Podcast host Shawn McNiel, MD, is joined by Michael Incze, MD, MSEd to discuss his new article Expert Panel Consensus of the Effectiveness and Implementation of Models to Support Posthospitalization Care Transitions for People With Substance Use Disorders which aimed to establish a hierarchy of existing SUD care transition models in 2 categories-effectiveness and implementation-using an expert consensus approach.

Dr. Michael Incze is a primary care physician in the Division of General Internal Medicine who is board certified in internal medicine and addiction medicine. His clinical interests include patient education, high value care, and caring for vulnerable populations including people experiencing homelessness and people with substance use disorders. He regularly volunteers at the Fourth Street Clinic, a federally qualified health center that specialized in providing care to people experiencing homelessness. He is a volunteer physician at the Rosebud Indian Health Service hospital in South Dakota. He also founded a clinic that focuses on providing primary care-based addiction treatment at Sugarhouse Health Center.

In this episode of Beyond The Abstract, Dr. Joji Suzuki stops by the show to discuss his recent co-authored review on GLP-1 agonists and their potential role in addiction treatment. Dr. Suzuki is the founding Director of the Division of Addiction Psychiatry in the Department of Psychiatry, Brigham and Women’s Hospital (BWH), and an Associate Professor of Psychiatry at Harvard Medical School (HMS). He is board certified in both Addiction Psychiatry and Addiction Medicine, and has continued to maintain his clinical role as an inpatient addiction consultant at BWH. He has received NIH funding continuously since 2017, having completed a K23 Career Development Award to receive training in conducting clinical trials with an emphasis on research to improve the care of hospitalized patients. He is now a principal investigator on multiple NIH funded trials to evaluate novel pharmacologic and psychosocial treatments for substance use disorders.

 

The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients: A Scoping Review

 

Journal of Addiction Medicine 18(5):p 488-498, 9/10 2024

 

Sept-Oct 2024

Host Shawn McNeil, MD, is joined by Michelle Lofwall, MD, DFAPA, DFASAM,  a professor in the Department of Behavioral Science and Psychiatry at the University of Kentucky and Medical Director of UK’s Robert Straus and First Bridge Clinics, which provide comprehensive OUD treatment within the UK Center on Drug and Alcohol Research. Dr. Lofwall and  her co-authors examined the relationship between the dose in the early stages of treatment and the subsequent risk of death and found some surprising results.

 

Higher First 30-Day Dose of Buprenorphine for Opioid Use Disorder Treatment Is Associated With Decreased Mortality

 

Journal of Addiction Medicine 18(3):p 319-326, 5/6 2024

May-June 2024

Podcast host Shawn McNiel, MD, is joined by Noa Krawczyk, PhD, an assistant professor in the Department of Population Health at NYU Grossman School of Medicine, and an author of Initiatives to Support the Transition of Patients With Substance Use Disorders From Acute Care to Community-based Services Among a National Sample of Nonprofit Hospitals. Dr. Krawczyk discusses the gap in transition of acute care to community care services among most US hospitals, efforts to increase acute care interventions, and how clinicians providing SUD treatment can help hospitals identify and implement best practices to support continuity of care.

 

Follow Dr. Krawczyk on Twitter @noakrawczyk

 

 

Article, Authors, and Links:

Initiatives to Support the Transition of Patients With Substance Use Disorders From Acute Care to Community-based Services Among a National Sample of Nonprofit Hospitals.

Krawczyk, Noa PhD; Rivera, Bianca D. MPH; Chang, Ji E. PhD; Lindenfeld, Zoe MPH; Franz, Berkeley PhD

Journal of Addiction Medicine 18(2):p 115-121, 3/4 2024

Xylazine Use Among People Who Inject Drugs, Philadelphia 2022

 

Host Shawn McNiel, MD,  is joined by Marissa Tan, DO, an Epidemiology Intelligence Service (EIS) Fellow for the Center of Disease Control and Prevention through the Philadelphia Department of Public Health. Dr. Tan and her co-authors sought to help clinicians better identify individuals at risk and inform patients and clinicians about xylazine risk factors.

Dr. Tan discusses their findings from National HIV Behavioral Surveillance Survey among persons who inject drugs data and offers recommendations for clinicians and public health professionals. 

 

Show Links:

Xylazine Use Among People Who Inject Drugs, Philadelphia 2022

Journal of Addiction Medicine, 18(2):p 194-200, 3/4 2024.

March-April 2024

Podcast host Shawn McNeil, MD, is joined by Joshua Sharfstein, MD, and Sara Whaley, MPH, from Johns Hopkins Bloomberg School of Public Health who delve into the strategic allocation of $56 billion from opioid litigation settlements. As they discuss the principles for effective fund utilization, they highlight opportunities for addiction medicine specialists to play a pivotal role in guiding state and local governments to spend these resources wisely to save lives.

 

Journal of Addiction Medicine, November-December 2023

Opioid Settlements: The Role for Addiction Medicine in Guiding Effective Spending

 

Also of Interest

Principles for the Use of Funds From the Opioid Litigation

Developed by a coalition of organizations across the spectrum of the substance use field including physicians, addiction medicine specialists, recovery, treatment, and harm reduction.

In episode 28 of  Addiction Medicine: Beyond the Abstract, host Shawn McNeil, MD is joined my Ashish Thakrar, MD, MS, an addiction medicine specialist and Assistant Professor of Medicine with the University of Pennsylvania. Dr. Thakrar discusses the outcome of his research, which aimed to determine whether fentanyl concentration is associated with the severity of opioid withdrawal.

 

Article Link: https://journals.lww.com/journaladdictionmedicine/abstract/2023/07000/association_of_urine_fentanyl_concentration_with.18.aspx

 

Ashish Thakrar, MD,  X (Twitter) Handle: @especially_APT

 

Journal of Addiction Medicine. 17(4):447-453, July/August 2023.

The language used to describe people with substance use disorder impacts stigma and influences clinical decision-making. Host Dr. Shawn McNeil, MD discusses with Dr. Scott G. Weiner, MD the presence of stigmatizing language in clinical notes and detects patient- and provider-level differences.

----more----

Based on original research published in the Journal of Addiction Medicine July/August 2023 - Volume 17 - Issue 4   The Incidence and Disparities in Use of Stigmatizing Language in Clinical Notes for Patients With Substance Use Disorder

The language used to describe people with substance use disorder impacts stigma and influences clinical decision-making. Host Dr. Shawn McNeil, MD discusses with Dr. Scott G. Weiner, MD the presence of stigmatizing language in clinical notes and detects patient- and provider-level differences.

 

Based on original research published in the Journal of Addiction Medicine July/August 2023 - Volume 17 - Issue 4   The Incidence and Disparities in Use of Stigmatizing Language in Clinical Notes for Patients With Substance Use Disorder

Examining the Primary Care Experience of Patients With Opioid Use Disorder: A Qualitative Study

In episode 26 of Addiction Medicine: Beyond the Abstract, host Shawn McNeil, MD, is joined by Michael Incze, MD, MSEd. Dr. Incze is a primary care physician at the University of Utah Health Division of General Internal Medicine. He is board certified in internal health and addiction medicine. Dr. Incze will discuss the advantages of primary care-based SUD treatment, focusing on both the perspective of patients and clinicians.

 

Journal of Addiction Medicine, July/August 2023

 

https://journals.lww.com/journaladdictionmedicine/pages/articleviewer.aspx?year=2023&issue=07000&article=00009&type=Fulltext&context=featuredarticles&collectionid=1

Meet JAM Editor-in-Chief, David A. Fiellin, MD, FASAM

 

Dr. Fiellin is an internist, board certified in addiction medicine. He is professor of Medicine and Emergency Medicine at Yale School of Medicine, and Public Health at Yale School of Public Health; vice chief of Faculty Affairs for the Department of Internal Medicine’s Section of General Internal Medicine; and serves as the inaugural director of the Program in Addiction Medicine at Yale.

Dr. Fiellin has focused his scholarly work on improving access to and the quality of substance use prevention and treatment, especially in general healthcare settings. His research focuses on the efficacy, effectiveness, and implementation of treatments for opioid use disorder and alcohol use disorder in office-based, primary care, Emergency Department, hospital, obstetrical and gynecologic practices, and HIV specialty settings. He has served and is serving as principal investigator and co-investigator on multiple NIH-funded research projects using a variety of research designs including clinical trials, observational studies, pharmacoepidemiology, qualitative methods, and implementation science. His work has been published in journals that include NEJM, JAMA, The Lancet, Annals of Internal Medicine, and BMJ.