Evidence-Based Substance Use Education

Duration: 1-hour and 3-hour formats available

In recognition of specific education on OUD and innovative treatment for chronic and/or acute pain, this new workshop will provide updated information on evidenced-based treatment modalities, including non-opioid alternatives to pain management. Medical providers will gain tools to reduce the risk of opioid overdose and treat pain safely, as well as the skills to screen and treat substance use disorders in a patient-centered way. Participants will gain knowledge on:

• Updated tapering recommendations for patients on chronic opioid therapy
• Enhanced information on harm reduction strategies
• Emerging data of postoperative pain management for patients with OUD
• Addressing stigma and bias that prevent patients from receiving the best care

*Designed to satisfy, partially or in full, the North Carolina Medical Board’s CME requirement for controlled substance prescribers.

Duration: 4 hours total (3 modules)

There is clear evidence that pain can be treated safely and effectively while also minimizing the risks of opioid misuse. We now know that behavioral approaches are the treatment of choice for chronic pain. About one-third of our population lives with chronic pain, and most of them are not receiving adequate pain care. Behavioral health providers, medical professionals, and rehab clinicians can all be equipped with the skills needed to help people improve their quality of life despite having pain. Cognitive-behavioral and mindfulness approaches have the strongest research support for pain treatment. This interactive and cutting-edge training will provide participants with innovative and evidence-based tools to expand their effectiveness in treating people with pain. Participants will gain skills and confidence to provide life-changing interventions to help people become more active; enhance social connections; find pleasure and meaning; and live fuller, richer lives.

Duration: 1 hour

This program will provide an overview of the collaborative efforts required to uniquely treat patients with OUD in peri- and post-operative pain management. Patients with OUD, with or without medication-assisted treatment (MAT), present a particular challenge when they require emergent or elective surgery. Due to a developed tolerance to opioids, patients with OUD require higher doses and longer postoperative prescribing of opioids to achieve analgesia, further increasing their risk of opioid misuse compared to opioid-naïve patients. Perioperative pain management is even more challenging for patients currently on MAT and requires a unique strategy to ensure that these patients achieve proper pain management without increasing the risk of OUD relapse. The complexity of peri- and postoperative pain management in patients with OUD suggests the need for a collaborative interdisciplinary care team composed of providers, surgeons, anesthesiologists, and inpatient nurses. Team-based healthcare will bridge the gap between acute inpatient and ongoing outpatient care to ensure that both the patient’s pain and OUD are properly managed during and after surgery.

Duration: 1 hour

This program will provide an overview and discussion of how to wean patients experiencing chronic pain who are on chronic opioid therapy to safe levels or to non-pharmacological therapy, when possible. The program will summarize the best practices of tapering opioids by reviewing evidence-based methods for initiating, evaluating, and titrating opioid dosages and/or discounting opioids for individuals with chronic pain. The program will also review alternative strategies for chronic pain.

*Designed to satisfy, partially or in full, the North Carolina Medical Board’s CME requirement for controlled substance prescribers.

Duration: 1 hour

This program will provide evidence-based analysis of the relative effectiveness of medications and their side effects, recommendations on how to improve treatment of acute and chronic pain, and how to recognize substance use/opioid use disorders. In addition, this course is designed to bolster your current skills in treating acute and chronic pain with alternative non-opioid treatment procedures and techniques. Despite the surprising lack of medical evidence to support the use of opioid medications to treat individuals with arthritis, lower back pain, nerve pain, and migraines, many physicians continue to prescribe opioid medications as the primary treatment for pain. When patients are prescribed opioids, they bear the risk of developing unpleasant side effects, including sedation, chronic constipation, addiction, and overdose leading to accidental death. There are many overlooked and underutilized pain management techniques that offer immediate relief or provide longer-lasting results that can be performed in a primary care setting. Osteopathic medicine treatments, trigger point injections, knee and shoulder injections, occipital nerve blocks, and sphenopalatine ganglion blocks are just a few procedures providers could develop in their practice to ease their patients’ pain. This skill-based workshop will provide physicians with hands-on training to confidently perform these procedures in their practice by skilled specialists. Utilizing these procedures can:

• Provide immediate and long-lasting pain relief to patients
• Reduce the amount of opioid prescriptions that may increase side effects, addiction, overdose, and death
• Increase physician skills and patient satisfaction
• Increase patient volume and billable revenue from office procedures

Duration: 1 hour

In the collective effort to reduce the opioid overdose crisis in North Carolina, MAHEC provides the Introduction to Medication-Assisted Treatment/Medication for Opioid Use Disorder (MAT 101) training in order to share best practices in the treatment of opioid use disorders. The program begins with an overview of the current state of the opioid overdose crisis on both a national and local level. Participants will gain knowledge on the CDC guidelines for the treatment of acute and chronic pain and the efficacy of non-opioid treatment modalities. The presentation outlines the origins of substance use disorders (SUDs) and the use of various medication-assisted therapies for the treatment of opioid use disorder (OUD) specifically. Lastly, the presentation ends with a discussion of how healthcare providers can address the bias and stigma associated with substance use disorders and the importance of using harm reduction strategies, such as naloxone distribution, in the treatment of patients with substance use disorders.

*Designed to satisfy, partially or in full, the North Carolina Medical Board’s CME requirement for controlled substance prescribers.

Duration: 8-hour and 4-hour Half & Half program available
For the Half & Half course, the PCSS portion of the training is completed in an online self-paced format.

As of December 29, 2022, the DATA X Waiver requirement for MDs, DOs, and APPs to prescribe MOUD was eliminated by the federal government. MAHEC will continue to provide Waiver Trainings until more information becomes available.

The presentation is designed to train qualified physicians in dispensing or prescribing specifically-approved Schedule III, IV, and V narcotic medications for the treatment of opioid use disorder in an office-based setting. The goal of this training is to acquire the knowledge and skills needed to provide optimal care to opioid use disorder patients by providing:

1. An overview of opioid use disorder
2. The efficacy and safety of buprenorphine
3. Process of patient selection
4. Clinical use of buprenorphine
5. Non-pharmacological interventions
6. Medical psychiatric conditions in patients with opioid use disorder
7. Office procedures
8. Special treatment population

*Designed to satisfy, partially or in full, the North Carolina Medical Board’s CME requirement for controlled substance prescribers.

Duration: 2 hours

In March 2021, Federal Health and Human Services (HHS) eliminated the 8-24 hour DATA-X Waiver training requirements for prescribers treating 30 or fewer patients with medication for opioid use disorder (MOUD). However, the continued presence of the X-waiver perpetuates the stigma associated with these treatments, which also plays a role in preventing clinicians from prescribing buprenorphine to patients. As a result, this treatment remains unnecessarily isolated from normal healthcare delivery. This program seeks to provide the foundation for the treatment of opioid use disorder through buprenorphine. Learners will understand how to assess a patient for OUD, how to prescribe buprenorphine for OUD and pain management,and how to use Urine Drug Screens. Our main goal is to have more prescribers treating OUD with medications for sustained recovery and harm reduction.

Duration: 2 hours

This course will outline the basics of substance use disorders/addiction (specifically opioid use disorder) and will discuss various models of treating substance use disorders (biomedical, psychological, and biopsychosocial) and address stigma and biases related to substance use, as well as an overview of some harm reduction strategies. Additionally, the course will provide information on some aspects of the ‘nuts and bolts ‘of what it takes to provide opioid use disorder treatment through an integrated care team approach. The program includes how to use screening, brief intervention, and referral to treatment (SBIRT) in primary care.

Duration: 1 hour

This program provides an introduction to harm reduction and training on naloxone administration. Participants will recognize the value of low barrier access to substance use disorder care, especially MOUD, particularly in the context of racialized/gendered health disparities. This course will provide a review of principles and evidence-based best practices for harm reduction, including naloxone distribution, safer consumption of services, overdose response and prevention, and HIV/HCV screening and treatment as prevention.

Duration: 1 hour

This program on stimulant use disorder led by a family medicine physician, licensed clinical counselor, and clinical pharmacist will review the epidemiology, trends and behaviors of use of patients who use stimulants. During the virtual hour presentation, the team will define stimulant use disorder, describe pathophysiology and identify signs and symptoms of a patient with stimulant use disorder. The program will detail the evidence-based behavioral therapy methods and novel pharmacotherapy options for for treatment. It will also focus on stigma, bias, health equity and disparities among people who use drugs as well as review harm reduction strategies for people who use stimulants.

Duration: 1 hour

Psychostimulants are an increasing cause of overdose and death in the United States. This program, led by a family medicine physician, is tailored for a non-clinical audience and will provide a general overview of psychostimulant use disorder including trends in use, health effects, and current treatment. Learners will gain a greater understanding of how stigma, health inequity, and trauma affect individuals with substance use disorders. Participants will get an introduction on effective strategies to support individuals with psychostimulant use disorder. Furthermore, harm reduction principles for psychostimulant use disorder will be covered as well as a brief summary of the evidence-based treatments currently available.

Duration: 2 hours

Despite the prevalence and impact of stimulant use in the U.S., current pharmacological treatment options have limited supporting evidence and none are FDA-approved for the treatment of stimulant use disorder. This program, developed by an addiction psychiatrist and family medicine physician, will review current treatment options and their supporting literature with an emphasis on what therapies to offer and which populations are most likely to benefit. Participants will hear from a peer-led panel as they discuss their role, how they engage with patients with stimulant use disorder, utilizing harm reduction, and the ways that providers can best address their patients’ needs. This program is designed to build upon knowledge previously presented in Stimulant Use Disorder 101 and will address topics such as:

• The provision of pre-exposure prophylaxis (PrEP) for harm reduction
• The management of patients who use stimulants who may also have a diagnosis of ADHD
• Treatment of stimulant-induced psychosis

Duration: 1 hour

MAHEC staff will describe the experience of implementing a successful Contingency Management program within Project CARA, the embedded perinatal substance use disorder program in MAHEC OB. This course provides:

• An understanding of contingency management
• How CM/incentives are used in treatment/recovery

Duration: 1 hour

This program, which provides an overview of perinatal substance use disorder, offers a review of evidence-based treatment recommendations for pregnant women with substance use disorder, Neonatal Abstinence Syndrome (NAS), and the ongoing needs for the family after delivery.

Duration: 90 minutes

Over the past 20 years, we have seen a steadily growing prevalence of pregnancies affected by substance use disorders while the screening, assessment, and evidence-based treatment of pregnant people affected by use disorders has not been a topic routinely taught in our healthcare training across our disciplines. Perinatal Substance Use Disorders 101 is a 90-minute webinar created to expand the basic knowledge of those who interface with families affected by perinatal substance use disorder and provide tools to help deliver best care. The target audience is the interdisciplinary team with a focus on inpatient and outpatient nurses, social workers, counselors, and medical providers. This training provides an introduction to four key topics:

1. The chronic disease model of substance use disorders
2. Recommendations for best practice for screening and treatment of perinatal substance use disorders
3. Delivery of care for mother and neonate affected by maternal substance use disorders
4. Transitions of care that occur leading up to and after delivery

Duration: 105 minutes

This training provides expanded content on the four key topics covered in Perinatal Substance Use Disorders 101. It is recommended that Perinatal Substance Use Disorders 101 has been completed prior to registering for this course.

Over the past 20 years, we have seen a steadily growing prevalence of pregnancies affected by substance use disorders while the screening, assessment, and evidence-based treatment of pregnant people affected by use disorders has not been a topic routinely taught in our healthcare training across our disciplines. Perinatal Substance Use Disorders 201 is a 105-minute webinar created to increase the knowledge and skill set of those who work regularly with families affected by perinatal substance use disorder and expand their expertise in delivering evidence-based perinatal substance use disorder care. The target audience is the interdisciplinary team with a focus on inpatient and outpatient nurses, social workers, counselors, and medical providers.

Duration: varied

MAHEC’s NARCAD-trained academic detailer will provide 1:1 supportive and educational academic detailing sessions with providers in North Carolina who would benefit from (or who request) mentoring on the management of patients with acute and chronic pain. The detailer will present evidence-based clinical education tools while building a peer-to-peer relationship that will encourage buy-in for sustainable practice change and improve the prescribing practices of the provider, thus improving patient outcomes in the short and long terms. CME credit can be provided.

Duration: 1 hour per session

Chronic Pain is at epidemic levels and has become the highest-cost condition in healthcare. Subsequently, there is now an opioid epidemic, and drug overdose is the leading cause of death from injury in the United States. This live video teleconferencing series explores evidence-based behavioral health interventions to increase a person’s ability to meet treatment goals, increase acceptance, handle adverse situations, reduce risks related to opioid use, and enhance functional ability despite their ongoing pain. This Behavioral Health for Chronic Pain ECHO is designed to provide behavioral health professionals with specialized training in cognitive behavioral therapies and mindfulness approaches. Participants will also explore strategies for increasing integration and communication with healthcare providers. Additionally, participants will increase their knowledge of individuals experiencing pain with or without co-occurring issues with chronic pain. This ECHO video teleconferencing series, guided by experts, takes place over five weekly modules (one-hour each) and will cover topics such as:

• Understanding Chronic Pain and Opioids
• CBT for Chronic Pain
• Integration Issues: Creating Collaboration and Communication Routes
• Mindfulness Approaches for Chronic Pain
• Common Co-occurring Issues with Chronic Pain

Duration: 1 hour per session

The increase in mortality due to the misuse of prescription medications has caused the medical field to re-examine the use of opioids for pain management. This live online course explores the benefits and risks of opioids as well as various medications currently available for the treatment of chronic pain. This Chronic Pain ECHO is designed to provide medical professionals with specialized training in opioid prescribing and interventional pain management. Evidence-based practices will be shared by an interdisciplinary team of experts in chronic pain management, integrated family practice, and medication-assisted therapy. This video teleconferencing series, guided by experts, takes place over five bi-weekly modules (1-hour each) and covers topics such as:

• Opioid Basics: Regulatory Update (CDC, NCMB & Stop Act)
• The Urine Drug Screen
• Psychology of Pain and Behavioral Health Treatment Modalities
• Opioid De-prescribing
• Central Sensitization and Addiction: Identifying and Treating Substance Use Disorder

Duration: 1 hour per session

The increase in mortality due to the misuse of prescription medications has caused the medical field to re-examine the use of opioids for pain management. MAHEC’s Medication-Assisted Treatment (MAT) ECHO is designed to provide medical professionals with specialized training in office-based opiate treatment (OBOT). Evidence-based practices will be shared by an interdisciplinary team of experts in OBOT, integrated family practice, and medication-assisted therapy This video teleconferencing series, guided by experts, takes place over six bi-weekly modules (1 hour each) and covers topics such as:

• Opiate Use Disorder Overview
• Nuts & Bolts of Office-Based Opiate Treatment: Part I
• Nuts & Bolts of Office-Based Opiate Treatment: Part II
• Buprenorphine Induction
• Medication-Assisted Treatment Options
• Behavioral Health Treatment Modalities

Duration: 1 hour

This program provides as overview of the history, progression, and impact of the opioid crisis.