AMERSA Talks

After you listen, please complete SAMHSA’s required Training and Technical Assistance (TTA) GPRA Post-Event Form. This form will gather satisfaction with the event to help improve future episodes.

For patients with cancer and substance use disorders, managing pain safely and effectively presents unique challenges. Clinicians must balance appropriate opioid prescribing with the risks of relapse, overdose, and fragmented care. This episode explores how addiction, oncology, and palliative care providers can work together to support both cancer treatment and recovery. Listeners will learn practical frameworks for managing cancer-related pain, coordinating care across specialties, and improving outcomes for patients navigating these intersecting and complex conditions.

Timestamps:

[06:42] Cancer Pain vs Other Pain
 [09:22] Patient Education and Safety
 [15:22] Active Use and MOUD Basics
 [18:33] Adjuvants During Treatment
 [20:47] Buprenorphine in Cancer Pain
 [25:25] Choosing Bupe Products and Doses
 [31:01] Methadone Logistics and Risks
 [41:19] Survivorship and Chronic Pain
 [48:39] Building Collaboration Systems
 [53:07] Key Takeaways and Resources

Links :

AMERSA

Opioid and Substance Use Disorder Training for DEA-Registered Clinicians | Center to Advance Palliative Care

Conversations that Matter: Engaging Patients around Pain and Substance Use - VitalTalk

14: Care at the Crossroads: Opioid Prescribing in Individuals with Serious Illness and Opioid Use Disorder - Providers Clinical Support System-Medications for Opioid Use Disorders

Virtual Workshop: Optimizing Buprenorphine for Pain and Substance Use Disorder - CAPC | Center to Advance Palliative Care

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

CTA: After you listen, please complete SAMHSA’s required Training and Technical Assistance (TTA) GPRA Post-Event Form. This form will gather satisfaction with the event to help improve future episodes.

Burnout is a growing crisis in addiction care, driven by increasing demand, emotional strain, and system-level pressures. Yet burnout is not inevitable—and prevention requires both individual and organizational solutions. This episode explores how burnout differs from compassion fatigue and secondary trauma, and what clinicians and healthcare systems can do to address it. Listeners will gain practical strategies to protect their well-being, strengthen resilience, and advocate for healthier workplace environments that support both providers and the patients they serve.

Timestamps:

[00:01:55] Why Burnout Matters
[00:04:10] Personal Stakes and Expertise
[00:06:48] Spotting Burnout Signs
[00:11:44] How Burnout Develops
[00:16:21] Vicarious Trauma Risks
[00:18:29] Scrutiny and Workplace Pressures
[00:22:20] Compassion Satisfaction Benefits
[00:25:00] Boundaries and Staying Engaged
[00:30:01] Resilience Strategies for Clinicians
[00:31:32] What Employers Should Change
[00:38:01] Big Picture Solutions and Closing

Links:

AMERSA

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

CTA

After you listen, please complete SAMHSA’s required Training and Technical Assistance (TTA) GPRA Post-Event Form. This form will gather satisfaction with the event to help improve future episodes.

Substance use during hospitalization is common, yet many healthcare systems lack clear, evidence-based approaches to respond effectively. Punitive responses can worsen outcomes, increase stigma, and lead to early discharge. This episode explores emerging best practices for addressing in-hospital substance use in ways that improve patient safety, strengthen trust, and support recovery. Listeners will learn practical strategies for proactive communication and collaborative approaches that center patient care while supporting healthcare teams navigating these complex situations.

Timestamps:

• [00:00:48] Why hospitals often struggle to respond to in-hospital substance use
• [00:04:07] Case study: A harmful security-led response inside the hospital
• [00:06:38] How stigma and poor communication damaged patient trust
• [00:09:02] A patient-centred response that led to successful treatment completion
• [00:11:43] Research into hospital policies around in-hospital substance use
• [00:18:14] Delphi consensus study and best practice recommendations
• [00:24:41] Where hospitals are falling short in substance use disorder education
• [00:30:11] Practical bedside communication strategies for clinicians
• [00:41:07] Managing staff concerns around methadone, opioids, and overdose risk
• [00:48:32] Future directions for hospital policy, implementation, and addiction care research

Links

• AMERSA
• ASAM Practice Pearls
• In-hospital Substance Use Policies: An Opportunity to Advance Equity, Reduce Stigma, and Offer Evidence-based Addiction Care - PMC
• Recommendations for Addressing In-Hospital Substance Use From a National Delphi Consensus Process | Health Policy | JAMA Network Open
• Hospital policy as a harm reduction intervention for people who use drugs | IJDP
• Ethical Considerations in the Care of Hospitalized Patients with Opioid Use and Injection Drug Use Disorders | JHM
• Illicit drug use while admitted to hospital: Patient and health care provider perspectives | PLoS ONE

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

After you listen, please complete SAMHSA’s required [Training and Technical Assistance (TTA) GPRA Post-Event Form](https://lanitek.com/P?s=260512). This form will gather satisfaction with the event to help improve future episodes.

This episode explores the real-world gap between evidence-based perinatal substance use disorder (PSUD) care and what many clinicians are able to deliver in practice. Through a candid, clinically grounded conversation, presenters examine where care breaks down, how stigma and systems shape outcomes, and what it takes to move from theory to implementation. Listeners will gain practical, trauma-informed strategies that can be applied immediately—including language shifts, screening approaches, documentation practices, and pathways to buprenorphine access. The episode addresses critical implementation gaps and offers actionable tools to strengthen care during pregnancy and the postpartum period.

Timestamps:

[00:00:00] Welcome and Series Intro
[00:02:45] Host Sets the Agenda
[00:04:38] Why Care Breaks Down
[00:06:08] Progress and Remaining Gaps
[00:10:09] Screening That Leads to Care
[00:13:18] Consent and Workflow Follow Through
[00:16:20] Trust Building Language
[00:19:09] Stigma Free Documentation
[00:24:37] Medications for OUD in Pregnancy
[00:30:42] Beyond Opioids and Finding Help
[00:35:34] Compassionate Care Wrap Up

Links

• AMERSA

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

After you listen please complete SAMHSA’s required Training and Technical Assistance (TTA) GPRA Post-Event Form. This form will gather satisfaction with the event to help improve future episodes.

Medications for opioid use disorder (MOUD) are life-saving, yet three-quarters of people who need them still can't access them. Pharmacists are uniquely positioned to expand treatment, especially in rural communities and those with the fewest treatment options. Working collaboratively or independently, they can improve access, timing, and patient choice for MOUD care, starting where patients and medications already are. This episode examines how pharmacy-based models are closing gaps in addiction care deserts, how pharmacists can strengthen interdisciplinary care teams, and why fair reimbursement for pharmacist services matters for sustaining care in the communities hit hardest by overdose.

Timestamps:

[00:00:00] Welcome and Meet the Guests 
[06:41:00] Training Pharmacist Clinicians 
[09:42:00] Collaborative Practice Agreements 
[15:31:00] Holistic Primary Care Model 
[19:22:00] Patient Success Stories 
[26:31:00] Policy Shifts Enabling Prescribing 
[32:39:00] State Policy Map Resource 
[36:34:00] Stigma and Gatekeeping Mindset 
[39:23:00] Community Pharmacy Workflow Hurdles 
[41:50:00] Future Vision for MOUD Access

Links

• AMERSA
• Pharmacy Bridge
• Buprenorphine Prescribing Requirements and Limitations

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Learn more about this topic. Download the companion toolkit and register for the follow-up live workshop at https://amersa.org/project/episode-2-substance-use-coercion/

Intimate partner violence is associated with a six-times higher risk of developing a substance use disorder, yet most behavioral health and recovery training programs do not address substance use coercion (the intersection of intimate partner violence and substance use) as a core competency. This episode explores substance use coercion—how it operates, why it creates barriers to safety and care, and how cross-sector collaboration can improve outcomes for survivors and their families. Listeners will learn how the evidence-supported Substance Use Coercion ECHO Toolkit strengthens provider skills, builds partnerships between domestic violence and substance use services, and addresses critical gaps in training, coordination, and survivor-centered practice.

Timestamps:

[00:00:00] Episode intro: Why opioid treatment must evolve for older adults

[00:01:00] Host and guest introductions + episode framing

[00:02:00] Key themes: defining substance use coercion and its impact

[00:03:00] What is substance use coercion? Core definition

[00:04:00] Real-world examples: how coercion blocks access to treatment

[00:05:00] Prevalence data: how common substance use coercion is

[00:06:00] High rates in treatment settings and link to IPV risk

[00:07:00] Training gaps across behavioural health and DV sectors

[00:09:00] Mismatch in care models: why traditional recovery approaches fall short

[00:12:00] Cross-sector collaboration: why it’s critical for better care

Links

• AMERSA
• Substance Use Coercion Echo Toolkit, an Evidence-Supported Capacity Building Curriculum - NCDVTMH
• https://ncdvtmh.org/toolkit/substance-use-coercion-palm-card-for-practitioners-english-and-espanol/
• 7 common practices in substance use disorder care that can hurt survivors
• Coercion Related to Mental Health and Substance Use in the Context of Intimate Partner Violence - NCDVTMH

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

After you listen please complete SAMHSA’s required Training and Technical Assistance (TTA) GPRA Post-Event Form. This form will gather satisfaction with the event to help improve future episodes.

Kratom products have rapidly evolved from traditional plant forms into highly potent semi-synthetic compounds now widely available in retail settings. This shift has introduced new risks, including use disorder, severe withdrawal, and overdose, while outpacing clinical guidance. This episode examines how these newer compounds differ pharmacologically, why they are more dangerous, and how clinicians can recognize and respond to kratom-related complications. Listeners will gain practical strategies for identifying kratom use disorder, managing withdrawal, and having informed, non-stigmatizing conversations with patients as these products continue to emerge and change.

Timestamps:

• [00:00:00] Podcast introduction and overview of the series
• [00:01:00] Introduction to synthetic kratom and emerging risks
• [00:02:00] Guest introductions and episode focus
• [00:03:00] Learning objectives and clinical goals
• [00:05:00] First clinical case of severe kratom-related withdrawal
• [00:06:00] Rise of more dangerous synthetic kratom products
• [00:07:00] Historical use of kratom vs modern synthetic variants
• [00:10:00] Potency differences and hidden risks in retail products
• [00:15:00] Treatment discussion and buprenorphine use begins
• [00:47:00] Key takeaways and clinical recommendations

Links

• AMERSA
• The Bridge Center / Network for Emergency Addiction Treatment (NEAT) Clinician Kratom Survey Results
• Bridge/NEAT Clinician Kratom Survey Analysis
• Bridge/NEAT Clinician Surveys Sign up (for future surveys)
• Bridge Guide to Adjuncts/Comfort Meds (see PAGE 2)
• Kratom | National Institute on Drug Abuse (NIDA)

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Learn more about this topic. Download the companion toolkit and register for the follow-up live workshop at https://amersa.org/project/episode-1-delivering-age-friendly-care-for-older-adults-in-opioid-treatment-programs/.

Older adults are one of the fastest-growing populations in opioid treatment programs, yet most programs were not designed to address the realities of aging—multimorbidity, mobility limitations, cognitive changes, and social isolation. This episode explores how opioid use disorder treatment must evolve to better support older adults and address fragmented care. Listeners will learn how to apply the geriatric 5Ms framework—What Matters Most, Medication, Mentation, Mobility, and Multicomplexity— in opioid treatment program settings, strengthen cross-system collaboration, and implement practical strategies that promote safety, dignity, and person-centered care. This episode addresses critical gaps in integrating geriatric principles into addiction treatment practice.

Timestamps:

• [00:00:41] Episode framing: older adults are the fastest-growing population in opioid treatment programs
• [00:01:08] Why treatment must evolve for ageing-related needs, fragmented care, and age-insensitive systems
• [00:03:06] Learning objectives: challenges, the 5Ms framework, and practical age-friendly care strategies
• [00:04:11] Why older adults in OTPs are increasing, including Medicare coverage and accelerated ageing with OUD
• [00:05:08] Kathy on the realities of caring for older adults, especially mobility and inaccessible clinic spaces
• [00:07:34] Zoe on retention, treatment access barriers, and the strain of co-occurring conditions like cancer and dialysis
• [00:09:16] Care transitions emerge as a major risk point, especially hospital to skilled nursing to home
• [00:15:19] Introduction to the geriatric 5Ms: Mobility, Mentation, Medications, Multicomplexity, and What Matters Most
• [00:23:11] Practical solutions for mobility barriers: medical exceptions, family support, visiting nurses, and dosing flexibility
• [00:42:28] Closing takeaways: logistical barriers, integrated care, and using age-friendly strategies in OTP settings

Links

• AMERSA

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

SafeSpot Overdose Prevention Hotline provides free, 24/7 virtual spotting services to people who use drugs alone. Born out of the grassroots Never Use Alone Massachusetts line, SafeSpot has evolved into a nationally recognized program housed at Boston Medical Center. In this episode, host Dr. Ruchi Shah speaks with Kimber King and TJ Thompson about SafeSpot’s journey from a volunteer-run initiative to a fully funded overdose prevention organization. Together, they discuss the importance of lived experience, lessons learned from rapid growth, and how SafeSpot is saving lives while challenging stigma, health disparities, and overdose risk in both urban and rural communities.

Learning Objectives

• Identify the risks of using substances alone and how virtual spotting addresses these risks.
• Analyze how stigma, isolation, and health disparities contribute to overdose deaths.
• Apply strategies for integrating hotline models like SafeSpot into clinical and community settings, including rural areas.
• Demonstrate how to do a warm handoff to SafeSpot in a traditional healthcare setting

Host & Guest Bios

• Ruchi Shah, DO (she/her) is an Assistant Professor of Medicine in the Division of General Internal Medicine at Montefiore Medical Center & Albert Einstein College of Medicine. She is the medical director of the Wakefield Hospital Addiction Medicine Consult Service and also provides primary care, addiction medicine, and reproductive healthcare outpatient. Ruchi strives to turn her big feelings into meaningful change and is grateful for the privilege of partnering with and learning from PWUD in their care.
• Kimber King (she/her) is the Operations Coordinator for the SafeSpot Overdose Hotline, an innovative virtual “spotting” service based at Boston Medical Center. A drug war and overdose survivor, she brings both lived experience and leadership to her work supporting people who use drugs and expanding access to overdose prevention services. Kimber’s story was featured on This American Life (“The Call”), and today she channels her journey into building workforce capacity, training operators, and advocating for practical overdose prevention strategies that save lives. She is also pursuing a Community Health Worker Certificate at the Community College of Vermont, further grounding her commitment to community health and meaningful change.
• Tj Thompson (they/them) is the Safety Coordinator at SafeSpot Overdose Helpline based out of Boston Medical Center. They have been advocating for the implementation and legalization of Overdose Prevention Centers in Massachusetts since 2019. They served on The City of Somerville SCS (Supervised Consumption Site) Taskforce from 2020-2022. Tj is currently serving on the Advisory Council for Substance Use for the Massachusetts Attorney General’s Office. Tj recently returned from Melbourne, Australia where they served as a consultant for the State of Victoria while they began to set up an overdose prevention hotline heavily influenced by the SafeSpot model.

Timestamps:

• 00:00:01 — Intro: Welcome and overview of the podcast series.
• 00:05:49 — Guest intro: Kimber King joins, sharing lived experience.
• 00:10:45 — TJ Thompson introduction and global Safe Spot perspective.
• 00:15:23 — Host outlines learning objectives of the episode.
• 00:19:15 — Kimber explains Safe Spot hotline — 24/7 national coverage.
• 00:24:11 — Volunteer → paid model transition; callers becoming staff.
• 00:27:49 — Discussion of stigma and criminalization in overdose deaths.
• 00:33:43 — Impact stats: 25,000 use events, 10,000+ calls, only 26 EMS activations.
• 00:35:02 — Walkthrough of a typical Safe Spot call — step-by-step process.
• 00:54:00 — Closing reflections and call to action for clinicians and communiti

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Medications methadone and buprenorphine – are the most effective treatments for opioid use disorder. Decades of evidence show that they treat acute withdrawal and cravings, improve quality of life, reduce risk for HIV and hepatitis C, reduce overdose, and reduce risk of drug-related and all-cause mortality. Yet in the US, fewer than 1 in 5 people with OUD accesses them.

In the US, Methadone is regulated unlike any other medication, including methadone for pain. With a few exceptions, in ambulatory settings, methadone must be administered from an opioid treatment program – a highly regulated addiction treatment setting.

This episode talks with two clinical innovators who are leading work to bring methadone into critical access points in the SUD care continuum – withdrawal management settings and the hospital.

Learning Objectives

• Describe the importance of utilizing methadone in withdrawal management settings and at hospital discharge.
• Provide practical guidance to develop processes to implement methadone administration/ dispensation via the 72h rule in non-OTP settings, drawing on experience from withdrawal management and hospital settings.
• Describe some potential challenges and examples of how to address them.
• Show what 72-hour methadone dispense has potential to achieve in withdrawal management and hospital settings.

Host & Guest Bios

1. Dr. Honora Englander is founder and Principal Investigator of the Improving Addiction Care Team (IMPACT), a nationally recognized model for hospital-based addiction care that includes physicians, social workers, and peers with lived experience in recovery. Dr Englander's work is at the intersection of addiction, health system transformation, and public health.
2. Dr. Mike Winer serves as the Medical Director of a withdrawal management center in Portland, Oregon, and is an Assistant Professor in the Section of Addiction Medicine at Oregon Health & Science University. His work focuses on clinical innovation aimed at breaking down barriers to substance use care.
3. Emily Skogrand, PharmD, is a clinical pharmacist at Oregon Health and Science University in Portland, Oregon. She works with the inpatient Internal Medicine department and on the addiction consult service with a special interest in optimizing care for patients with substance use disorders.

Timestamps:

• 00:00:00 — Intro, sponsors, goals
• 00:01:00 — Topic + guests (72-hour rule)
• 00:02:00 — Dr. Weiner background + disclosures
• 00:02:15 — Why meds (methadone/bupe) matter
• 00:03:20 — Access gap (<1 in 5 treated)
• 00:04:20 — Aim: expand methadone via 72-hour rule
• 00:05:05 — What is the 72-hour rule?
• 00:06:00 — Law expanded “administer → dispense”
• 00:07:00 — WM site use case (fentanyl era)
• 00:09:00 — Hospital challenges (discharge, OTP limits)
• 00:11:30 — Systems harm of limited access
• 00:13:00 — WM implementation steps overview
• 00:15:50 — Six key setup steps
• 00:16:40 — Hospital workflow challenges
• 00:20:00 — Need champion + team buy-in
• 00:21:00 — WM impact + patient micro-induction story
• 00:24:00 — Hospital outcomes (OB case)
• 00:26:00 — Business case (saves bed days)
• 00:27:20 — Adoption advice (patient stories)
• 00:29:00 — Bigger picture, reduce barriers
• 00:31:00 — Ops tip: supplier quotas
• 00:33:00 — Find a pharmacy champion
• 00:34:20 — Closing: WM + hospital access points
• 00:36:00 — Outro, survey, disclaimers

Links

• AMERSA

Find us online at amersa.org/amersa-podcast 

Frontiers in Substance Use & Stigma & Substance Use are sponsored by Provider’s Clinical Support System – Medication for Opioid Use Disorder (PCSS-MOUD). Learn more about PCSS-MOUD at pcssnow.org.

Funding for this initiative was made possible by cooperative agreement no. 1H79TI086770 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Substance Use Across the Lifespan and Innovation in Action are sponsored by the Opioid Response Network (ORN). Learn more about ORN at opioidresponsenetwork.org.

Funding for this initiative was made possible (in part) by grant no. 1H79TI088037 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.