NIDA Blending Conference Joins ASAM Conference

Mary Ellen Michel, Ph.D., Deputy Director of NIDA's Center for Clinical Trials Network, (left) and Geetha Subramaniam, M.D., Medical Officer, NIDA Center for Clinical Trials.

Mary Ellen Michel, Ph.D., Deputy Director of NIDA’s Center for Clinical Trials Network, (left) and Geetha Subramaniam, M.D., Medical Officer, NIDA Center for Clinical Trials.

The National Institute on Drug Abuse (NIDA) brought its annual Blending Initiative Knowledge Exchange Meeting Thursday directly to ASAM attendees for the first time. Leading addiction medicine specialists focused on four key areas with a new hands-on workshop style.

“We at NIDA convened a planning committee that included Gavin Bart, M.D., FACP, FASAM, as the ASAM representative and sought to create program content that was an interactive, bidirectional, hands-on, and practice-based learning opportunity for the attendees, very different from most passive lecture-format sessions,” says committee chair Geetha Subramaniam, M.D., Medical Officer, NIDA Center for Clinical Trials.

This was the first time the Blending Conference was held at the ASAM Medical-Scientific meeting; in the past, NIDA conducted this as a standalone conference, says committee member Mary Ellen Michel, Ph.D., Deputy Director of NIDA’s Center for Clinical Trials Network.

“We wanted a forum for practitioners to ask questions, to share cases, and to talk about their real-life experiences in implementing different approaches to addiction medicine,” she says. “This is information clinicians can begin to apply the first day they are back at their practices.”

Two plenary sessions addressed the issue of addiction as a chronic illness from different perspectives. A. Thomas McLellan, Ph.D., M.S., Chief Executive Officer, the Treatment Research Institute, Philadelphia, took a policy perspective. He discussed the opportunities presented for integrating addiction treatment with general medical settings in the emerging health care system of medical-centered homes.

Robert Califf, M.D., Director of the Duke Translational Medicine Institute, Duke University Medical Center, Durham, N.C., took a clinical perspective. He offered insights into how clinical trials for addiction and other chronic illnesses could be innovative in adapting to and accommodating the challenges of the evolving landscape of the health care system.

The highlight of the Blending Conference was concurrent interactive workshop sessions, led mostly by physician experts, focusing on four topic areas, Dr. Subramaniam says. These included motivational interviewing; new pharmacological treatments; screening, brief intervention, and referral; and rapid HIV testing.

“Motivational interviewing is very well known and is highly efficacious,” Dr. Michel says. “But actually implementing it, creating that neutral atmosphere for the client, is more difficult than many people appreciate. The workshop ‘Making Motivational Interviewing Techniques Accessible to Primary Care’ offered practical tips on putting this important technique to work in real practices with real patients.”

Session video recordings and copies of support materials from Thursday’s Blending Initiative Knowledge Exchange Meeting are available at NIDA’s Center for the Clinical Trials Network Dissemination Library.

Medication-Assisted Treatments
Physicians and non-physician clinicians are always looking for tips on implementing and/or addressing challenges in pharmacologic treatments for patients with substance use disorders. The Blending Conference did not disappoint.

In the intermediate-level workshop,”Medication-Assisted Treatment,” leaders provided a quick overview of the latest evidence for opioid dependence using buprenorphine and extended-release naltrexone. They elicited and shared strategies to adopt medicine-assisted treatment into clinical practice, reviewed the available training and mentoring programs, and discussed strategies to deal with challenges resulting from integrating these treatments into either general medical settings or counseling-focused treatment settings.

“We at the NIDA Center for Clinical Trials Network just finished a trial with buprenorphine in prescription opioid addiction,” Dr. Michel says. “This is an important population in whom it can be an effective treatment.”

ASAM members are familiar with Screening, Brief Intervention, and Referral for Treatment (SBIRT), but few outside the addiction specialist community recognize either the acronym or the concept. NIDA wants to close that knowledge gap.

“We are very concerned about bringing SBIRT to as wide an audience as possible,” Dr. Michel says. “Presenting two sessions on the topic at ASAM might seem counterintuitive, but we see substance abuse physicians as an ideal vehicle to reach out to more traditional primary care settings, emergency departments, and general physician offices. This notion of screening, a brief intervention, and an appropriate referral for treatment can reach many, many more people with substance abuse problems and help educate other providers.”

One workshop focused on ways to work more closely with emergency departments, she says. They discussed how to successfully refer and link higher severity patients to specialty and higher levels of addiction treatment. The other workshop looked at ways to shape the emerging workforce by training medical students, residents, and non-physician practitioners that ASAM members work with on a regular basis.

“If you want to bring SBIRT into your own practice, connecting with other practitioners is a very good way to do it,” she says.

Rapid HIV Testing
Rapid HIV testing has emerged as a new frontier for substance abuse. Rapid testing can provide almost-instant results in the office setting, Dr. Michel says.

“The workshop presented how rapid HIV testing can be introduced into substance abuse treatment practices,” she says, “including approaches to positive results, including giving the individual information, confirming results, referring them for treatment, and so on.”