The Workshop Sessions/Hot Topics address the issues and challenges of opioid treatment. These sessions also provide information on how to develop and / or enhance the skills for practitioners providing treatment and the adoption of evidence-based practices within opioid treatment.

Workshops will offer participants a chance to review the latest treatment data and health care policies, examine their implications for our patients, and strengthen the skills needed to improve the quality of services.

Basic Track: This year we will again be offering a special sequence of workshops designed to act as a refresher for seasoned professionals and to meet the needs of individuals who are new to this field. Those who attend all six sessions listed will receive a special certificate of completion. Basic Track Workshop Sessions: A1, B1, C1, D1, E1, and F1.

Monday, October 22, 2007
10:30 AM – 12:00 NOON

A – 1
Medical Issues for Counselors: Four Patient Questions about Methadone

A – 2
Enhancing Access to Opiate Agonist Treatment for Homeless and Other Hard-to-Reach Populations: The San Francisco ’s COPE and Mobile Methadone Van Programs

A – 3
Methadone Maintenance Treatment and Reentry for Prisoners

A – 4
NAS: Addressing Institutional Stigma and Maladaptive Parental Behaviors

A – 5
Gender Specific HIV/AIDS Prevention and Interventions for Drug Abuse Treatment

Monday, October 22, 2007
3:30 PM - 5:00 PM

B – 1
New Developments in Treating Methadone Patients with Co-occurring Disorders

B – 2
Interim Methadone Maintenance: A Treatment Approach

B – 3
Implementation and Evaluation of a Methadone Program in a Metropolitan Jail

B – 4
Making Motivational Incentives Effective and Sustainable in OTPs

B – 5
Improving Hepatitis C Management and Care in Methadone Clinic Settings

Tuesday, October 23, 2007
Time: 10:30 AM – 12:00 NOON

C – 1
Alcohol Abuse in the OTP: Evidence-Based Problem / Evidence-Based Response

C – 2
Expansion of Services for Vermonters in Need of MAT for Opiate Dependence

C – 3
Implementation Challenges and Initial Outcomes in a Correctional OTP

C – 4
Reducing HIV in Drug User Populations - New Research Findings, Clinical and Policy Implications - International Panel

C – 5
HEPATITIS C TREATMENT: An Integrated Approach

Tuesday, October 23, 2007
Time: 1:30 – 3:00 PM

D – 1
Tips for Counselors: Patients with Medical Problems

D – 2
Continuous Readiness: A Risk Management Tool for Emergency Preparedness

D – 3
The Power of Personal Narrative: Using Art to Change the Perception of MAT

D – 4
Pregnancy and Opioid Dependence: Frequent Questions and Common Challenges

D – 5
Reducing HIV in Drug User Populations - New Research Findings, Clinical and Policy Implications - US Panel

Wednesday, October 24, 2007
8:00 AM – 9:30 AM

E – 1
Anti-Discrimination Laws Protecting People in Medication Assisted Treatment

E – 2
Utilizing OTPs to Provide Overdose Prevention Education and Medication to at Risk Patients

E – 3
Opium Use and Methadone Treatment of Hmong Refugees

E – 4
Buprenorphine: Continuing Evolution and Financing of a Treatment Innovation

E – 5
The SAMHSA TWINRIX Vaccination Project: The Importance of Hepatitis A & B Vaccination

Wednesday, October 24, 2007
Time: 9:45 AM - 11:15 AM

F – 1
Peer Recovery Services for the Methadone Community: The M.A.R.S. Project

F – 2
Applying the Medical Model of Treatment to Opiate Dependence

F – 3
Changing Organizational Culture to Improve Treatment Access for Consumers

F – 4
Bringing Evidence-Based Practices and Practice-Based Evidence Together

F – 5
Rapid HIV Testing in Opioid Treatment Programs

HOT TOPIC ROUND TABLES
Monday, October 22, 2007
TIME: 1:30 PM – 3:00 PM

A – 1
Medical Issues for Counselors: Four Patient Questions about Methadone
Judith Martin, MD, 14th Street Clinic, Oakland , CA
This workshop introduces the medical model of addiction and reviews questions commonly asked by patients about the medication itself. Why is methadone better than using heroin? How do I know I’m taking the right dose? How long should I stay on methadone maintenance? What are the side effects of methadone? Counselors use this information in their therapeutic alliance with the patient who is enrolled in methadone maintenance.

Sponsored and Supported by the Center for Substance Abuse Treatment

A – 2
Enhancing Access to Opiate Agonist Treatment for Homeless and Other Hard-to-Reach Populations: The San Francisco ’s COPE and Mobile Methadone Van Programs
Alice Gleghorn PhD, San Francisco Department of Public Health, San Francisco, CA; Yong Song, PhD, University of California– San Francisco, San Francisco, CA; Matt Tierney, NP, University of California, San Francisco, San Francisco, CA

The first part of this workshop will describe the San Francisco system of care and the demographic characteristics of the patients, patterns of heroin and other substance use, rates of successful linkage with treatment, and performance in treatment (e.g., retention, impact on drug use and other indicators). Part two will describe the relevant planning, program development, and clinical implementation issues involved in the successful development and implementation of the San Francisco Mobile Methadone Van program.

A – 3
Methadone Maintenance Treatment and Reentry for Prisoners
Michael S. Gordon, DPA, Friends Research Institute, Inc., Baltimore, MD; Terrence T. Fitzgerald, MD, Man Alive, Inc., Baltimore, MD; Gary Sweeney, CACAD, Man Alive, Inc., Baltimore, MD
This workshop will describe the results from a randomized clinical trial studying the effectiveness of initiating pre-release prison inmates with histories of heroin addiction on methadone maintenance. Methadone maintenance continues in the community with the same provider. In addition, the practical medical and counseling aspects of program implementation will be presented to assist practitioners and program directors who are considering implementing this intervention.

A – 4
NAS: Addressing Institutional Stigma and Maladaptive Parental Behaviors
Jeneane Burke, MSN, MATER, Thomas Jefferson University, Philadelphia, PA; Kate Vandegrift, MA, MATER, Thomas Jefferson University, Philadelphia, PA
The workshop will focus on optimizing parental experiences during infants’ treatment for Neonatal Abstinence Syndrome (NAS). Information on how staff perceptions and patient behaviors may cause alienation and interference with nursery care will be presented along with interventions to address stigma, positively engage parents and promote improved communication among NTP staff, nursery staff and parents. Tools include collaborative meetings, staff training, parental agreements and support groups.

A – 5
Gender Specific HIV/AIDS Prevention and Interventions for Drug Abuse Treatment
Donald A. Calsyn, PhD, University of Washington Alcohol & Drug Abuse Institute, Seattle, WA; Susan Tross, PhD, New York State Psychiatric Institute, New York, NY
Individuals in treatment often engage in risky sexual behaviors. Effective sexual risk reduction interventions provide information on risk and preventative behaviors, exercises to increase motivation to adopt lower risk, and skill training in employing risk reduction. The NIDA Clinical Trials Network conducted gender-specific sexual risk reduction interventions based on these principles. The lead investigators will present main findings, describe the interventions, and demonstrate some of the interventions. Differences related to gender will be emphasized.

B – 1
New Developments in Treating Methadone Patients with Co-occurring Disorders
Mark P. McGovern, PhD, Dartmouth Medical School, Lebanon, NH; Phil Richmond, MS, Hartford Dispensary, Hartford, CT; Sam Segal, MA, Connecticut Counseling Centers, Waterbury, CT
This workshop describes current efforts to enhance services for patients with co-occurring disorders in community opioid treatment programs. The workshop will discuss studies ranging from a specific intervention of cognitive behavioral therapy for patients with PTSD to integrating mental health services to agency level applications. Outcomes are presented, and practical implementation issues discussed. Attendees will learn how to apply each model in their own settings.

*Note: Basic Track

B – 2
Interim Methadone Maintenance: A Treatment Approach
Robert P. Schwartz, MD, Friends Research Institute, Baltimore , MD ; Sharon Kelly, PhD, Friends Research Institute, Baltimore , MD ; Carol B. Butler, MA, Institutes for Behavioral Resources, Baltimore, MD
Out-of-treatment heroin-addicted individuals suffer the adverse consequences of addiction and contribute to public health and safety problems in their communities. This presentation will use data and experiences from two NIDA-funded studies of treatment entry and interim methadone maintenance to characterize the needs and desires of out-of-treatment individuals and to describe interim methadone maintenance and its effectiveness.

B – 3
Implementation and Evaluation of a Methadone Program in a Metropolitan Jail
Mitchell Simson, MD, University of New Mexico School of Medicine, Albuquerque, NM
This workshop will discuss the creation, implementation and evaluation of a Methadone Maintenance Pilot Project at the new Metropolitan jail in Albuquerque , New Mexico . This project was established through a collaborative effort involving the local county Corrections Department, the New Mexico Department of Health and State Methadone authority, and a local methadone clinic. This project began service delivery in November, 2005 and, to date, has served over 300 inmates.

B – 4
Making Motivational Incentives Effective and Sustainable in OTPs
John A. Hamilton, MFT, Regional Network of Programs, Inc., Shelton, CT; Patrick McAuliffe, MBA, Connecticut Renaissance, Newtown, CT; Tracey D. Hutchins, MS, Hartford Dispensary, Voluntown , CT
This workshop will highlight the recently released NIDA/SAMHSA blending team product, Promoting Awareness of Motivational Incentives (PAMI) and its implementation in methadone treatment. Additionally, key components of an organizational culture of change for effective adoption of motivational incentives will be discussed, and specific strategies for the effective adoption and sustainability of incentives will be offered.

B – 5
Improving Hepatitis C Management and Care in Methadone Clinic Settings
Martha B. Saly, MA, The Center for Health Improvement, Sacramento, CA
The workshop will highlight the work of a collaborative effort modeled after the Institute for Healthcare Improvement’s (IHI) Health Disparities Collaboratives, established in California OTPs to improve access to care and services for their patients with HCV. The workshop will present the eight components that comprise a patient-centered menu of HCV interventions for which there are known best practices and explain how following the chronic care model for improving care may be introduced in OTPs

C – 1
Alcohol Abuse in the OTP: Evidence-Based Problem / Evidence-Based Response
Allan J. Cohen, MA, Bay Area Addiction, Research and Treatment, Sherman Oaks, CA; Adeline Nyamathi, PhD, University of California, Los Angeles, Westwood, CA
Alcohol abuse within Opioid Treatment Programs is a very significant and difficult problem to treat. Some estimates put the prevalence of alcohol abuse as high as 30% while clinical experience supports the severity of this problem. Alcohol abuse adversely affects both patients and treatment programs in a variety of areas that include medical, psychological, social, financial and treatment outcomes. This workshop will explore this problem from a research as well as treatment program perspective.

*Note: Basic Track

C – 2
Expansion of Services for Vermonters in Need of MAT for Opiate Dependence
Peter W. Lee, MA, Vermont Division of Alcohol and Drug Programs, Burlington, VT; Todd W. Mandell, MD, Vermont Division of Alcohol and Drug Programs, Burlington, VT
Access to methadone treatment programs in Vermont has been greatly limited with the first program opening in 2002. This workshop will describe two creative programs undertaken to expand services; identify ways programs can improve access to treatment through interagency coordination of services and creative reimbursement models; emphasize the use of evidence-based evaluation for determining appropriate treatment; and introduce the Coordination of Office Based-Medication Assisted Therapies initiative as a strategy for improving access to treatment.

C – 3
Implementation Challenges and Initial Outcomes in a Correctional OTP
Gregory C. Warren, MA, Maryland Department of Public Safety and Correctional Services, Baltimore, MD
The first part the presentation will describe the challenges of creating, operating and evaluating an OTP within Baltimore ’s jail, forging linkages with community OTPs, and the regulatory and policy changes needed for the jail to help the city reach its goal of treatment on demand. The second part of the presentation will describe the needs assessment for drug treatment, HIV, Hepatitis B and C as well as overdose prevention for the pre-sentence population.

C – 4
Reducing HIV in Drug User Populations - New Research Findings, Clinical and Policy Implications - International Panel
Moderator: Steven Gust, PhD, National Institute on Drug Abuse, Rockville, MD
Zunyou Wu, MD, National Center for AIDS/STD Control and Prevention, Beijing, China; George Woody, MD, University of Pennsylvania, Philadelphia, PA; Marek Chawarski, PhD, Yale University School of Medicine, New Haven, CT

Intravenous drug use is driving emerging HIV epidemics in Eurasia . Providing evidence-based drug treatment is one of the critical strategies for preventing HIV transmission. This session will describe how China is addressing HIV in drug abuse populations. Furthermore, data from two NIDA-funded studies will be presented: the impact of naltrexone on reducing HIV in Russia and buprenorphine maintenance treatment with behavioral counseling in Malaysia .

Sponsored by National Institute on Drug Abuse

C – 5
HEPATITIS C TREATMENT: An Integrated Approach
Ann B. Beeder, MD, Weill Cornell Medical College, New York, NY; Eugenia Curet, PhD, Weill Cornell Medical College, New York, NY; Herman Joseph, PhD, NDRI, New York, NY
The presenters will describe an integrated treatment model for hepatitis C positive patients at the Vincent P. Dole Institute for Research and Treatment of Opiate Dependency of the Weill Cornell Medical College and New York Presbyterian Hospital, which allows for an efficient, patient-centered delivery of health care that facilitates treatment readiness and medication adherence, while decreasing hospitalizations and reducing risky behaviors. The treatment team is composed of psychiatrists, hepatologists, internists, nursing and social work/counseling staff.

D – 1
Tips for Counselors: Patients with Medical Problems
Judith Martin, MD, 14th Street Clinic, Oakland , CA
This workshop will present information for counselors on the medical problems common in people who are addicted to opioids and how these problems may show up in counseling interactions. Up to ninety percent of needle users are infected with hepatitis C. Other problems include skin infections, chronic pain and HIV/AIDS. Counselors are well placed to help the patient with these medical conditions and to support good medical care.

Sponsored and Supported by the Center for Substance Abuse Treatment

*Note: Basic Track

D – 2
Continuous Readiness: A Risk Management Tool for Emergency Preparedness
Megan Marx, MPA, The Joint Commission, Littleton, CO; Mary Cesare-Murphy, PhD, The Joint Commission, Oak Brook Terrace, IL
The Joint Commission's new accreditation initiative has brought about a complete paradigm shift away from a process focused on survey preparation and score achievement to one of continuous systematic and operational preparedness or “continuous readiness”. Presenters will discuss key concepts of risk management in the context of “continuous readiness”, examine how accreditation standards are embedded into daily program operations and how accreditation standards apply to the development and maintenance of a comprehensive emergency preparedness plan.

D – 3
The Power of Personal Narrative: Using Art to Change the Perception of MAT
Patrick S. Griswold, MEd, North Charles Institute for the Addictions, Somerville, MA; Hilary Jacobs, MSW, Department of Public Health, Arlington, MA; Maura Matarese, MA, North Charles Institute for the Addictions, Somerville, MA

This workshop presents a collaborative film project, between North Charles, Inc. and a local creative arts organization, which significantly changed medical and social-service providers’ negative beliefs and attitudes towards MAT. This video features patients who, through their participation in a writing group, describe their stories of addiction and find recovery through MAT. The workshop discusses the project’s genesis, the dual role of clinician and artist, and the impact on health care providers’ attitudes toward MAT

D – 4
Pregnancy and Opioid Dependence: Frequent Questions and Common Challenges
Karol Kaltenbach, PhD, Thomas Jefferson University , Philadelphia, PA
This workshop will discuss the management of opioid dependence during pregnancy, including dose/split dose, postpartum tapering, coordination of prenatal care, intrapartum and postpartum management of pain, breastfeeding, compliance with treatment and treatment for neonatal abstinence. Challenges and questions that arise in providing treatment for this population will be addressed.

Sponsored and Supported by the Center for Substance Abuse Treatment

D – 5
Reducing HIV in Drug User Populations - New Research Findings, Clinical and Policy Implications - US Panel
Moderator: Betty Tai, PhD, National Institute on Drug Abuse, Bethesda, MD
Bernard Branson, MD, Centers for Disease Control and Prevention, Atlanta, GA; Robert Booth, PhD, University of Colorado School of Medicine, Denver, CO; Donald Calsyn, PhD, University of Washington School of Medicine, Seattle, WA

This session will provide an overview of CDC's recommendation for expanded HIV screening in health care settings, including rapid HIV testing. Furthermore, results from the three NIDA/Clinical Trials Network studies will be presented: HIV risk reduction interventions among injection drug users in detoxification settings and reduction of risky sexual behavior in men and women in opioid treatment programs.

E – 1
Anti-Discrimination Laws Protecting People in Medication Assisted Treatment
Paul Samuels, Esq., Legal Action Center , New York , NY
This presentation will cover the federal laws that protect people in medication assisted treatment from discrimination in employment, housing, health care, and other areas of life. It will also cover how to respond to frequent problems, such as medication appearing in a workplace drug test, judges requiring individuals to withdraw from methadone maintenance as a condition of getting children back, and DUI charges against people who drive with methadone in their system.

Sponsored and Supported by the Center for Substance Abuse Treatment

*Note: Basic Track

E – 2
Utilizing OTPs to Provide Overdose Prevention Education and Medication to at Risk Patients
Scott O. Farnum, MS, Hill Health Center Corporation, New Haven , CT ; Lynn M. Madden, MPA, APT Foundation, New Haven , CT
This workshop will describe an overdose prevention program at two urban OTPs engaged in a cooperative effort that offers specific overdose prevention, including naloxone. This program came about because of the dramatic increase in opioid overdose deaths in our community. We will discuss regulatory issues, community partnerships and outcomes, and share our prevention materials.

E – 3
Opium Use and Methadone Treatment of Hmong Refugees
Gregory A. Carlson, BA, HCMC / HFA Addiction Medicine, Minneapolis, MN; Gavin Bart, MD, HCMC / HFA Addiction Medicine, Minneapolis, MN; Mao Xong, BS, HCMC / HPA Addiction Medicine, Minneapolis, MN
More than 166,000 Hmong refugees have migrated to the US from Laos and refugee camps in Thailand . It is estimated that between 2-5% of these refugees are regular users of opium. Many of these individuals have sought methadone treatment presenting a variety of cross cultural issues for methadone clinicians. This workshop will present an overview of opium use among the Hmong, treatment methods and techniques proven helpful in treating this challenging group of patients.

E – 4
Buprenorphine: Continuing Evolution and Financing of a Treatment Innovation
Arlene Stanton, PhD, Center for Substance Abuse Treatment, Rockville, MD; Judith Martin, MD, 14th Street Clinic, Oakland, CA ; Suzanne Gelber, PhD, Avisa Group / SGR Health, Ltd., Berkeley, CA
Availability of buprenorphine has expanded treatment options for the growing number of persons dependent on opioids, including prescription analgesics. The opportunity exists to create further elasticity in the overall system and to increase capacity by extending buprenorphine treatment into Opioid Treatment Programs. What needs to happen, and how would such changes impact programs and patients? Presenters discuss evaluation findings, ongoing policy and financing issues, and real-life experience introducing buprenorphine into The 14th Street Clinic.

E – 5
The SAMHSA TWINRIX Vaccination Project: The Importance of Hepatitis A & B Vaccination
Randy Seewald, MD Beth Israel Medical Center MMTP, New York, NY; Valentin Bonilla, RPA, Beth Israel Medical Center MMTP, New York, NY; Kenneth Hoffman, MD, SAMHSA, Rockville, MD
This workshop describes the SAMHSA TWINRIX demonstration project at the BIMC MMTP: how it was implemented at the BIMC MMTP, data collected and lessons learned. Training on Viral Hepatitis (A, B, and C), the effects of hepatitis on the liver will be followed by a review of the Hepatitis A and B vaccination and the use of the combined vaccine. Future SAMHSA vaccination and hepatitis testing initiatives for Opioid Treatment Programs will be discussed.

F – 1
Peer Recovery Services for the Methadone Community: The M.A.R.S. Project
Walter Ginter, CMA, National Alliance of Methadone Advocates, New York, NY; Joycelyn Woods, MA, National Alliance of Methadone Advocates, New York, NY; Tom Hill, MSW, Health Systems Research/Altarum, Inc., Washington, DC

A collaboration of the National Alliance of Methadone Advocates (NAMA) and the Albert Einstein College of Medicine (AECOM) Medication Assisted Recovery Services (MARS) Project provides peer recovery support services to patients usually neglected by the recovery community. The workshop will provide an understanding of MARS, the RCSP program and how to prepare a grant. Dedicated to Drs. Dole and Nyswander who utilized peer recovery services before their value was recognized. (SAMHSA/CSAT RCSP grant #TI 18077)

*Note: Basic Track

F – 2
Applying the Medical Model of Treatment to Opiate Dependence
Sarz Maxwell, MD , Chicago Recovery Alliance / MOST, Chicago , IL ; Daniel Bigg, AB, Chicago Recovery Alliance / MOST, Chicago , IL ; Karten Stanczkiewicz, BA, Chicago Recovery Alliance / MOST, Chicago,IL
This workshop will discuss several innovative strategies we have been utilizing in MOST for improving the delivery of methadone maintenance treatment: the “medicalization” of MMT, i.e., using the physician as dispensing agent for the medication; providing opiate replacement treatment seamlessly integrated into the spectrum of other harm reduction measures, including hepatitis vaccination, overdose prevention with naloxone and ready availability of clean injection equipment; providing opiate replacement treatment within the patients’ community, from a mobile van.

F – 3
Changing Organizational Culture to Improve Treatment Access for Consumers
Bob Freeman, BS, APT Foundation, New Haven, CT; Cheryl Doebrick, PhD, APT Foundation, New Haven, CT; Lynn Madden, MPA, APT Foundation, New Haven, CT
Wait time and retention are critical issues for most opioid treatment programs. The presenters provide a case study of how these concerns led them to re-evaluate current practices and corporate culture. They describe how use of rapid cycle process improvement techniques led to reduced wait time for methadone treatment by 66% and increased program census by more than 12% with a corresponding revenue increase that supports other patient services.

F – 4
Bringing Evidence-Based Practices and Practice-Based Evidence Together
Wendy R. Ulaszek, PhD, State of Connecticut Department of Mental Health and Addiction Services and the University of Connecticut, Hartford, CT; Nicole L. Belisle, MSW, APT Foundation Inc., New Haven, CT; Kimberly A. DiMeola, MSW, APT Foundation Inc., Branford, CT
This workshop will describe a collaborative effort to disseminate two evidence-based practices (Motivational Enhancement Therapy (MET) and Cognitive Behavioral Therapy (CBT) throughout a opioid treatment program of over 1500 patients, located in 3 locations and serving different populations, in order to improve treatment outcomes in that agency. The presenters will also describe the clinical, administrative, and organizational needs assessment that took place before implementing this model and the tasks completed to address those needs.

F – 5
Rapid HIV Testing in Opioid Treatment Programs
Kimberly Jeffries Leonard, PhD, MayaTech Corporation, Silver Spring, MD; Rick Dulin, BS, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Silver Spring, MD; Angel Johnson, MS, MayaTech Corporation, Silver Spring, MD

SAMHSA’s rapid HIV testing initiative provides an avenue to increase access to HIV testing for those individuals being treated in OTPs who are at risk for HIV/AIDS and Hepatitis due to substance abuse disorders. This workshop will present this implementation model from the federal, state, community, and technical assistance provider perspectives, addressing rapid HIV testing capacity building and implementation from federal-level initiation to OTP implementation.

HOT TOPIC ROUND TABLES
Monday, October 22, 2007
TIME: 1:30 PM – 3:00 PM

Hot Topic Round Tables are facilitated discussions that focus on current controversial issues in an informal context. Meet with your colleagues as you learn, challenge, support and share your views with others who may have similar or different opinions, experiences, or interests. Engage in one or more of these facilitated discussions.

• Dealing with Alcohol and Benzodiazepine Use
  Facilitator: Ernie Vasti, MD
  
  
• Dealing with Stimulant Use
  Facilitator: Cheryl Kupras, LCSW
  
  
• New Labeling for Methadone: Implications for Providers
  Facilitator: Laura McNicholas, MD
  
  
• Responding to the New Challenge of Pharmaceutical Opioid Use Facilitator: Anton Bizzell, MD
  
  
• Coping with Accreditation
  Facilitator: Sarah Crowley
  
  
• Pain Management in Addiction Treatment
  Facilitators: Karen Miotto, MD & Roxanne Baker, CMA
  
  
• Take-Home Medication Issues
  Facilitator: Jack McCarthy, MD