Annual Meeting

Workshop Presentations

Thursday, December 4, 4:00 – 5:30 pm

Legalization of Marijuana: Are We Ready?

Kevin Hill, MD, MHS, McLean/Harvard, McLean Hospital;  Herb Kleber, MD, Columbia University;  and Richard Ries, MD, University of Washington

At the end of the workshop participants will be able to:

  • Describe marijuana use trends in the context of  current marijuana policies
  • Discuss the impact of legalization of marijuana on the state of Washington
  • Review the scientific and policy issues relevant to the question of legalization

Marijuana continues to be a hot topic in the United States. State after state has been faced with questions around decriminalization, medical marijuana, and, most recently, legalization of marijuana. Fifty-eight percent of Americans currently are in support of the legalization of marijuana. While these debates rage, use of marijuana among Americans, particularly young Americans, continues to rise as the perception of marijuana’s risk decreases.

Addiction psychiatrists are in a difficult position as experts on marijuana—often being asked to comment on the risks of marijuana in the face of these complex policy issues. Dr. Hill will introduce the current state of the policies regarding decriminalization, medical marijuana, and legalization of marijuana. He will also discuss several key risks associated with legalization of marijuana and also the arguments in favor of legalization. Dr. Ries will share Washington State’s experience as one of two states that has implemented legalized marijuana. He will discuss how this experience should shape the way other states examine the issue of legalization. Dr. Kleber will moderate a lively discussion and debate among our members about how addiction psychiatrists and AAAP specifically should approach legalization.

Source of Funding: Although all faculty are funded or have been funded by NIDA, they have not received funding solely for the purpose of this workshop.

Managing Gambling Disorders: Six Different Cases and Their Appropriate Treatments

Iman Parhami, M.D., MPH, Delaware Division of Substance Abuse and Mental Health and Timothy W. Fong, MD, University of California, Los Angeles

At the end of the workshop participants will be able to:

  • Identify and screen gambling disorders
  • Recognize the different types of individuals who suffer from gambling disorders
  • Appreciate the appropriate treatments for different types of gamblers

Nearly 4% of the adult U.S. population suffer from gambling related problems and 6% experience harm from gambling during their lifetime. Although no FDA treatments are approved for gambling disorders, research demonstrates that a number of treatments, including psychotropics, have been beneficial in reducing gambling behavior and their associated repercussions.

For the first 15 minutes, this workshop will review the diagnosis, repercussions, and available treatments for gambling disorders. In the remaining time, six cases, and their appropriate treatments, will be interactively presented and discussed among the participants. These cases include: the adolescent gambler, the college gambler, the geriatric gambler, the depressed gambler, the manic gambler, and the suicidal gambler.

Source of Funding: None

Psychostimulant treatment of Cocaine and Other Stimulant Use Disorders: Is it Time Yet?

John Mariani, MD;  Frances Levin, MD, and Adam Bisaga, MD, Columbia University Medical Center

At the end of the workshop participants will be able to:

  • Discuss stimulant pharmacotherapy research findings
  • Describe basic science of dopaminergic system

Cocaine and other stimulant use disorders continue to be a substantial public health problem in the United States and around the world, yet no clearly effective pharmacotherapy has been identified. Controlled trials of behavioral treatments for cocaine use disorder yield abstinence rates of up to 30%, with the majority of patients continuing to use cocaine. Scores of double-blind, placebo-controlled pharmacotherapy clinical trials for cocaine use disorder have been conducted testing agents drawn from a wide variety of medication classes, yet none have been shown to have clinical benefit. Psychostimulant medications have shown promise as a treatment for cocaine use disorder, as well as other stimulant use disorders, despite resistance in the field to using controlled substances as therapeutic agents for addictive disorders. Substitution pharmacotherapy for cocaine and other stimulant use disorders has met with resistance, despite this approach being effective for opioid and nicotine use disorders. In addition, psychostimulants are an effective treatment for ADHD and may offer a unique approach for treating co-occurring ADHD and cocaine use disorder. Psychostimulants and related dopamine agonist medications also may have a unique role in augmenting behavioral treatments, in particular contingency management. The objective of this workshop is for the learner to become more competent at treatment planning for patients with cocaine and other stimulant use disorders.

Dr. Bisaga will provide a brief review of cocaine use disorder neurophysiology and stimulant pharmacology. He will also review the use of stimulant and dopaminergic medication with behavioral treatments for cocaine and stimulant use disorders, with an emphasis on contingency management strategies. Dr. Mariani will discuss stimulant pharmacotherapy of cocaine and amphetamine use disorders with an emphasis on recent clinical trials. Dr. Levin will discuss the unique relationship between ADHD and cocaine and other stimulant use disorders, a summary of clinical trials testing stimulants for co-occurring ADHD and cocaine use disorders, with an emphasis on recently available data.

Source of Funding: National Institute on Drug Abuse

Community Reinforcement and Family Training: Utilization Across the Treatment Cycle

Jeffrey Foote, PhD, Carrie Wilkens, PhD, and Nicole Kosanke, PhD, Center for Motivation & Change

At the end of the workshop participants will be able to:

  • Discuss a behavioral and motivational approach for families dealing with substance users
  • Distinguish these concepts from traditional approaches currently utilized in the field
  • Discuss concepts related to CRAFT directly with patients

Substance Use Disorders have affected approximately 30% of American adults during their lifetime (Hasin et al., 2007) and 12% of high school students meet clinical criteria for substance use disorder (CASA, 2011). Unfortunately, a majority of individuals struggling with substance use problems do not seek treatment (Compton et al., 2007). Family members often bear the brunt of navigating the treatment system and experience the burden of motivating substance users in their family to seek help for their problems. Utilizing the Community Reinforcement and Family Training approach (CRAFT; Smith and Meyers, 2004), families can be provided with specific skills for understanding the function of substance use in their family member’s life and methods for effectively responding to substance use issues. CRAFT demonstrably increases the probability of the substance user seeking professional help and improves family functioning.

The workshop will provide an overview of CRAFT, its use in different treatment contexts, and the training and implementation of these skills with both trained mental health professionals as well as peer “coaches”. The audience will be asked to discuss the issues associated with working with family members of individuals with substance use problems (including dealing with the advice they have previously been given about management of their loved one) and the clinical strategies used to incorporate family members in the treatment process. We will provide suggestions on the implementation of CRAFT in clinical practice and review the resources available to the practitioner implementing CRAFT as part of their treatment plan.

Source of Funding: None

Implementing the Women’s Recovery Group: Group Therapy for Women with Substance Use Disorders

Shelly Greenfield, MD, MPH, McLean Hospital, Harvard Medical School

At the end of the workshop participants will be able to:

  • Recognize how gender-specific treatment is helpful for women with substance use disorders
  • Identify the gender-responsive components of the Women’s Recovery Group
  • Identify and problem solve common issues related to conducting the Women’s Recovery Group

This workshop will provide information to introduce and familiarize participants with the manual-based, empirically supported Women’s Recovery Group (WRG). The presenter will first review the relevant background information related to the development and support surrounding the WRG. Next, the presenter will discuss research findings demonstrating the effectiveness of the WRG in treating women with substance use disorders who are heterogeneous with respect to other co-occurring psychiatric disorders, and age and stage of life. The presenter will use actual therapist video clips to demonstrate the key components of the WRG and how to conduct this group therapy. This interactive session will provide an opportunity for participants to learn about gender-specific treatment and how to implement the WRG in practice.

Dr. Greenfield will first present a background on women and addiction. Next, Dr. Greenfield will discuss research on the benefits of gender-specific treatment while specifically focusing on the key components of the WRG. Dr. Greenfield will also discuss the successful implementation of this program at her treatment site and will provide suggestions for implementing the program in community treatment programs. Part of this presentation will demonstrate the nuts and bolts of conducting WRG using therapist video clips. The workshop will conclude with an interactive discussion of the WRG and its applicability to a variety of treatment settings.

Source of Funding: Support for this research was provided by NIDA grants R01 DA015434 and K24 DA019855.

Thursday, December 4, 6:30 – 8:00 pm

Careers in Addiction Psychiatry 7: An update

Jose Vito, MD;  Laurence Westreich; MD, New York University School of Medicine;  Frances Levin, MD, Columbia University Medical Center;  Timothy Fong, MD, University of California, Los Angeles;  Karen Drexler, MD, Emory University School of Medicine;  and Robert Milin MD, FRCPC, DABPN, University of Ottawa

At the end of the workshop participants will be able to:

  • Describe a wide range of career opportunities in Addiction Psychiatry and the profession
  • Explore the participants’ own decision-making process regarding career options
  • Assess how the treatment of substance use disorders fits within the general practice of psychiatry

The practice possibilities in Addiction Psychiatry are very diverse and becoming more so. Psychiatrists have a wide range of interest in lifestyle goals and working style. It is no surprise that the decision trainees and early careers make regarding long term career decisions are difficult and complex. The APA recently surveyed psychiatry residents about their interest in a career in Addiction Psychiatry. Many trainees noted the lack of information during residency about career opportunities in Addiction Psychiatry, including concerns about the availability of stable employment, interesting positions, and competitive salaries. This workshop is organized to address these concerns and to provide specific information about the range of career opportunities in this field. Each speaker will discuss about lessons learned about their career choices. An interactive session with the audience will proceed with ample of time for questions and answers. This workshop is particularly relevant to trainees and early career addiction psychiatrists. Participants will evaluate and recognize a wide range of career opportunities in Addiction Psychiatry and the professional gratifications associated with this type of work.

This workshop is to help residents, fellows, and early careers determine if Addiction Psychiatry meets their needs and furthers their career goals. Expert speakers will describe a variety of career options including private practice, and careers that primarily focus on training and mentoring, research and administration. Speakers will discuss their own decision-making process and give personal accounts on how they chose their area of specialization (each for 6 minutes). They will also describe what their daily work is like and what drew them to their current work settings to help the trainees develop strategies for fostering successful careers in Addiction Psychiatry. Finally, they will offer their own insight on what they wish they’d done differently.

Source of Funding: None

Friday, December 5, 10:15 – 11:45 am

Innovative Treatment Strategies for PTSD and Co-Occurring Addictions

Chaya Bhuvaneswaran MD MPH, University of Massachusetts-Worcester;  Kathleen Brady, MD PhD, Medical University of South Carolina; and Denise Hien PhD, City College of New York

At the end of the workshop participants will be able to:

  • Discuss the epidemiology (including prevalence among subpopulations)of substance use disorders among PTSD patients in the United States and globally
  • Identify at least three clinically and scientifically significant research results from recent treatment research among patients with PTSD and co-occurring addictions
  • Identify two novel treatment modalities relevant to clinical practice (including mindfulness and complementary/ alternative medical treatment modalities) for patients with this co-morbidity.

PTSD ranks among the most common psychiatric disorders co-morbid with addiction, with over half of veterans seeking treatment for PTSD meeting criteria for alcohol dependence, and PTSD also representing a significant risk factor for other substance use disorders including smoking, cocaine, and opioids. Thus developing novel and effective treatments for patients with the PTSD-addiction co-morbidity has a pressing public health priority.

In this panel, after providing an overview summary on the epidemiology and presentation aspects unique to this co-morbidity we will focus on: cognitively enhanced exposure therapies for co-morbid PTSD and substance disordered populations (with a focus on recent trials for alcohol dependence and opioid dependence in these populations) and ‘next wave’ behavioral treatments with an emphasis on mindfulness training to treat addiction among PTSD patients in low socioeconomic settings. Drs. Bhuvaneswaran, Brady, and Hien will present on treatment trials using prolonged exposure therapy and other cognitive behavioral modalities enhanced with medication as well as next wave behavioral therapies such as mindfulness training, with an emphasis on considerations for minority and low SES populations; and NIDA- and NIAA-funded treatment studies among women and minority patients.

Source of Funding: None

The Addiction Psychiatry Milestones – Questions and Answers

Marian Fireman, MD, Oregon Health and Science University;  Andrew Saxon, MD, University of Washington;  Laura Edgar, Accreditation Council on Graduate Medical Education;  Frances Levin, MD, Columbia University Medical Center; and Kyle Kampman, University of Pennsylvania

At the end of this workshop the participant should be able to:

  • List the six core competencies
  • Describe the purpose of the Milestones
  • Discuss the use of milestones in the evaluation of trainees.

Over the last decade residency and fellowship training in the United States has seen a shift from a focus on the educational process to specific educational outcomes expected for trainees successfully completing these programs. In 1999 the Accreditation Council on Graduate Medical Education (ACGME) established the six core competencies as an initial step in this process. The Milestones are a major component of this project and describe the key knowledge, skills, outcomes, behaviors and attitudes that residents should achieve as they progress through a training program. This is a major change from the prior evaluation system. The milestones allow the program director and trainee to outline specific goals to be achieved during training and provide trainees with a detailed description of their progress. The six core competencies include 1) Patient Care, 2) Medical Knowledge, 3) Systems-Based Practice, 4) Practice-Based Learning, 5) Interpersonal Skills and Communication, and 6) Professionalism. The proposed Addiction Psychiatry Milestones include 16 sub-competencies within these core competencies.

The participants in this workshop include the members from Addiction Psychiatry Working Group as well as the Advisory Group. The members will present the background of the Milestones and describe the process of Milestone development. The Milestones themselves will be presented in detail and time-permitting a “mock” Clinical Competency Committee meeting will be included. Input and discussion from the audience will be a key component of this workshop. The purpose of the workshop is both to inform the audience regarding the Milestones as well as answer from training directors and faculty regarding application of the milestones. Implementation of the Milestones is planned for July 2015. The workshop will include at least 45 minutes of time for audience discussion, questions and feedback with regard to the milestones.
Source of Funding: None

Expanding Access to Opioid Overdose Intervention and Naloxone: Roles for Addiction Treatment Provider

Seddon Savage, MD, MS, Geisel School of Medicine at Dartmouth and Silver Hill Hospital and Eric Collins, MD, Columbia University and Silver Hill Hospital

At the end of the workshop participants will be able to:

  • Integrate overdose intervention and naloxone prescribing into clinical practice
  • Effectively advocate for expansion of naloxone availability in the community

This workshop will explore the role of the medical community, with focus on addiction treatment providers, in making naloxone available for patients and their families to prevent opioid overdose deaths. The workshop will open with an interactive audience response query of the naloxone-related policy contexts in which attendees practice and their opinions about prescribing naloxone to patients and their families. The first presenter will review naloxone pharmacology and it clinical actions including therapeutic actions, side effects and risks. Other aspects of opioid overdose intervention will be discussed and evolving educational standards for preparing professionals and non-professionals to intervene in opioid overdoses explored.

The second presenter will discuss current Federal and State policies that may present barriers to dissemination of naloxone and will explore innovative legislation and regulatory changes in different States that expand access. A “map” of diverse systems that might be fully engaged to give the broadest possible access to naloxone at the level of the community will be explored, including law enforcement, safety and fire; by healthcare providers and/or pharmacies prescribing or dispensing to patients and families; and AED type boxed availability in public buildings.

Source of Funding: None

Motivational Interviewing in Everyday Practice: A Hands-On Interactive Workshop

Carla Marienfeld, MD;  Noah Capurso, MD;  Michael Hoefer, MD; Yale University School of Medicine;  Nahil Chohan, MD; and Petros Levounis, MD, Rutgers New Jersey Medical School

At the end of the workshop participants will be able to:

  •   List the three terms for the spirit of motivational interviewing (MI), the five core principles of MI, the four core MI skills, and the three A’s of MI inconsistent practices.
  • Practice key stills and MI tools in an interactive workshop using small groups and role-play exercises
  • Discuss the rationale and choices for using MI consistent techniques in everyday clinical care

Motivational Interviewing (MI) seeks to hasten natural change by creating an interpersonal situation, wherein the patient can engage through a collaborative dialogue that supports positive behavioral change. This workshop will review key concepts in MI, including the stages of change, the style and spirit of MI, the core principles and skills in MI, two important clinical tools in MI, as well as MI inconsistent behaviors. After this review, we will use presenter rolE modeling and interactive small group practice sessions to practice core skills in MI for using MI in everyday clinical practice. Participants will be provided with a packet of useful MI materials.

The workshop is open to all who would like to learn more about the effective use of the Motivational Interviewing approach to treatment but is particularly targeted towards members in training and early career psychiatrists. This presentation has direct benefit for clinical practice, and the implications are improved interaction with patients and improved patient care.

Source of Funding: None

“Urine Luck” – Overview of New Drug Testing Technologies and Conundrums

Gregory Skipper, MD

At the end of the workshop participants will be able to:

  • List various matrices and their benefits and deficiencies for detecting specific drugs
  • Describe issues related to panels, cutoffs and methods of cheating and how to respond to them
  • Discuss new alcohol testing technologies and how they are best utilized

An overview of drug testing in the USA including the history, benefits, techniques, and interpretation of drug testing, including data regarding common methods used to cheat testing and how to respond to them and new alcohol markers and devices. Understanding drug testing including various testing techniques, panels, cutoffs, issues related to concentration, and common conundrums is important to successful monitoring. This is a practical presentation to bring psychiatrists up to date and will reference relevant research.

Source of Funding: None

Friday, December 5 at 8:00 – 10:30 pm

Addiction in Film 12: “Requiem for a Dream” and the Art, Science, and Culture of a Cult Classic

Petros Levounis, MD, MA;  Shaojie Han, MD;  and Humaira Shoaib, MD, Rutgers New Jersey Medical School

Learning Objectives:

  •   Utilize popular films to enhance didactics and teach fundamentals of Addiction Psychiatry to students and trainees
  • Identify three discrepancies between scientific and cinematographic reality
  • Discuss the portrayal of addiction in the media from a cultural perspective

This is the twelfth year that we offer a workshop for Addiction Psychiatry educators who would like to incorporate popular films in their teaching. Movies offer us an invaluable tool in exploring the complexities of addiction in everyday life, beyond familiar settings, such as Emergency Rooms, inpatient rehabs, and outpatient programs.

“Requiem for a Dream” is a horror film about four people who get addicted to heroin, cocaine, and prescription amphetamines. While writing the screenplay, director Darren Aronofsky came to the realization that his characters were secondary players to the true villain. He says: “The hero was the characters’ enemy: addiction. The book is a manifesto on Addiction’s triumph over the Human Spirit. I began to look at the film as a monster movie. The only difference is that the monster doesn’t have physician form. It only lives deep in the characters’ heads.” Over the past 15 years, the film has reached cult status for its extraordinary power in depicting the very essence of the addictive process—from dream to nightmare.

We will use the film as a springboard for exploring how Hollywood—and by extension the general public—looks at addiction. “Requiem for a Dream” provides a unique platform for such analysis as its scientific basis is not uniformly sound. At times it is brutally accurate and at times it completely misses the mark. Sara Goldfarb’s stimulant intoxication scene (brilliantly performed by Ellen Burstyn) is arguably the best depiction of substance-induced psychosis in all of film history. On the other hand, heroin injection repeatedly results in erroneous pupil dilation. When is Hollywood right, and, more importantly, when are popular movies helpful to the general public’s understanding of addiction and its treatments?

Furthermore, we will address the more technical aspects of using films as teaching tools including choice of films or movie clips, timing, and suggestions for lecturer’s comments before and after showing a movie. Participants are encouraged to bring their own examples and add to the list of addiction-related films, which will be provided at the workshop.

Source of Funding: None

Saturday, December 6, 10:15 – 11:45 am

Pain School: Incorporating Addiction Psychiatry into the Treatment of Pain

Akiva Daum, MD;  Claudia Rodriguez, MD;  SueAnn Kim, MD; Boston University School of Medicine;  Tu Ngo, PhD; Bedford VA, and John Renner, MD, Boston University School of Medicine, VA Boston Healthcare System

At the end of the workshop participants will be able to:

  • Explain the concept of gate control theory and describe how it impacts perception of physical pain
  • Discuss the importance of a multimodal approach to pain management and how Pain School can be used
  • Facilitate the integration of Addiction Psychiatry into programs for chronic nonmalignant pain

The workshop will consist of a series of presentations and exercises with the goal of highlighting a relatively new method of educating chronic pain patients about pain management. The presentations will focus on gate control theory, the multimodal/biopsychosocial aspects of pain and how Pain School is used to educate patient about their pain and treatment options. We will discuss the potential role of an addiction psychiatrist in the evaluation, prevention, early acknowledgement, and treatment of substance use disorders among this patient population. Following brief informative presentations, there will be a role play in which the audience will observe and then practice ways to introduce Pain School to their patients. Open discussions and Q&A to follow.

Methods will include a review of current literature, with a focus on Pain School and other educational options for patients who suffer from chronic pain. Literature examining opioid use disorder associated with the treatment of chronic non-malignant pain (CNMP), development of aberrant drug related behaviors, and current standards of care in pain management will also be reviewed. The presentation will then highlight ways to introduce and utilize Pain School for patients who suffer from chronic pain. The audience will be asked to consider ways in which addiction services can be incorporated into this multimodal treatment.

Source of Funding: None

QTc – Unraveling Myths From Realities

Gregory Acampora, MD, Massachusetts General Hospital;  Carla Marienfeld, MD, Yale University School of Medicine;  and Joseph Westermeyer, MD, University of Minnesota/Minnesota VA

At the end of the workshop participants will be able to:

  • Describe QTc origins and sources of variance
  • Discuss clinical pertinence of QTc, Learning objective
  • Cite correct questions to ask patient and tests to best assess QTc risk

Our activity aims to shed light on QTc as it pertains to clinical practice. The reality is that as psychiatrists seek “evidenced based knowledge” for “best practice” regarding QTc, they are met with several levels of poor understanding, misinformation, misunderstanding and misapplication of the factors that determine QTc and what that number means to them and their patient. We aim to demonstrate that the literature can be either misleading or lend to misapplications on a practical level. After a review of physiology, we will discuss data gathered from a sophisticated lab at the Twin-Cities VA comparing in-vivo blood data to EKG’s demonstrating pharmacokinetic variance in methadone patients. We will intersperse with illustrative and applicable cases taken from a high volume methadone clinic in New Haven to generate lively discussion.

Questions concerning the QTc interval are frequently encountered by clinicians in and out of the hospital. There are many variables that can prolong QTc; these should be considered when met with an abnormal value. The fulcrum is understanding the Long QT Syndrome (LQTS). We will present three discussions of LQTS, with methadone as the representative drug: 1) discussion of determinates of QTc , 2) data demonstrating the proposed physiology by correlating in-vivo real-time methadone levels to EKG’s obtained for those blood draws, and 3) real cases that will illustrate clinical decision making.

Source of Funding: None

Military Culture 101: What Addiction Psychiatry Needs to Know

John Rodolico, PhD, McLean Hospital/Harvard Medical School

At the end of the workshop participants will be able to:

  • Describe military culture in relation to treating military personnel with co-occurring disorders
  • Cite what the recent trends in co-occurring disorders are in a Military and Veteran population
  • Describe and discuss the recent interventions that are being piloted by the active duty and reserve components of the military, along with interventions being used by the Department of Veterans Affairs.

The psychological injuries from the recent conflicts in Iraq and continuing in Afghanistan have taken a tremendous toll on our service members, including an increase in treatment-seeking for symptoms of PTSD, Major Depressive Disorder, and Substance Use Disorders. The suicide rate among service members and veterans continues to climb at an alarming rate, particularly in the Reserve Component. Increased behavioral health demand has prompted the military to increase its force of contracted civilian clinicians to treat veterans and active duty service members. One of the questions asked by civilian providers is how would they interact differently with this population than others, developing a cultural competency. From the other side of the therapeutic partnership, many Soldiers and Marines state that they can’t talk to clinicians that haven’t served, because they have to explain many details of military life. This workshop will explore these organizational/cultural differences along with the similarities that can enhance a better working relationship.

Dr Rodolico will present a brief didactic summary of cultural differences and some of the recent trends and interventions used for military personnel and veterans. The second half of the workshop will include role-plays where each participant will get to practice the new skills they were introduced to during the workshop. An example of this would be: a clinical vignette paragraph will be read in military language and the clinician will need to interpret this and continue with an appropriate therapeutic intervention. There will also be video recordings of service members who had good and bad experiences in treatment settings.

Source of Funding: None

Maximizing Patients’ Twelve-Step Experience

Marc Galanter, New York University School of Medicine;  Richard Ries, MD, University of Washington; and Penelope Ziegler, MD, Professionals Resource Network

At the end of the workshop participants will be able to:

  • Work effectively with the patient who is resistant to attending meetings due to a misperception that they are religious or require belief in God
  • Direct the patient who is prescribed medication, either for medication-assisted addiction treatment or for co-occurring psychiatric disorders
  • Assist the patient who has cravings to drink or drug during meetings
  • Use Twelve-Step Facilitation techniques (an evidence-based treatment modality) in working with patients with co-occurring psychiatric disorders.

This workshop will start with a “Fishbowl style” Twelve Step meeting in which recovering members of 12-Step programs share brief synopses of their experiences with addiction and recovery, utilizing the format of a typical AA meeting. This will be followed by a group discussion by workshop attendees, presenters and 12-Step meeting participants. The presenters will guide the discussion toward providing attendees with clinically relevant tools for facilitating patients’ exploration of and participation in 12-Step modalities as an important component of their overall recovery from addiction. Specific topics to be addressed will include:

1. The patient who is resistant to attending meetings due to a misperception that they are religious or require belief in God
2. The patient who is on prescribed medication, either for medication-assisted addiction treatment or for co-occurring psychiatric disorders
3. The patient who has cravings to drink or drug during meetings.
4. Participants prepare patients effectively for meeting attendance

Source of Funding: None

Sophisticated 5-Minute Tobacco Interventions for Young People

Alessandra Kazura, MD, MaineHealth-Center for Tobacco Independence and Tufts University School of Medicine;  Kevin Gray, MD, Medical University of South Carolina; Garrett Sparks, MD, Western Psychiatric Institute & Clinic;  and Catherine Martin, MD, University of Kentucky College of Medicine

At the end of the workshop participants will be able to:

  • Describe the rationale for providing tobacco treatment to adolescents and young adults who are in treatment for other substance use
  • Identify the key elements of a brief assessment and psychosocial intervention for tobacco use
  • Discuss pros and cons for prescribing tobacco treatment medications to adolescents and young adults

Tobacco use continues to kill more people than all other substances combined and tobacco use rates are higher in people with substance use disorders than in the general population. Despite the imperative need, implementation of tobacco treatment with adolescents and young adults does not receive the attention that is warranted in substance use treatment settings. This workshop will offer practical information and demonstrate skills to routinely incorporate evidence-based brief interventions in the context of general substance use treatment with young people.

Dr. Martin will present a rationale for integrating tobacco treatment with treatment of other substances. She will identify opportunities for intervention and will address common myths about integrated tobacco treatment. Dr. Sparks will review the key elements of a brief, psychosocial assessment of tobacco use that incorporates information gathered with the assessment and treatment of other substances. He will discuss highlights of evidence-based, psychosocial treatment with a focus on brief interventions.Dr. Gray will discuss tobacco treatment medications. He will summarize strengths and limitations of knowledge about FDA approved medications as applied to this age group, providing guidance about decision-making amid a limited evidence base. He will discuss medications currently under study for tobacco treatment in youth. Dr. Kazura will lead the skills practice component, with the assistance of all presenters to optimize individualized attention. She will begin with a summary of critical elements covered in the talks and invite audience questions. She will then facilitate audience participation exercises using cases that illustrate ways that 3-5 minute interventions can be effective with adolescents and young adults.

Source of Funding: None