other stories took center stage.

For many addiction treatment professionals and patient advocates, the issues surrounding celebrity deaths represent the daily struggles that must be confronted by a wary public. A number of issues naturally come to surface during such times about opioid addiction and treatment.”

The AATOD message addresses:

  • Changing Social Attitudes
  • Changing Federal and State Oversight
  • The Opportunity to Educate

“The tragedy of Mr. Hoffman’s death will inevitably be revisited by another celebrity death in the future. We will engage once again in the flurry of media stories which typically have a limited lifespan. Ultimately, we need to work effectively to change America’s perceptions about the safety and danger of prescription opioids, the danger of heroin (which is obviously not an FDA approved drug), and the value of prevention and early intervention in providing access to care. Mr. Hoffman’s death is a stark reminder of the dangers of using heroin. It is not, nor has ever been, a safe drug. The user simply does not know what the drug has been cut with or its potency.

Many people who have worked in the addiction treatment community for many years know that heroin has been adulterated with all sorts of dangerous chemicals which can lead to death. We need to continually educate the public about these issues and work with patient advocates and public policy officials to ensure that the message is consistent and sticks.”

http://www.aatod.org/news/message-from-aatod-regarding-the-death-of-philip-seymour-hoffman/

Source: The American Association for the Treatment of Opioid Dependence – February 11, 2014

MARS™ Thought-Leadership Helps Raise Profile of Peer Recovery Support Services: Ginter Joins Plenary, Will Showcase Innovative Trainings at 2013 AATOD Conference

Medication-Assisted Recovery Services (MARS™), part of a leading national nonprofit organization that provides peer support services and training to address the needs of the medication-assisted recovery community, announced its Project Director has been invited to deliver a plenary presentation at the upcoming 2013 AATOD Conference in Philadelphia. Walter Ginter will join other prominent treatment and recovery leaders during the middle plenary session to talk about “Keeping Recovery the Focus”.

In his plenary session, Mr. Ginter will focus specifically on how methadone became the pathway for him to reach his full potential and how he has taken that experience to create the MARS™ Project, a structured program of education and peer support that is helping many others across the country who are in medication-assisted treatment to strengthen their recovery. He will also share his work as an advocate for medication-assisted recovery, helping overcome the barriers and stigma that can fight against recovery efforts.

Mr. Ginter will participate in the plenary session entitled “Keeping Recovery the Focus”, which hones in on a new era that will require programs to adapt to the ongoing implementation of health care reform. Emphasis will be on the 50-year evolution of methadone treatment and where the field is today as an accredited, science-based modality.

The press release can be accessed at: http://www.prweb.com/releases/2013/10/prweb11226954.htm

Source: PRWeb.com – October 14, 2013

Forced Methadone Withdrawal in Jails Creates Barrier to Treatment in Community

jail croppedMethadone treatment for opioid dependence remains widely unavailable behind bars in the United States, and many inmates are forced to discontinue this evidence-based therapy, which lessens painful withdrawal symptoms. Now a new study by researchers from the Center for Prisoner Health and Human Rights, a collaboration of The Miriam Hospital and Brown University, offers some insight on the consequences of these mandatory withdrawal policies.

According to their research, published online by the Journal of Substance Abuse Treatment and appearing in the May/June issue, nearly half of the opioid-dependent individuals who participated in the study say concerns with forced methadone withdrawal discouraged them from seeking methadone therapy in the community after their release.

“Inmates are aware of these correctional methadone withdrawal policies and know they’ll be forced to undergo this painful process again if they are re-arrested. It’s not surprising that many reported that if they were incarcerated and forced into withdrawal, they would rather withdraw from heroin than from methadone, because it is over in days rather than weeks or longer,” said senior author Josiah D. Rich, M.D., M.P.H., director of the Center for Prisoner Health and Human Rights, which is based at The Miriam Hospital.

He points out that methadone is one of the only medications that is routinely stopped upon incarceration. “This research highlights that what happens behind bars with methadone termination impacts our ability to give methadone, a proven treatment, to people in the community,” he added. “Given that opioid dependence causes major health and social issues, these correctional policies have serious implications.”

For the past four decades, methadone has been the treatment of choice for opioid dependence, including heroin, and is on the World Health Organization’s list of “Essential Medicines” that should be made available at all times by health systems to patients. This “anti-addictive” medication prevents withdrawal symptoms and drug cravings and blocks the euphoric effects of illicit opioids. Additionally, methadone therapy has been shown to reduce the risk of criminal activity, relapse, infectious disease transmission (including HIV and hepatitis) and overdose death.

However, in the United States, a significant proportion of people who are opioid dependent are not engaged in methadone replacement therapy. Rich says the majority of patients terminate treatment prematurely, often within the first year.

In their study, Rich and colleagues surveyed 205 people in drug treatment in two states – Rhode Island and Massachusetts – that routinely enforce methadone withdrawal in correctional facilities. They found nearly half of all participants reported concern regarding forced methadone withdrawal during incarceration. Individuals in Massachusetts, which has more severe methadone withdrawal procedures, were more likely to cite concern.

“If other evidence-based medicines like insulin therapy were routinely terminated or withdrawn from those who were incarcerated, we would hear about these serious lapses in care. They would likely garner some attention. But routine termination of methadone maintenance therapy has been occurring in the criminal justice system for decades and remains a little discussed and highly neglected issue,” says lead author Jeannia J. Fu, Sc.B., a former researcher with The Miriam Hospital who is now affiliated with the Yale University School of Medicine.

Rich adds, “We should examine the impact of incarceration itself, and what happens behind bars, on public health and public safety outcomes, and tailor our policies appropriately. We have methadone, which has been shown to improve public health and public safety, yet we have policies that reduce access to this treatment. The correctional policies on methadone should be re-evaluated in terms of the impact they have on the individual and the community.”

http://www.eurekalert.org/pub_releases/2013-03/l-fmw032713.php

Information on the American Association for the Treatment of Opioid Dependence (AATOD) initiatives to increase access to methadone treatment in the Criminal Justice System is available at: http://www.aatod.org/projectseducational-training/methadone-treatment-in-the-criminal-justice/

Source: Eurekalert.org – March 27, 2013

AATOD Guidelines for Guest Medication

“Absent regulations or published practices for Guest Medication, AATOD is providing these recommended “Guest Medication” guidelines. Guest Medication provides a mechanism for patients who are not eligible for take-home medication to travel from their home clinic for business, pleasure or family emergencies. It also provides an option for patients who need to travel for a period of time that exceeds the amount of  eligible take-home doses to do so within regulatory requirements. While AATOD acknowledges there may be state and program variations, AATOD believes that Guest Medication should be patient centered, respectful, and compassionate.”

http://www.aatod.org/policies/policy-statements/aatod-guidelines-for-guest-medication/

Source: American Association for the Treatment of Opioid Dependence, Inc. – March 6, 2013

AATOD Conference a Resounding Success

More than 1,350 people attended the American Association for the Treatment of Opioid Dependence (AATOD) meeting held in Las Vegas April 21-25 at the Venetian/Palazzo Hotel. Among the more than 60 attendees from other countries was a large delegation from Vietnam, reporting on that nation’s successful expansion of methadone treatment.

Under the theme “Recovery for Patients, Families, and Communities,” the conference was co-hosted by the Substance Abuse Prevention and Treatment Agency (SAPTA) of the Nevada Department of Health and Human Services/Division of Mental Health and Developmental Services.

Plenary Highlights

The conference opened with Gov. Brian Sandoval endorsing the work of Nevada’s opioid treatment programs (OTPs).  The governor remained to listen to Deborah A. McBride, MBA, SAPTA director, make her opening remarks. There are 11 OTPs in Nevada, and Ms. McBride expressed unwavering support for their valuable contribution in the wake of epidemic prescription-drug abuse in Nevada. AATOD president Mark Parrino, MPA, reported on AATOD’s national work. Gilberto Gerra, MD, director of the Drug Prevention and Health Branch of the United Nations Office on Drugs and Crime, Vienna, Austria, emphasized the international need for medication-assisted treatment (MAT). 

The second plenary session, dedicated to Lisa Mojer-Torres, lawyer, methadone patient, and tireless advocate, who died last year, focused on methadone as a valid pathway to recovery. The session was led by Carol McDaid, co-founder and principal of Capitol Decisions, and William L. White, MA, senior research consultant, Chestnut Health Systems, both in recovery themselves.

“The whole issue of methadone as part of recovery is critical,” remarked Mr. Parrino, noting the negative attitude in many states among legislators and judges who simply don’t think methadone maintenance treatment constitutes recovery.

Timothy P. Condon, PhD, visiting research professor at the Center for Alcoholism, Substance Abuse, and Addictions at the University of New Mexico, did an excellent job of highlighting the science and policy aspects of MAT during the closing plenary. There was also a presentation on MAT as part of health care reform, provided by Paul Samuels of the Legal Action Center.

And during the closing plenary, Justice Michael Cherry, now Chief Justice of the Nevada Supreme Court, expressed strong support for methadone and buprenorphine in the courts and criminal justice system. It is rare to have the highest judge in the state participate throughout an entire AATOD conference, said Mr. Parrino.

Hot Topics

Buprenorphine and Federal Register Notice

Nicholas Reuter, senior public health advisor with the division of pharmacologic therapies at the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA), talked with AT Forum about hot topics at the conference, including the pending Federal Register notice allowing OTPs to dispense buprenorphine.

Mr. Reuter said the final rule is now in the Office of Management and Budget (OMB) regulatory review process, where it has been since March 8. The final rule will allow OTPs to prescribe buprenorphine under the same rules as DATA 2000-waived physicians, with some additional requirements.  Now, OTPs can dispense buprenorphine only with the same take-home and treatment rules that apply to methadone in 42 CFR Part 8.

This final rule has taken years to reach this point. The approval may be slowed by the interagency review, speculated Mr. Parrino, with one or two agencies expressing concern about diversion. Ironically, when the proposed rule was first published three years ago, comments expressed concern about OTPs causing buprenorphine diversion. Diversion of buprenorphine is now a major issue, without the final rule. Many OTPs feel that is due to the lack of counseling and other services in the office-based system.

Hepatitis C—A SAMHSA Priority

Robert Lubran, director of the division of pharmacologic therapies at CSAT, talked about the public health implications of hepatitis C virus (HCV) in the U.S., noting that SAMHSA will shift emphasis to screening and treatment for HCV. (See related article in this issue.)

Mr. Reuter added that CSAT has had a focus on HCV at many AATOD conferences: “We emphasize screening and treatment. This is the same situation we had with HIV,” he said. Programs are concerned that if widespread testing is undertaken, funds for treatment must be available.  Most states cover the medical treatment for HCV, but stigma against opioid dependence and OTP patients makes it harder for them to access care.  Mr. Parrino added that AATOD has trained over 700 clinical staff in hepatitis C testing and counseling, but few programs offer on-site treatment.

Methadone Mortality Form Becomes Optional

Surprising AATOD, CSAT announced the suspension of their methadone mortality form, introduced only about three years ago.  CSAT will do a “more formal information collection and analysis,” Mr. Lubran told the AATOD Board. “Instead of a voluntary form, we thought we would work with our colleagues in the Center for Behavioral Health Statistics and Quality to do something more official,” he said. “Right now we’re trying to come up with the best analytic procedure, and pursue a pilot. The idea is to do this in a way that is consistent.”  A Dear Colleague letter to the field about the change is dated April 3, but Mr. Parrino wasn’t given it until April 30. (For a copy of the letter, go to http://www.atforum.com/addiction-resources/documents/DearCollegueMethMortalitySuspension-04-2012.pdf).

Benzodiazepine Use in OTP Patients

The use of benzodiazepines in OTP patients was again a hot topic. Ron Jackson, MSW, LICSW, conducted an excellent, well-attended roundtable discussion about how to handle benzodiazepine use in OTP patients. The long-awaited benzodiazepine guidelines are expected to be part of a set of guidelines that cover the use of many different psychoactive substances in an OTP, instead of just benzodiazepines, Mr. Reuter said after the meeting. “We decided to broaden it, to talk about psychoactive medications in general,” confirmed Mr. Parrino. “But it’s really about benzodiazepines.” (See related article in this issue.)

Awards Banquet

Beny J. Primm, MD, executive director, Addiction Research and Treatment Corporation, presented the Nyswander/Dole “Marie” Awards to nine recipients.

Joseph V. Brady, PhD, Maryland

Otto C. Feliu, MS, New York

Hilary Jacobs, MSW, Massachusetts

Edward J. Johnson, MA, South Carolina

Barbara Schlichting, LCSW, New Jersey

Stacy Seikel, MD, Florida

Steve Tapscott, MA, Texas

Stephan Walcher, MD, Germany

William C. Wilson, California

Banquet honorees also included William L. White, MA, who received the prestigious Friend of the Field Award, and Roxanne Baker, CMA, recipient of the Richard Lane/Robert Holden Patient Advocacy Award for her work on behalf of methadone and recovery.

The next AATOD National Conference will convene in November 2013 in Philadelphia.

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