Midwest Opioid Summit

The opioid overdose crisis has evolved significantly in recent years. Between 2010 and 2015, annual opioid prescribing actually dropped, but opioid overdose deaths increased by 63%, mainly due to an increase in overdoses involving heroin and fentanyl. To understand this changing epidemiology, we obtained the prescription monitoring program, hospitalization, and ED discharge records for all 2016 opioid overdose decedents.
Upon completing this session, attendees will be able to:
1. Articulate the mismatch between the current paradigm of short-term episodic treatment for substance use disorder and the lifelong threat of the disorder.
2. Reframe the goal of SUD treatment as long-term or 5-year recovery.
3. Redefine the goal of youth prevention as no use of any alcohol, nicotine, marijuana, or other drugs for reasons of health.

This session will detail effective clinical and policy solutions, including prevention programs focused on youth and families, detection and treatment of co-occurring mental and physical disorders, harm reduction, motivational enhancement, cognitive and medication-assisted therapies, mind-body techniques (yoga, meditation, mindfulness, and slow breathing), family education and support, 12-Step recovery, and clinical programs that put the patient and family first. These are actions we can take now.

After attending this session, attendees will be able to:

1) Understand the predominant state-level policy responses to ending the nation’s opioid epidemic;
2) Discuss whether those policy responses have had a measurable effect on opioid-related overdose and death; and
3) Consider what it will require for states to invest the resources and policy initiatives to increase access to treatment.

The impact of the evolving opioid epidemic calls for a coordinated government response that unites public health and public safety agencies.  This session will provide an overview of opioid-related fraud and diversion schemes occurring across the care continuum. Trends vary over time or by region, due to a myriad of factors. Factors driving the prevalence of fraud and diversion schemes include drug distribution patterns, local health care practice patterns, addiction treatment accessibility, policy changes, and others. Panelists will discuss how these schemes exploit and hurt individuals, families, the health care system, and the greater nation. The importance of a coordinated public health and public safety response will be emphasized in how to overcome the challenges and seize the opportunities in addressing opioid-related and diversion schemes.

Upon completing this session, attendees will be able to:

Explain the latest insights on factors driving variation over time and by region in the levels of fraud and diversion schemes.
Identify the effects of fraud and diversion schemes on individuals, families, healthcare system, and the greater nation.
Describe strategies and case studies on how federal, state, and local public health and public safety agencies can partner to combat fraud and diversion.

Douglas O’Brien will share how HHS has a comprehensive strategy to empower local communities on the frontlines, as the opioid epidemic is one of the Department's top priorities. In 2017, HHS launched a 5-point Opioid Strategy that it continues to promote today: 
  
1.    Improving access to prevention, treatment, and recovery support services
2.   Strengthening timely public health data and reporting
3.    Advancing the practice of pain management
4.    Targeting availability and distribution of overdose-reversing drugs
5.    Supporting cutting-edge research

The approach to prescribing opioids is changing. Globally, prescription opioid pain relievers are among the most commonly misused and abuse medications. It is important for practitioners to be able to identify a substance use disorder and know treatment options. Understanding prevention methods, public policies and effective interventions will help reduce the stigma around substance use disorders.  

Upon attending this session, participants will be able to:
· Recognize the impact of opioid crisis
· Identify barriers to successfully address the opioid crisis
· Understand potential interventions

Upon completion of this session, attendees will be able to:

· Identify common chronic pain conditions and treatment pathways
· Recognize when to refer to an interventional pain physician
· Understand how regenerative therapy works
· Discover ways to avoid opioid dependence

Treatment of substance use disorders and specifically opioid use disorder continues to evolve as we understand more about the neurobiology of addiction. The use of medication-assisted treatment (MAT) is often misunderstood, and sometimes referred to as simply “drug substitution.” Medical evidence suggests that when individuals use medication in addition to therapy, retention in treatment is higher and risk for overdose death is lower, as compared to individuals who do not utilization medication as part of their treatment. This session will address the current evidence behind the use of medication-assisted treatment and describe the role it can play in some peoples' recovery.

Upon completion of this session, attendees will be able to:
1. Name the three FDA-approved medications for the treatment of opioid use disorder.
2. Describe how each of the medications work.
3. Describe the evidence base behind the use of medication in conjunction with behavioral intervention.

Upon completion of this session, attendees will be able to:
· Review the components, distinguishing factors, advantages, and current outcomes data for the Client Centered Comprehensive Treatment Program model of care
· Understand the differences in outcomes, based on validated data, for length of treatment time/retention in a CCCTP
· Learn how and why to redefine treatment strategies in a Comprehensive Treatment Program against synthetic opiates such as fentanyl

In 2016 the Chicago High Intensity Drug Trafficking Area program (C-HIDTA) spearheaded an effort to divert from arrest and prosecution and into treatment a specific opioid impacted demographic in Chicago. A partnership was developed to include the Chicago Police Department, The University of Chicago, Urban Labs, and treatment service providers such as Thresholds, Haymarket, and Heartland Health Outreach. This Initiative, the Westside Narcotics Diversion and Treatment Initiative (WNDTI), focused on Chicago’s Westside which encompasses Northeastern Illinois’ largest open-air opioid trafficking locations. The WNDTI started in a small controlled manner with an intent to expand.

This presentation will explain the Initiative, its goals, obstacles encountered, partnerships, results, and steps to expansion. Partners from the University of Chicago Urban Labs, the Chicago Police Department, Chicago HIDTA, and treatment providers will present and participate in a panel discussion.

When a person is addicted, we treat that individual for addiction. When a person is partnered with an addict, what do they get? Nine times out of ten, they are told their choice to enter and remain in close relationship with an addict is codependence, a pseudo-pathology linked to unresolved early-life trauma. But is that really the case? And does telling loved ones of an addict there is something wrong with them really help? In my experience, it usually does not. These caregivers are merely trying to help a person they love while living in the ongoing crisis of addiction. Sure, they may at times engage in behaviors that are not as helpful as they might like (enabling, enmeshing, controlling, etc), but this is not a pathology, nor is it automatically the manifestation of unresolved trauma. Instead, it’s an attachment-based attempt to love a person while the proverbial house is burning down. And who could be expected to do that perfectly without empathetic support? Understanding, empathy, and helpful support are exactly what prodependence provides. Prodependence is an evolved prism through which therapists and loved ones of addicts can examine, evaluate, and improve relationships damaged by addiction (and all other relationships). Learn more about this new, positive, attachment-based model.
Upon completion of this session, attendees will be able to:
1) Define prodependence.
2) Determine how prodependence differs (and how it mirrors) codependence.
3) Identify cases where prodependence is a more useful model and how therapists can implement prodependence in their practice.