Wisconsin Opioid Forum Breakout Session Descriptions

May 5-7, 2020
Kalahari Resort and Convention Center, Wisconsin Dells, WI

Prior to registering, we ask that you review the breakout session descriptions. To view descriptions, click on the dropdowns below.

​Tuesday, May 5, 2020

Opening Keynote from 9-10:30 a.m.

Be Here Now: Enhancing Recovery Services with Mindfulness-Informed Interventions
Jamie Marich

The benefits of mindfulness practice in the treatment of mental health and addiction issues continue to receive good press and solid research backing. However, in working with addicted individuals, especially those in recovery from opioid use disorders, several key adjustments must be made. In this workshop participants will learn about the benefits of teaching mindfulness-informed strategies as part of a comprehensive treatment program. Connections are also made between the attitudes of mindfulness practice and common concepts in the recovery literature. Fundamentals of teaching mindfulness in a trauma-informed and addiction-responsive way are highlighted.

Objectives:

  1. Define mindfulness and explain how teaching mindfulness-informed skills assist professionals in working with recovery principles
  2. Describe the risks of working with pure mindfulness meditation practices with recovering individuals; apply themodifications suggested for optimal trauma-focused and addiction-responsive care
  3. Instruct 2-3 mindfulness-informed skills with appropriate modifications made for those in recovery from an opioid use disorders

Breakout Sessions 1-8 from 10:45 a.m.-Noon
1
Drug Trends, Diversion, and the Opioid Epidemic 
Amber Davis and Laura Reid

This session will contain an overview of the Drug Enforcement Administration's Diversion Control Division including its mission and efforts to combat the opioid epidemic. Additionally, the presentation will address current drug trends, types of diversion, and methods for identifying diversion.

Objectives:
  • Opioid epidemic
  • Diversion of Controlled Substances
  • Drug Trends
2
What You Need to Know: The Wisconsin Addiction Recovery Helpline
Rachel Gundacker and Charlene Mouille

The Wisconsin Addiction Recovery Helpline is powered by the 211 Wisconsin System. In this session, we will provide a brief overview of the 211 Wisconsin System and an in-depth look at how the Wisconsin Addiction Recovery Helpline operates and how it can be used in your work.

Objectives:

  • Provide an overview of the 211 Wisconsin System
  • Demonstrate the ways people can utilize the Wisconsin Addiction Recovery Helpline
  • Learn how to partner with the Wisconsin Addiction Recovery Helpline
3
Project TORCH: Trauma-Informed Opioid Response through Connection and Hope 
Katie Lepak and Jon Rivamonte
Each of these objectives will highlight the value of multidisciplinary collaboration to address substance misuse in the Southshore Milwaukee County communities. Traditionally, police, fire, and public health have all played a role in substance misuse prevention and response; however, there has been little collaboration between departments. Project TORCH brought together police, fire, and public health to identify opportunities for collaboration, including developing and implementing joint trauma-informed care training and quick response teams that reach out to individuals and families impacted by addiction following a non-fatal overdose.

Objectives:
  • Identify opportunities for a unified multidisciplinary (Public Health, Police, Fire) response to substance misuse at the municipal level
  • Application of a Trauma-Informed Care lens from 2 different perspectives:
    • First responders managing individuals who have experienced varying degrees of trauma
    • First Responders dealing with the trauma they experienced professionally and personally
  • Partnership development to foster resource sharing to support individuals and families impacted by addiction
4
Opioids and Stimulants 
 Dennis Radlof

Details TBA 

5
Evidence-Based Treatment for Opioid Use Disorder in the Emergency Department: The Evolution of a Peer-Led Model 
Julie Dees, Davis Hermann, and Nicole O'Donnell
Emergency Departments (EDs) across the country are seeing increasing numbers of patients presenting with overdose and other opioid use disorder (OUD)-related visits. There is evidence ED-initiated buprenorphine increases engagement in treatment, but there are barriers to implementing this practice in real-world settings, including patient identification, access to X-waivered physicians, willingness to engage in the treatment, and linkage to ongoing care. The Penn Center for Opioid Recovery & Engagement (CORE), in partnership with the Penn Medicine Center for Healthcare Innovation, set out to improve care in each of these areas. In this presentation, we will share our process for  implementing this model, lessons learned, and discuss ongoing efforts to expand and scale the program.

Our model leverages Certified Recovery Specialists (CRSs) for patient engagement, care coordination, treatment linkage, and follow-up to improve retention. We have developed a novel system to automatically notify CRSs of patients with likely OUD based on real-time data in the electronic health record and have also implemented posters to allow patients to self-identify directly to CRS for treatment or harm reduction-oriented support. Coupled with health system efforts to increase the number of X-waivered ED providers, CRSs support patients and assist providers with engagement and linkage to care, resulting in significantly increased buprenorphine initiation, reduced 30-day ED revisits, and reduced 30-day readmissions among patients admitted to the hospital. Currently, more than 2/3 of patients seen in the ED by a CRS and started on buprenorphine remain engaged at 30 days.

Specific Aims:
  1. Share novel methods to increase the identification of patients with OUD in the ED
  2. Discuss strategies for leveraging CRS expertise in ED workflows and collaborating with ED providers to increase buprenorphine initiation and care linkage
  3. Describe future directions to expand the program in the hospital and community"
Objectives:
  • Summarize the evidence for emergency department (ED) treatment of Opioid Use Disorder (OUD), particularly ED-initiated buprenorphine.
  • Describe methods for identifying patients and incorporation Certified Recovery Specialists (CRS) into ED workflows to increase treatment initiation.
  • Identify opportunities for increasing engagement and treatment linkage for patients in your ED and communities.
6
Treatment in Motion 
Speaker TBD

Details TBA 

7
Using Alternatives to Opioids in Pain Management
Alaa Abd-Elsayed


  I will discuss the hazards of opioids and the use of alternatives to opioids to reduce the opioid epidemic.

Objectives:

  • Hazards of opioids
  • Alternative modalities to opioids
  • Proposed guidelines
8
Using EMDR to Treat Co-Occurring Traumatic Stress and Substance Use Disorders
Jamie Mariach

Eye Movement Desensitization and Reprocessing (EMDR) is a viable psychotherapy for the treatment of trauma and other trauma and stressor-related disorders. This workshop is designed for those not presently trained in EMDR and wanting to receive a thorough orientation about how the therapy works and how it can be used in various levels of the addiction treatment process. Common misconceptions about the therapeutic approach are also addressed. Due to the recovery nature of this conference, the latest in research and practice knowledge on using EMDR therapy in the treatment of addiction is covered. You will also receive more information to help you to decide if further training in EMDR therapy is for you. The EMDR approach to trauma is also discussed in this course, which can help you to enrich your delivery of trauma-informed services whether or not you go on for further training in EMDR therapy. Several EMDR-related techniques using bilateral stimulation are also taught in this course, available for you to use in clinical settings.

Objectives: 
  • Discuss briefly the history of EMDR therapy, as a trauma intervention, and briefly describe how it works
  • Describe how EMDR therapy can work as a relapse prevention/recovery enhancement measure
  • Evaluate client appropriateness for EMDR therapy and discuss logic for referral
__________________________________________________________________________________________________

Plenary Session from 1-2:30 p.m.

"Providing Dignified and Respectful Care to Patients Who Use Drugs" 
Speaker: Sharon Stancliff

Breakout Sessions 9-16 from 2:45-4 p.m.
9
Human Trafficking and Opioids
Melinda Hughes

Drugs are a powerful tool in sex trafficking toolbox. This workshop will examine the impact of opioids in survivors' lives, and scenarios that illustrate the vulnerabilities created and/or exploited by traffickers. We will also discuss the integrated treatment elements necessary to provide the greatest opportunity for a successful recovery for trafficking survivors.

Objectives:

  • Examine available data regarding opioid use and human sex trafficking
  • Explore the common patterns of the interplay between opioids and trafficking
  • Understand 10 Healing Domains for recovery success
10
From the Clinic to the Community: Strategies to Address the Opioid Crisis through
Behavioral Health and Public Health
Jeffrey Coady
Addressing the Opioid Crisis through the expansion of prevention, treatment, and recovery support services is a critical element of any strategic plan. This plenary session will focus on ways to increase access to the continuum of OUD services through behavioral health integration with other public health initiatives in your community including Ending the HIV Epidemic, Suicide Prevention, and Social Determinants of Health (SDOH). This session will be interactive and include small group discussion to facilitate peer to peer learning.

Objectives:
  • Learn approaches that address the intersection of OUD, HIV, HCV
  • Learn about the intersection between recovery-oriented systems of care and social determinants of health
  • Learn best practices in suicide prevention for individuals with OUD
11
Collaborating with the Faith-Based Community
Drew Brooks and Molly Derza
Research has linked religiosity and spirituality to positive prevention, recovery, and behavioral health outcomes; but little theory and practice focuses on faith communities themselves. This interactive workshop describes the Faith Partners model of congregational readiness and capacity-building that moves faith leadership from rare conversations about behavioral health to active involvement in community prevention and recovery support activities. Participants will receive tools, strategies, and a spiritual basis to initiate an effective ministry in their congregational communities.
 
An informed clergy, supported by committed congregational members, have a tremendous opportunity to serve their congregational community. They can offer help to those who suffer by addressing individuals and families through referral and recovery support activities as well as assistance to those who want to prevent problems through awareness, education and early intervention strategies. A ministry of prevention and recovery support offers real HOPE, HELP, and HEALING.
 
We will highlight the initial stages of a project with the Greater Milwaukee Synod of the E.L.C.A. and Faith Partners (a faithbased organization) to equip the faith community to address behavioral health issues. Faith Partners has trained nearly 1,000 congregational teams in 29 states with 23 different faith traditions, which include Caucasian, African American, Hispanic, and Native American congregants. These efforts are often initiated by agencies, community coalitions, ministerial associations, or denominational leadership.
 
A Research Study of the Faith Partners model through the Substance Abuse and Mental Health Service Administration (SAMHSA) Service to Science (S2S) Evaluation Enhancement Process, has revealed key factors associated with readiness and change capacity. This research has helped move the Faith Partners model from a promising practice to an evidencebased intervention. The intervention consists of training congregational teams to provide prevention, early intervention, referral assistance, recovery support, and advocacy activities.  

Objectives:
  • Identify the importance role religion, spirituality, and faith community play to address substance use disorders including the Opioid Crisis.
  • Understand Faith Partners' model in building congregational teams to collaborate with community-based prevention and recovery support efforts.
  • Illustrate an initial project with the Greater Milwaukee Synod of the E.L.C.A. to equip the faith community to address substance use disorders including the Opioid Crisis.
12
Hidden Trauma
Robin Matthies and Scott Webb

Trauma-informed care is an intervention and organizational approach that focuses on how trauma may affect an individual's life and their response to receiving behavioral health services. This presentation will explore trauma and its prevalence in society. We will review the adverse childhood experiences study and how the five values of trauma-informed care drive connection and can be applied in multiple service settings. Those who work as first responders are often "wounded helpers" themselves. We will look at vicarious trauma, its effects on our work and discuss strategies to practice proper self-care – for ourselves and those that depend on us for help.

Objectives:

  • Increase understanding of signs and symptoms of toxic stress.
  • Understand the linkage between toxic stress and common risk behaviors (harmful substance use, self-harm, etc.).
  • Improve strategies to identify and cope with toxic stress for self and colleagues.
13
The Co-Use of Methamphetamine and Opioids Among Patients in Treatment in 
the State of Oregon
Andrea Lopez
This presentation discusses findings from a NIDA-funded qualitative Hot Spot study that investigated emerging patterns in methamphetamine and opioid co-use at the Serenity Lane treatment program in Eugene and Coburg, Oregon. The presentation will explore the following:
  • The key role of regional/geographic information in understanding patterns of methamphetamine use locally
  • The ways in which patients experienced stigma related to methamphetamine, opioids and the use of medication-assisted treatment
  • The rationales and motivations regarding the co-use of methamphetamine and opioids which include: 
    • methamphetamine perceived as a safer alternative than heroin
    • methamphetamine used as a strategy to detoxify or titrate the effects of heroin
    • methamphetamine as a financially beneficial way to maintain a desired high
    • easy access to purchasing methamphetamine and heroin in combination

Objectives:

  • Provide information on recent trends in opioid and methamphetamine co-use
  • Explore the public health implications of co-use, including harm reduction strategies for this population
  • Demonstrate the importance of using qualitative data to understand motivations and rationales for co-use
14
Opioid Crisis: Forensic Toxicology
Sara Schreiber

This presentation will provide an overview of forensic toxicology especially as it pertains to the opioid crisis. Time will be spent on drugs, trends, and case review.

Objectives:

  • Review of toxicology.
  • Review of trends.
  • Review of cases.
 
15
Providing Buprenorphine Induction with Dignity and Respect
Sharon Stancliff

Details TBA 

16
Effective Allies: non-Pharmacologic approaches to Decreasing Opioid Use
and Treating Pain
Jeff King, Steven Mui, and Jessie Podolak
What options can we provide those in pain? In this panel discussion, experts in non-pharmacologic treatment will discuss the latest evidence supporting the early incorporation of chiropractic care, acupuncture and physical therapy for a multitude of painful conditions. Moving these treatments onto the front lines in the thoughts of health care providers and the public has been shown to decrease opioid use in patients and improve outcomes. We will also discuss the barriers to patients' ability to access these services and potential opportunities to successfully navigate these barriers.

Objectives:
  • Discuss the benefits of early referral to physical therapy, chiropractic care, and acupuncture in terms of decreased
    downstream use of opioids.
  • Describe the role of chiropractic care, acupuncture and physical therapy in the treatment of patients with pain.
  • Discuss the opportunities and barriers for the utilization of non-pharmacological treatments for individuals struggling with pain.

Wednesday, May 6, 2020

Opening Keynote 2 from 9-10:30 a.m.


Harm Reduction and Public Health 
Mark Kinzly

Details TBA

Breakout Sessions 17-24 from 10:45 a.m.-Noon
17
MIH and MORI: More than Just Acronyms
Amber Davis and Laura Reid Michael Wright and Amanda Rodriguez

Details TBA

18
Infections Related to Injection Drug Use Can Be Prevented and Treated: A Call to Action to Improve Access to Prevention and Treatment in Wisconsin
Amber Davis and Laura ReidMatt Hazelberg, Jennifer Jaeger, Ruth Kopeke, Kailynn Mitchell
While injection drug use has increased nationwide and in Wisconsin, infections commonly acquired through injection drug use have also increased substantially. This workshop will describe the trends, prevention, and treatment of infections commonly acquired through injection drug use, focusing on hepatitis C, the most common blood-borne illness in the United States. An estimated 70,000-95,000 Wisconsin residents have hepatitis C, but only half have been diagnosed, and only a small proportion have received treatment to cure their hepatitis C.
  • The Department of Health Services (DHS) will describe trends in infections associated with injection drug use in Wisconsin, and how DHS is working with state and community partners to improve access to prevention and treatment services for people who inject drugs.
  • Representatives from community-based harm reduction programs will describe the prevention services they provide, including the materials essential for sterile injection to reduce the risk of disease transmission. They will provide examples of the work they do in their community and provide examples of factors that can impact the likelihood of disease transmission among their program participants.
  • Finally, the audience will learn that receiving curative treatment for hepatitis C has never been more accessible in Wisconsin than it is today. Wisconsin Medicaid and the Wisconsin Department of Corrections provide treatment to people who use drugs.
Nevertheless, most people with hepatitis C have not received treatment. To reduce the burden and spread of hepatitis C in Wisconsin, we all need to work together to find opportunities to increase the number of people cured of hepatitis C. This includes educating health care systems and people with hepatitis C about the importance of treating hepatitis C among people who use drugs. In addition, we all need to work together to remove any remaining barriers to accessing treatment within health care systems.

Objectives:
  • Learn about common infections among people who inject drugs
  • Learn about examples of community-based harm reduction programs aimed at preventing infections among people who inject drugs
  • Learn about the importance of testing for hepatitis C and accessing treatment for hepatitis C
19
Loved Ones and the Ones They Love
Amber Davis and Laura Reid Panel Presentation

Details TBA

20
Dispelling the Stigmas about Medicated-Assisted Treatment
Amber Davis and Laura Reid Andrew Schreier
In today's opioid epidemic, medicated-assisted treatment (MAT) has been supported by SAMHSA, NIDA and other organizations as 
evidenced-based; yet it still faces several stigmas associated with its application and use for treating people with opioid use disorder. Individuals struggling with substance use disorders and professionals helping them are no stranger to stigmas associated with alcohol and drug use. Stigmas negatively impact how the individual views themselves, their willingness to seek treatment, and receiving the support and services they need in order to recover.  

Unfortunately, the stigmas towards people with use disorders, and even the treatment methods to help people recover, also occur within professional settings. Licensed Professional Counselors, Marriage and Family Therapists, Psychologists, Psychiatrists, Doctors, and other helping professionals are vulnerable to stigmas connected to treatment methods associated with helping people recover. Ask yourself, "What happens when a client tells me they are using methadone to treat their addiction? What thoughts do I have when someone is seeking help for their mental health and inform me they are also using Buprenorphine? Do I hold some of the beliefs such as they are substituting one drug for another? If so, how do these views impact how I treat this individual and others who are seeking treatment to stop their opioid use?"

Addressing stigmas within the helping profession towards medicated-assisted treatment is crucial in helping those who are seeking to stop their opioid use and hopefully work towards a plan to recover. The best ways to start overcoming these stigmas is by identifying some of the current ones about MAT, review the paradigm shift in how medicated-assisted treatment programs provide services to patients, and learn about the benefits and limitations of MAT for those currently and potentially seeking services.

Objectives:

  • Identify some of the stigmas towards medicated-assisted treatment and the impact it has on people seeking/receiving treatment, their family members and loved ones, as well as the professionals who are trying to help them recover.
  • Discuss and review the paradigm shift from how medicated-assisted treatment was viewed in the past and the efforts it strives to make today in fighting the opioid epidemic and other issues related to mental health and substance use.
  • Learn the benefits and limitations of medicated-assisted treatment and identify ways to build support and connection with other service providers.
21
State Opioid Response: Past, Present, Future
Jason Harris and Dean Krahn

This will be aa interactive presentation to include a brief over view of what strategies have been implemented through federal opioid grant funding, what is currently happening and what is planned for future implementation. The presentation will also discuss strategies for addressing co-occurring disorders and provide updates related to the State Opioid Response Grant.  The presenters will also be seeking feedback from participants who have been or plan to provide services within the state related to what their experience has been and the challenges they face.

Objectives:

  • Understand how current federal grant funding is being utilized
  • Become familiar with the evidence and benefits of implementing MAT in EDs, prisons, and jails
  • Understand the importance of and strategies for providing immediateaccess to MAT
22
Resilient Wisconsin: Connected, Stronger, Thriving
Amber Davis and Laura Reid Robin Matthies

Details TBA

23
Multiple Pathways to Recovery: Igniting the Fitness Journey
Adam Kindred

Details TBA

24
Neonatal Opioid Withdrawal Syndrome in Native Americans
Ted Hall
Details TBA

 
__________________________________________________________________________________________________

Plenary Session from 1-2:30 p.m.

"Wisconsin Attorney General Josh Kaul and DHS Secretary" 
Speaker: Designee Andrea Palm

Breakout Sessions 25-32 from 2:45-4 p.m.
25
Opioid Prevention Grant: Past, Present, and Future
Sara SchreiberPanel Presentation

Details TBA

26
Employer Toolkit for the Opioid Crisis
 Representative from the MN Department of Health

Details TBA

27
Invisible Impacts of Caregiver Substance Addiction
Donna Rifken
The opioid and substance abuse crisis has traumatic impacts on children and youth in both obvious and silent ways.  Caregivers who are preoccupied with meeting their substance use needs are often not available to make a meal, wash their children's clothes, or help them with homework. They may end up incarcerated off and on which leads to their children being placed out of their homes. There are silent and equally traumatic impacts of caregiver substance use that include failure to establish and nourish attachment bonds between caregiver and child. The basis for attachment and learning is the 'serve and return' interaction between a child and their caregiver. That is, a child 'serves' an invitation to interact and the caregiver 'returns' the serve by attending to the child and meets their need. If the caregiver is physically present but emotionally unable to 'return' a child's 'serve', then the child eventually comes to believe that adults are uninterested, don't care, and won't/can't help. These weak attachment bonds then form the basis for interactions with other adults at school and in the community. Children with impaired attachment bonds due to caregiver substance abuse are more likely to show behavior and learning impairments at school.
Understanding how attachment develops and how caregiver-child ruptures can be repaired is an important skill for substance use providers.

Objectives:

  • Understand how caregiver-child attachment is built and strengthened
  • Review the ways that caregiver substance abuse negatively impacts attachment bonds
  • Explore 3 ways that caregivers can repair the ruptures in attachment bonds and strengthen 'serve and return'
    interactions with their children.
28
Opioid Crisis: How Jails Can Help
Brent Gibson

Details TBA

29
GunderKids: Substance Use Disorder and Its Impact on Families
Charles Schauberger

Details TBA

30
Gathering Community Voices: A Listening Session with the DHS Director of Opioid Initiatives 
Paul Krupski and Kate Rifken
The Wisconsin Department of Health Services can only address the opioid crisis with the help of partners and stakeholders statewide providing prevention, intervention, treatment, and recovery services. This session will provide attendees the opportunity to share successes, challenges, and recommendations with the DHS Director of Opioid Initiatives. The landscape of drug use and specifically opioid use has changed over time and input from the community is essential to find solutions to this crisis. As DHS moves forward, feedback from partners is vital to continuing our collaborative efforts and making an impact statewide. As part of this session, DHS staff will also present the most recent statewide, regional, and services data of howingtrends and the current state of the crisis in Wisconsin.

Objectives:
  • Provide an overview of the opioid crisis in Wisconsin using current data
  • Learn from attendees the successes, challenges, and reccomendations from their communities
31
Stigma and MAT: What Deters People From Participating in Evidence-Based Treatment
Brenda Bryson, Amanda Rodriguez, Samuel Spencer, and Michael White

The panel will address and discuss stigma that continues to deter people from participating in evidence-based practices.

Objectives:

  • Discuss and educate audience medication-assisted treatment
  • Evaluate ideological preferences which may be causing bias towards people's recovery
  • Assess examples of stigma and discrimination which lead to negative outcomes for people's recovery
32
Multiple Pathways to Recovery: Igniting the Fitness Journey
Adam Kindred

Details TBA

​Thursday, May 7, 2020

Breakout Sessions 33-40

Sessions TBA

__________________________________________________________________________________________________

Plenary Session from 8:45-10:15 a.m.

"The National Opioid Crisis and How Jails Can Help" 
Speaker: Brent Gibson and Dennis Lemma

__________________________________________________________________________________________________

Plenary Session from 10:30 a.m.-Noon

"The Voice of Lived Experience: The Greatest Story Ever Told" 
Panel Presentation

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