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Missouri’s State Targeted Opiod Crisis Grant: What We’re Doing and Why

Speaker(s):

Rachel Winograd, PhD

Presentation: Funds from the Federal 21st Century Cures Act were distributed to states by SAMHSA in Spring, 2017, to address the opioid crisis in the form of State Targeted Response to the Opioid Crisis (Opioid STR) grants. Missouri’s is led by Dr. Rick Gowdy, Director of the Division of Behavioral Health, Missouri Department of Mental Health, and directed by Dr. Rachel Winograd of the Missouri Institute of Mental Health-University of Missouri, St. Louis. Collaborative partners include substance use and healthcare agencies, organizations, and academic affiliates throughout the state. This talk will describe the landscape of opioid use and overdose deaths in Missouri and how the Opioid STR project plans to curb the trend and change the system of care in our state. The primary goals of the Missouri Opioid STR project include: 1) Increase provider and consumer-focused opioid use and overdose prevention initiatives and programs (through school-based prevention, telehealth consultation on safe opioid prescribing in primary care, and expanded overdose education and naloxone distribution efforts); 2) Increase access to evidence-based Medication Assisted Treatment for uninsured individuals with Opioid Use Disorder (OUD) (through rigorous provider training, direct service delivery, healthcare integration, and improved transitions of care in hospital and outpatient settings); 3) Increase the number of individuals with an OUD who receive recovery support services (through four new Recovery Community Centers, supportive recovery housing, and peer specialist services); and 4) Increase the likelihood of sustainability through policy and practice change as well as demonstrated effectiveness of grant-supported protocols.

Objectives:

  • Describe the regions and populations in Missouri most heavily impacted by opioid use and overdose death
  • Describe the role of agonist and partial agonist medications (e.g., Suboxone) in an evidence-based approach to the treatment of opioid use disorder
  • Review the primary objectives of the Missouri State Targeted Response to the Opioid Crisis Grant in the areas of prevention, treatment, and recovery support

Slides and Handouts:

Winograd STI Missouri Opioid STR

 

 

 

 

 

 

 

 

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Buprenorphine for Heroin Dependence: An Update

Speaker(s):

Luis Giuffra, MD, PhD

Presentation:  Dr. Giuffra will describe the result of scientific data on how to use buprenorphine successfully in the treatment of heroin dependence.

Objectives:

  • Review the role of medications in the treatment of heroin dependence.
  • Describe the best methods of using buprenorphine.
  • Discuss the role of psychosocial interventions in the context of buprenorphine use.

 

 

 

 

 

 

 

 

 

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Beyond Awareness: Changing systems to reverse the overdose epidemic

Speaker(s):

Ned Presnall, MSW, LCSW and Robert Riley II, MAADC II

Presentation: For at least a decade, we have been training front-line substance abuse counselors in the science of addiction and Medication Assisted Treatment (MAT). Many counselors have come to understand that effective treatment for opioid dependence starts with medication. Yet, lack of access to maintenance pharmacotherapy remains a major contributor to our rising overdose rate. This presentation will look at the system-level barriers to treatment access and propose effective and cost-effective models of treatment that can be used to improve access to treatment on a large scale. The presenter will argue that even without additional financial resources to fight OUD we could be using the resources we already have to begin reversing the overdose epidemic.

Objectives:

  • Explain which approaches to OUD are best supported by research.
  • Review cost-effective and scalable models of OUD treatment with potential to reverse the opioid epidemic, e.g. models that can be implemented in primary care.
  • Describe the barriers to implementing these models and initial strategies to overcome them.

 

 

 

 

 

 

 

 

 

 

 

 

 

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Medication Assisted Treatment: Myths, Facts, and Successful Incorporation into Practice

Speaker(s):

A. Benjamin Srivastava, MD

Presentation: This will be a didactic presentation with audience engagement regarding practical issues with medication assisted treatment in addiction practice.

Objectives:

  • Describe the rationale for pharmacotherapy in addiction treatment
  • Explain reasons for under utilization
  • Promote evidence based practices

Slides:

Srivastava_DMHSpringTraining2017

 

 

 

 

 

 

 

 

 

 

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My Career in Translational Research: From 1972-Present

Speaker(s):

Mark Gold, MD

Presentation:  This presentation will review the early work on drugs, memory, and state dependency of memory and how these relate to slips, relapse, cravings and depression. The link between locus coeruleus to opiate withdrawal and nucleus accumbens to cocaine withdrawal will be described. The dopamine hypothesis and proof of cocaine being addictive led to a change in the DSM diagnosis for addiction and made it possible for gambling and other processes to be addictive. The learner will follow the theory to the development of new treatments for opiate, cocaine, and other addictive processes. The learner will understand how smoking is injection without a needle and how smoking cigarettes or marijuana is like and unlike nicotine or THC.

Objectives:

  • Review the early work on drugs, memory and state dependency of memory and how these relate to slips, relapse, cravings and depression.
  • Discuss the link between locus coeruleus to opiate withdrawal and nucleus accumbens to cocaine withdrawal.
  • Outline the theory to the development of new treatments for opiate, cocaine and other addictive processes.
  • Describe how smoking is injection without a needle and how smoking cigarettes or marijuana is like and unlike nicotine or THC.

Slides:

Gold_Missouri handout

Gold-RYCU April 2017

Gold-RYCU May 2017

 

 

 

 

 

 

 

 

 

 

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Weird Science: Subconscious and Epigenetic Drivers of Mental Health

Speaker(s):

Rob Paul, PhD

Presentation: The mainstream scientific community has long struggled to adopt concepts that cannot be readily observed or measured. Yet, modern advances in the neurosciences have revealed that two powerful drivers of behavior and mental health operate at levels below human consciousness. A direct challenge to “I think, therefore I am”. The vast majority of information sensed by our bodies does not reach the level of conscious awareness. However, subconscious mechanisms have a major impact on our behavior, particularly emotion. Similarly, epigenetics operate “below the surface” and with dynamism that challenges most of what was once considered to be static effects of genetic predispositions on our behavior and mental health. Further understanding of both subconscious mechanisms and epigenetics will fundamentally transform the field of mental health.

Objectives:

  • Describe the subconscious mechanisms of human behavior.
  • Examine the methods of measuring subconscious brain activity.
  • Review the impact of beneficial and maladaptive subconscious processing on emotion and decision making.
  • Provide a brief introduction into the field of epigenetics.
  • Define the relevance and risk of epigenetic discoveries in contemporary health and wellness.

 

 

 

 

 

 

 

 

 

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Building Organizational Contexts for Implementing Evidence-Based Treatments

Speaker(s):

Ryan Lindsay, MSW, LCSW

Presentation:  EBT’s and EBP’s are primarily designed with one goal in mind: improved health outcomes in people. From academics to organizational CEO’s and program directors to new clinicians, you continuously hear this chant of EBP’s. Evidence-based treatments and practices give us predictability in our ability to generate changes in behavioral and health outcomes. Some were introduced to this concept while in our training programs and some of us are just now learning about new ways of moving the needle on behavioral health and health change. This workshop draws from the facilitator’s extensive history of working with organizations to implement new evidence-based treatment programs. These “lessons learned” from a decade of implementation experience will provide practical advice and a model to consider when organizations plan to adopt and implement a new evidence-based treatment. A model is only as effective as it is implemented and this workshop will help bridge the gap between failed implementation to successful implementation.

Objectives:

  • Discuss an overview of the implementation process for evidence-based treatments and practices in organizations.
  • Identify potential pitfalls in the process of implementing evidence-based treatments and practices in organizations.
  • Utilize a model for thinking about, beginning, selecting, implementing and sustaining evidence-based mental health treatments within organizations.

Slides and Handouts:

Lindsay_Creating Organizational Contexts for Implementing Evidence-based Treatments

 

 

 

 

 

 

 

 

 

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Improving Mental Health: 4 Secrets in Plain Sight

Speaker(s):

Lloyd Sederer, MD

Presentation: My talk on Four Secrets of Mental Health Care uses patient stories, historical incidents and notable people, books and movies, and research findings to support each of the secrets, which I stress are hidden in plain sight. They are: 1) Behavior serves a purpose; 2) The power of attachment; 3) As a rule, less is more; and 4) Chronic stress is the enemy.

Objectives:

  • Identify 4 “secrets” hiding in plain sight to improve mental health care.
  • Describe how action can be taken to improve patient care.
  • Illustrate the “secrets” with science, clinical examples, stories, etc.

Slides:

Sederer-Secrets Book Flyer

 

 

 

 

 

 

 

 

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Develop a Deeper Understanding of Yourself While Internalizing the Emotional Milestones of Young Children

Speaker(s):

Stephen Zwolak, MEd

Presentation: This interactive Prezi presentation will allow participants to apply Early Childhood Mental Health Consultation primary prevention concepts in the classroom, clinician’s office, and home addressing the mental health concerns of children, educators, and families. Through mixed media (videos and photos), reflection, and break-out discussions, participants will learn about themselves, trauma in early childhood, children’s emotional milestones, and how they can use this knowledge to strengthen relationships with children and families while advocating for children’s mental health.

Objectives:

  • Express the importance of understanding ourselves, so we can better understand children and improve our day-to-day practice.
  • Identify emotional milestones that will enhance their relationships with children and families.
  • Express participants become advocates for promoting the mental health of children.

Slides:

Zwolak_Develop a Deeper Understanding of Yourself.Steve Zwolak, M.Ed.

 

 

 

 

 

 

 

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Integrating the Six Principles of Trauma Informed Care with the Six Principles of Strengths-Based, Person-Centered Model of Interpersonal Helping

Speaker(s):

Walter Kisthardt, PhD, MSW

Presentation:  Behavioral Health professionals have become increasingly aware of the importance of integrating the 10 principles of Trauma Informed Care into all aspects of interventions that are designed to promote social, psychological, physical and spiritual well-being. Research has also demonstrated how Strengths-Based, Person-Centered practice may generate increased proactive goal attainment on the part of a diverse group of service participants. In this workshop, Dr. Kisthardt demonstrates how the principles of Trauma Informed Care are inextricably linked to, and supported by, the principles of the Strengths Perspective in Social Work Practice. Participants then will explore how to consciously incorporate strategies into their work that increase the level of participant engagement in the interpersonal helping process; how to utilize the Person-Centered Strengths Assessment to assure attention to addressing how trauma may impact current and future goal attainment; and how the use of collaborative planning and documentation on the Personal Wellness/Recovery Plan promotes movement at the participants’ own pace and attends to positive, hopeful accomplishments that fuel recovery. Those who have attended Dr. Kisthardt’s workshops over the years have reported feeling affirmed, challenged, informed, aware of creative ideas to incorporate in challenging situations, while at the same time have fun in the process.

Objectives:

  • Introduce skills identified by the research that serve to promote engagement and the development of a trusting collaborative helping partnership
  • Explain how to integrate the Person-Centered Strengths Assessment as developed primarily by the service participant to reflect expression of trauma-informed principles
  • Describe how the Personal Wellness/Recovery Plan may be utilized to promote social/behavioral goals and outcome oriented practice.

Slides:

Kisthardt Strengths and Trauma