News from the Node

Despite accounting for only 6% of the US population, men who have sex with men (MSM) account for 53% of all people living with HIV. The targeted promotion of HIV self-testing and simplified access to test kits and PrEP (pre-exposure prophylaxis) medication is a promising approach to HIV prevention among this high-risk population.

Online services are increasingly becoming a platform for efficiently delivering public health campaigns and targeting those in need who may be missed by other conventional forms of prevention outreach (e.g. physicians).

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In June of 2018, the Substance Abuse and Mental Health Services Administration (SAMHSA) updated its Opioid Overdose Prevention Toolkit, originally published in 2016. The updated toolkit is designed to help people who use opioids, healthcare providers, families, and other community members prevent overdose deaths related to opioid use. The toolkit addresses several factors that can lead to an opioid overdose death and discusses when and how to use naloxone, or Narcan, a medication that can reverse an opioid overdose. The toolkit also describes how to respond to a suspected opioid overdose, information for prescribers, and general tips for family members to help recognize an opioid use disorder and address early signs of dependence.

You can download the updated Toolkit here.

Northeast Node Core Investigators Dr. Sarah Lord and Daisy Goodman have been approved for $5.3 million in funding from the Patient-Centered Outcomes Research Institute (PCORI) to study medication-assisted treatment (MAT) models for pregnant women with opioid use disorder (OUD). The study will span across five years and will look at three different types of MAT and obstetric treatment for pregnant women with OUD at 21 sites across Maine, New Hampshire, and Vermont. Many of these sites are partners or affiliates of the Northeast Node or work closely with its partners in the care of pregnant women with OUD.

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The Fire Chief of New Hampshire’s Manchester Fire Department, Daniel Goonan, attended the 2018 CTN Annual Steering and Scientific Meeting in North Bethesda, MD to present Safe Station to CTN researchers, partners, and affiliates.

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Bangor, Maine — Noah Nesin, MD, Vice President of Medical Affairs, announced that Penobscot Community Health Care (PCHC) will provide a prescription for Narcan for any person in Maine who requests it, at the pharmacy of their choice.

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The Northeast Node was pleased to kick off the 2018 calendar year with a Science Series presentation by Ryan McCormack, MD, MS, and Kathryn Hawk, MD, MHS, on “Initiating Treatment of Opioid Use Disorder in the Emergency Room.” The Emergency Department (ED) is a critical venue for initiating substance use disorder (SUD) interventions because ED patients have a disproportionately high prevalence of SUD, are at an elevated risk of overdose, and many do not access healthcare elsewhere. Despite this, SUD interventions are rarely initiated in EDs.

In their presentation, Dr. Hawk and Dr. McCormack reviewed common barriers to initiating treatment in the ED, including stigma, lack of resources, and perceptions of SUD as being a choice rather than a chronic disease with a biological basis. For example, Dr. Hawk spoke about how using language like “addict, alcoholic, and dirty” versus “person with an alcohol or drug use disorder” reinforces negative perceptions.

Drawing on recent and ongoing research, they also described best practices for the treatment of opioid use disorder (OUD) and alcohol use disorder in the ED, including ED-initiated buprenorphine, extended-release naltrexone, and naloxone distribution. ED patients with OUD who received ED-initiated buprenorphine were twice as likely to be engaged in treatment at a 30-day follow-up than those who were given a referral or brief intervention. While the current federal regulations may make it challenging for ED providers to administer medication-assisted treatment for OUD, Dr. McCormack and the CTN are exploring the role that buprenorphine, including injectable extended release buprenorphine formulations, could play.

Dr. McCormack is an Assistant Professor of Emergency Medicine at New York University School of Medicine. He is a practicing emergency medicine clinician at Bellevue Hospital in New York with a broad clinical background in Emergency, Internal and Addiction Medicine. His research focuses on using collaborative strategies to practically and sustainably integrate substance use interventions in the ED to enhance healthcare quality.

Dr. Hawk is an Assistant Professor of Emergency Medicine at Yale University and works as an Attending physician at Yale-New Haven Hospital. Her research focuses on overdose prevention in high-risk populations and ED-initiated buprenorphine and linkage to treatment for substance use disorders.

Their full presentation can be viewed on the Northeast Node’s website. If you would like to join the Science Series mailing list, please email Bethany McLeman.