The Northeast Node of the Clinical Trials Network sponsors a bimonthly Science Series on the state of the science on addiction and integrated care models. Topics will include opioid use disorder, medication assisted therapy, addiction in adolescents, the intersection of pain and addiction, among others. The Science Series occurs during the lunch hour, from 12:00 to 1:00 PM EST and is open to health and mental health professionals. 1 AMA PRA Category 1 Credits approved by Dartmouth-Hitchcock Medical Center is available for those who attend. If you are interested in attending the webinar please email Northeast.Node.CTN@dartmouth.edu.
Parental Substance Misuse and Child Trauma
Children exposed to parental substance misuse suffer from high rates of abuse, neglect, traumatic loss and posttraumatic sequelae. Moreover, an estimated 40-80% of families involved with child protection services due to child abuse or neglect involve substance abuse in the home. With the high rates of substance use disorders including opioid use disorders, and rising rates of death from drug overdose, services to meet the needs of the children and youth whose parents are addicted to alcohol, opioids and other drugs are sorely lacking. This talk will provide an overview of the effects of parental substance misuse on children and youth, with special focus on the association between parental substance misuse and child trauma. Models for treating traumatized children that have high relevance and utility for children and youth coming from substance misusing families will be discussed.
About the presenter
Kay Jankowski, PhD, is an Assistant Professor in the Department of Psychiatry, and Associate Director of the Dartmouth Trauma Interventions Research Center, Dartmouth Hitchcock Medical Center. She received her Doctorate in Psychology from the University of Vermont and completed her internship and post-doctoral work at Geisel School of Medicine at Dartmouth. Jankowski has published numerous articles and presented widely in the area of child and adolescent trauma, including developing and testing new treatment interventions, disseminating evidence-based practices into "real world settings", and transforming child serving systems to bring a more trauma-informed approach to care and services for children, youth and their families. Most recently she is the Principal Investigator for the New Hampshire Partners for Change Project, a federally funded (ACF, DHHS) demonstration project to improve the social and emotional well-being of children and youth in child welfare and juvenile justice systems. She is also the Co-Principal Investigator for the federally funded New Hampshire Adoption Preparation and Preservation Project, with a goal of promoting successful adoption by creating a trauma-informed, evidence-based and adoption competent child welfare system. Jankowski also is a certified trainer for Trauma-Focused Cognitive Behavior Therapy (TF-CBT). She provides training and consultation to clinicians across New England in the model, as well as training in trauma-informed care to a range of organizations including mental health agencies, substance abuse treatment centers, organizations that serve homeless populations, and schools, and has expertise in leading learning collaborative models of practice change. In addition, she is an experienced clinical psychologist, and maintains a practice, treating traumatized children, adolescents and adults at Dartmouth-Hitchcock.
SBIRT in Primary Care Pediatrics: Lessons and Opportunities Beyond Implementation
About the Presenter
Steven H. Chapman, MD, is a general pediatrician with 20 years of experience, currently practicing at the Children's Hospital at Dartmouth (CHaD) and teaching at Geisel School of Medicine at Dartmouth. He served four years in the National Health Service Corp and is currently the Director of the Boyle Community Pediatrics Program as well as Vice President of the New Hampshire Pediatric Society. He also serves on the Board of New Hampshire Kids Count/Children's Alliance of New Hampshire, and is the school physician for his local Dresden School District. He has particular interest in integrated behavioral health in primary care, Screening, Brief Intervention, and Referral to Treatment (SBIRT) in primary care, and support of parents in recovery who are raising young children.
Geomapping substance use in Appalachia (Title TBD)
Harnessing Digital Technologies in the Treatment of Substance Use Disorders
A growing line of research has highlighted the promising role that interactive technologies (e.g., web, mobile devices) may play in the assessment, prevention, treatment, and recovery management of substance use disorders. In this presentation, Dr. Marsch provided an overview of the state of the science in the development, evaluation, and implementation of technology-based therapeutic interventions for substance use disorders. This research underscores the role that technology may play in improving treatment for substance use disorders in a manner that increases access to care, is cost-effective, ensures fidelity, and enables the rapid diffusion and widespread adoption of science-based interventions.
About the Presenter
Dr. Lisa A. Marsch is the Director of the National Drug Abuse Treatment Clinical Trials Network Northeast Node, the Director of the Center for Technology and Behavioral Health, and the Andrew G. Wallace Professor of Psychiatry at the Geisel School of Medicine at Dartmouth. You can see her full bio here.
The Safe Station Project
An overview of the Safe Station program run by Manchester Fire Department and the partners involved. The history, how it came to be, and identifying key components and concepts involved with the process. You will be able to identify the key factors in your community to be able to start the discussion of whether or not the Safe Station Project is something your community can execute and what resources are needed to move the mission forward.
About the Presenter
Chris is a certified career Firefighter I/II since 2004 and Nationally Registered Paramedic since 2000. Currently, he is a full time Firefighter Paramedic with the Lexington MA Fire Department and a fulltime Firefighter and EMS Officer for the Manchester NH Fire Department. Prior to coming to the Manchester Fire Department, Chris was a field paramedic, Field Supervisor, and Station Manager for Rockingham regional Ambulance and then American Medical Response. Happily married to his wife of 17 years Melissa, his family resides in Merrimack NH with their two boys Gavin (9) and Seamus (6) and their 5 year old boxer Bailey. In his spare time, he coaches Merrimack Youth Lacrosse and plays video games with his sons.
Perinatal Substance Use Disorders: Rationale for Integrated Care
Perinatal substance use disorders are a public health problem of increasing severity in northern New England, straining the capacity of the maternity care system. Providing adequate and effective services for this vulnerable population requires an understanding of their complex needs. Because pregnancy is a time of high motivation for self-care, women often seek treatment for substance use disorders for the first time after conception. Integrating addiction treatment with maternity care provides a unique opportunity to increase access, address co-morbid conditions, and improve perinatal outcomes.
About the Presenter
Daisy Goodman is a certified nurse midwife in clinical practice at Dartmouth Hitchcock Medical Center, and an Instructor in Obstetrics and Gynecology at the Geisel School of Medicine at Dartmouth. She received a certificate in nurse-midwifery and women’s health at the Frontier Nursing University, a Masters in Public Health from the Dartmouth Institute for Health Policy and Clinical Practice, and a Doctorate in Nursing Practice at the Massachusetts General Hospital Institute of Health Professions. Her area of clinical and research interest is focused on improving access to care for pregnant women with opioid use disorders, and on the intersection of trauma and substance use in women’s lives. Dr. Goodman currently practices at Dartmouth-Hitchcock Medical Center in the Department of Obstetrics and Gynecology, and is part of the treatment team at the DHMC Perinatal Addiction Treatment Program. She is currently involved in the development of a toolkit to help standardize practice among maternity and addiction treatment providers caring for pregnant women with substance use disorders. Prior to coming to Dartmouth-Hitchcock in 2013, she worked in the community hospital setting in Maine where she led implementation of a screening and brief intervention program in maternity care and participated in a workgroup sponsored by Maine CDC which developed state guidelines for the management of perinatal substance use.
Why Strategies to Integrate Behavioral Health in Primary Care Are Unsuccessful and What Can Be Done About It?
With the Affordable Care Act and Mental Health and Addiction Parity Act, it is widely assumed that behavioral health care is in the midst of enormous transformation. Epidemiological studies and health services research document the high prevalence of behavioral health conditions in primary medical care settings, and the significant costs associated with not addressing psychiatric and substance use disorders. A variety of behavioral health interventions, both pharmacological and psychosocial, have been developed and studied in primary care situations. Examples of evidence-based interventions include the Collaborative Care Model for Depression, SBIRT for high risk alcohol use, and medication-assisted treatment (MAT) for opioid use disorders. Although these treatments have consistently been found to pass efficacy and effectiveness trials, they are not widely implemented—in fact few if any are sustained beyond the funded research time frame. Implementation science provides systematic insight into the barriers and facilitators of evidence-based practice adoption and reach in routine practice settings and health care systems. In this presentation, the challenge of implementing and sustaining integrated behavioral health in primary care will be analyzed using a pragmatic research framework. Solutions are proposed that consider policy and financing; unified trans-diagnostic approaches to typical and complex behavioral health conditions (psychiatric and substance-related); optimization of care of individual providers and teams; and, the role of technology-based platforms to enhance the quality of behavioral health care, reduce practice variation, and empower patients and families.
About the Presenter
Dr. Mark McGovern is a Professor of Psychiatry, of Community & Family Medicine, and of The Dartmouth Institute of Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth in Lebanon New Hampshire USA. His clinical practice is based at the Hanover Psychiatry, and his scientific program is focused on behavioral health services and implementation research. Read his full biography here.
The Changing Landscape of Marijuana (Cannabis): What's Real and What's Not
Perceptions about cannabis are changing. This webinar discusses the potential impact of changes in cannabis laws and regulations, limitations of the evidence for cannabis as a therapeutic substance, and concerns related to adolescents’ use of cannabis and prevention messaging, and how the changing landscape interacts with these issues.
About the Presenter
Dr. Budney is a Professor at the Geisel School of Medicine at Dartmouth, Co-Director of the Addiction and Health Research Laboratory, and Director of the Treatment Development and Evaluation Core of the Center for Technology and Behavioral Health. Read his full biography here.
Interfaces of Pain & Addiction: Phenomenology, Clinical Care & Open Questions
As opioid prescribing for pain treatment increased over the past two decades, prescription opioid overdose deaths and demand for treatment of opioid addiction increased in parallel. More recently, cheap and abundant heroin and street fentanyl have been associated with a surge in opioid-related harm. While opioids remain the most powerful analgesic medications available, pain is an experience with sometimes complex biopsychosocial components that that may respond to diverse other treatments. This webinar will explore the phenomenology of pain, clinical management options for pain-with and without co-occurring addictive disorders, and the roles and liabilities of opioids in treatment of pain and opioid use disorders. The evolution of the current opioid epidemic and the contributions of prescribed and illicit opioid sources will be considered.
About the Presenter
Dr. Seddon Savage is a clinician, educator, and advocate in the fields of addiction medicine and pain medicine. She is Medical Director of the Chronic Pain and Recovery Center at Silver Hill Hospital in Connecticut and served as Director of the Dartmouth Center on Addiction Recovery and Education from 2004 through 2015. She is an Associate Professor of Anesthesiology on the adjunct faculty of the Geisel School of Medicine at Dartmouth and is currently working with Dartmouth-Hitchcock to support substance-related education and practice improvement. She earned a BA in Art History from Barnard College, an MS in Human Nutrition from the Columbia University College of Physicians and Surgeons, and her MD from Dartmouth Medical School. She earned a certificate of added qualifications in Pain Management from the American Board of Anesthesiology in 1984 and is certified in Pain Medicine by the American Board of Pain Medicine. Dr. Savage is certified in Addiction Medicine by the American Board of Addiction Medicine and is an elected fellow of American Society of Addiction Medicine.
Pharmacotherapy for Opioid Use Disorder
Opiate addiction continues to spread and plague our communities, raising concerns about both public health and widespread suffering. Unlike other addictions, opiates are unique in both their persistence and lack of response to traditional abstinence-based therapies. This webinar will provide a brief overview of current prevalence, natural history, and an introduction to available pharmacotherapy treatment options.
About the Presenter
Dr. Tod Miller was educated at Reed College (BA) and Oregon Health & Sciences University (MD). He completed his residency in psychiatry at the University of Vermont. Dr. Miller spent several years doing outpatient addictions work at Oregon Health & Sciences University in Portland, Oregon before moving east to work at the Brattleboro Retreat and Baystate Franklin Medical Center. For the past five years, he has been the Medical Director for Behavioral Health at Springfield Medical Care Systems, an unusual and innovative Federally Qualified Health Center that includes a critical access hospital with a dedicated 10-bed psych unit, the Windham Center. Their focus is providing behavioral health services that are fully integrated within primary care clinics, exploring a new model of community based care.