Substance Use Disorders: Matching to the Right Level of Care

David R. Gastfriend, M.D., DFASAM

Summary:

The goals of evidence-based standards in assessment and placement criteria in treating substance use disorders include: 1) comprehensive, patient-centric evaluation of patients’ needs, strengths and resources; 2) ensuring reliability through standards across providers and systems; and 3) achieving predictive validity, i.e., obtaining the best outcome for patients using the least intensive and restrictive services and settings.

In the 1980s, the American Society of Addiction Medicine began to define a national set of criteria that provides results-based care in the treatment of addiction. Today, The ASAM Criteria are the most widely used set of standards in the United States for placement, continued stay and transfer/discharge of patients with addiction and co-occurring conditions.

This workshop will address six areas or dimension of care needs, multidimensional assessment and placement using ASAM criteria in order to determine the right level of care.

Learning objectives:

      • Contrast usual care approaches with the rationale for standardized multidimensional assessment and placement according to evidence-based decision criteria.
      • Describe the six-dimensional model of assessment using the ASAM Criteria.
      • Implement the principles of utilizing the least intensive and restrictive treatment setting that provides effective care for a given patient’s needs and strengths.

2 CEUs: Requests submitted for Ph.D., PharmD, LADC, CADC, LCSW, LPC, LMFT, and Case Management. Nursing documentation of participation. Pre-registration is required.

Oklahoma LADC: 2.0 total CEUs approved (2.0 Alcohol and Drug Specific)

Kansas LPC & LCPC, Psychologist, LAC & LCAC – meets continuing education requirements for CEUs as described in K.A.R. 102.
Missouri Psychologist – Meets with continuing education requirements as described in Chapter 337.050, 12.(1)
Missouri Social Worker – Application was not made for approval.
Missouri LPC – Verification of training hours and attendance will be provided for required Missouri LPC Continuing Education reporting.
Arkansas Psychologist – Meets with continuing education requirements as described in Arkansas Psychology Board Rules and Regulations 2009, 9.1.A(2)(a).
Arkansas LPC,LADAC – This CE offering is not offered as an NBCC approved seminar.

Please check with your licensing board(s) for approval status.

About the Presenter

David R. Gastfriend, M.D., DFASAM

Dr. Gastfriend is an addiction psychiatrist. At Harvard Medical School, he directed addiction research at Massachusetts General Hospital and was an investigator in the NIDA Cocaine Collaborative Study, NIAAA’s COMBINE Study and NIDA’s Clinical Trials Network. As Vice President at Alkermes, Inc., he directed scientific publications on Vivitrol in clinical, criminal justice and health economics research.

His research led most states to endorse the American Society of Addiction Medicine (ASAM) Criteria. His 150 scientific publications include the books The ASAM Criteria and Addiction Treatment Matching. His ASAM CONTINUUM – The ASAM Criteria Decision Engine® and ASAM’s CO-Triage® tools are being adopted nationwide.

In 2016, he co-founded DynamiCare Health, a nationally-scalable technology for Contingency Management and predictive analytics, winning awards from Harvard Business School, the Commonwealth of Massachusetts, the Governor of Ohio, and the New York Times. He has consulted to governments in Belgium, China, Iceland, Israel, Norway, Russia and the U.S.

Thursday, November 10, 2022, noon – 2:15 p.m.

Registration is now open

Click to register now for November 10, 2022

Please check your “junk” or “spam” folder in addition to your inbox for your webinar access link. Please log-in by 12:00 noon and remain in the session. Workshop concludes at 2:15 p.m.

This is NOT a telephonic presentation. Approvals for this event were based upon this being a live webinar with both video and audio feed. You must be logged into the webinar, using the link provided in order to obtain the educational time credit.

Certificates of attendance will be distributed by Monday November 14 via email with a link for downloading a hard copy if desired. Please check your “junk” or “spam” folder in addition to your inbox.

Motivating the Brain Reward Center for Addiction Recovery

David R. Gastfriend, M.D., DFASAM

Summary:

Among the behavioral approaches to treating substance use disorder, contingency management (CM) is the best-researched, most effective – and yet least utilized. While physiological approaches address withdrawal, craving, and peripheral drivers of addictive behavior and “talk therapies” engage the cortex and consciousness, the target of CM is the fundamental limbic drive center impact of substances of abuse on motivation. CM draws upon principles of operant conditioning, behavioral economics, and gamification. After a half-century of research, clinicians still have numerous concerns: ethics (is it enabling to pay patients money?), resources (where will the money come from?), testing (frequent and visually witnessed drug testing?), & management (who will do the intricate accounting?).

Technology can surmount each of these obstacles. Studies indicate that technology may enhance motivation, e.g., boosting effort in cognitive behavioral therapy, and supporting MAT adherence, and improve treatment attendance and retention.

This workshop will examine the research foundation for enhancing treatment outcomes using contingency management and technologies that help to overcome obstacles.

Learning objectives:

      • Describe the research foundation for enhancing treatment outcomes in patients with substance use disorders using contingency management.
      • Explain the obstacles that have prevented wide-spread adoption of contingency management in routine care.
      • Analyze the utility of various new technologies that have been proposed and implemented to overcome the obstacles to adoption of contingency management.

2 CEUs: Requests submitted for Ph.D., PharmD, LADC, CADC, LCSW, LPC, LMFT, and Case Management. Nursing documentation of participation. Pre-registration is required.

Oklahoma LADC: 2.0 total CEUs approved (2.0 Alcohol and Drug Specific)

Kansas LPC & LCPC, Psychologist, LAC & LCAC – meets continuing education requirements for CEUs as described in K.A.R. 102.
Missouri Psychologist – Meets with continuing education requirements as described in Chapter 337.050, 12.(1)
Missouri Social Worker – Application was not made for approval.
Missouri LPC – Verification of training hours and attendance will be provided for required Missouri LPC Continuing Education reporting.
Arkansas Psychologist – Meets with continuing education requirements as described in Arkansas Psychology Board Rules and Regulations 2009, 9.1.A(2)(a).
Arkansas LPC,LADAC – This CE offering is not offered as an NBCC approved seminar.

Please check with your licensing board(s) for approval status.

About the Presenter

David R. Gastfriend, M.D., DFASAM

Dr. Gastfriend is an addiction psychiatrist. At Harvard Medical School, he directed addiction research at Massachusetts General Hospital and was an investigator in the NIDA Cocaine Collaborative Study, NIAAA’s COMBINE Study and NIDA’s Clinical Trials Network. As Vice President at Alkermes, Inc., he directed scientific publications on Vivitrol in clinical, criminal justice and health economics research.

His research led most states to endorse the American Society of Addiction Medicine (ASAM) Criteria. His 150 scientific publications include the books The ASAM Criteria and Addiction Treatment Matching. His ASAM CONTINUUM – The ASAM Criteria Decision Engine® and ASAM’s CO-Triage® tools are being adopted nationwide.

In 2016, he co-founded DynamiCare Health, a nationally-scalable technology for Contingency Management and predictive analytics, winning awards from Harvard Business School, the Commonwealth of Massachusetts, the Governor of Ohio, and the New York Times. He has consulted to governments in Belgium, China, Iceland, Israel, Norway, Russia and the U.S.

Friday, November 11, 2022, noon – 2:15 p.m.

Registration is now open

Click to register now for November 11, 2022

Please check your “junk” or “spam” folder in addition to your inbox for your webinar access link. Please log-in by 12:00 noon and remain in the session. Workshop concludes at 2:15 p.m.

This is NOT a telephonic presentation. Approvals for this event were based upon this being a live webinar with both video and audio feed. You must be logged into the webinar, using the link provided in order to obtain the educational time credit.

Certificates of attendance will be distributed by Monday November 14 via email with a link for downloading a hard copy if desired. Please check your “junk” or “spam” folder in addition to your inbox.

COVID -19 updates: Parkside’s Response and Recent Changes to Patient Visitation

COVID -19 – Parkside’s response, patient visitation, etc.

If you have questions about COVID-19, or questions about testing, the Oklahoma State Department of Health has a COVID-19 hotline. Call 877-215-8336

If you are showing any sign of possible COVID-19 symptoms, please do not come into Parkside and do not go to an emergency room. Please contact your primary health care provider first. Your provider or a nurse will direct you. If you meet testing criteria, you will be directed to a local testing site.

Parkside is following the evolving COVID-19 situation closely and is prepared for any needed response. Parkside always maintains a robust infection control program and is prepared for emergencies.

Here are some of the steps Parkside is taking to manage the COVID-19:

Monitoring patients: Parkside is actively monitoring patients, staff and visitors to quickly identify those with travel-related risk factors or potential contact with infected people. We are disallowing visitors who are sick from visiting the hospital, as is always our practice during flu season.

Coordinating with public health officials: We are working closely with public health officials at the local, state and national levels to monitor the spread of the virus. Public health officials are providing guidance and Parkside is responding to protect the health and safety of our patients, visitors and staff.

Supplies and facilities: Parkside is monitoring supplies like masks, hand sanitizer and other personal protective equipment and is proactively placing orders for additional supplies. Parkside’s Environmental Services Department is responding with additional cleaning and sanitation measures.

Telemedicine:We are expanding plans for telemedicine visits to assist in managing patient care when appropriate. Telemedicine is also available for inpatient assessments when indicated and can help prevent the spread of disease and prevent unnecessary travel.

Visitation and passes: The safety of our patients, their families, and our staff is of utmost importance at Parkside. Due to the increasing numbers of positive COVID-19 cases in Tulsa County, we have adopted increased safety measures to prevent the spread of COVID-19 in our patient environment.

Parkside has discontinued all on-site visitation effective Monday, July 20. We are offering virtual visitation via Zoom teleconferencing, and will contact familes with details about the days, times, and procedures for these virtual visits. Many families are already using the Zoom app for family therapy participation.

Parkside Response to COVID-19

Parkside Response to COVID-19

With confirmed cases of COVID-19 (Coronavirus) on the rise in Oklahoma and throughout the United States, Parkside is taking proactive steps to ensure the continued safety of our patients and staff.

To reduce the spread of COVID-19, Parkside has implemented the following safety measures:

Active Monitoring:

  • Parkside is screening all patients, visitors, staff, and vendors who enter our buildings to identify any symptomatic people.

  • Parkside is enforcing a 14-day quarantine for all staff members (and those in their household) who have symptoms or have had illness or exposure to COVID-19.

Social Distancing:

  • Parkside staff practice social distancing by allocating 6 feet of physical separation between patients and other staff. We practice this by limiting group sizes, staggering unit schedules, and even coordinating the placement of furniture.

  • Parkside has asked all food delivery drivers and vendors to leave their deliveries at a specified delivery point away from the front desk.

  • We are building video conferencing on the units in the hopes of moving visitation to virtual visits instead of face to face, further reducing exposure.

Coordinating with Public Health Officials:

  • Parkside works closely with public health officials at the local, state, and national level to monitor the spread of the virus and enact timely preventive measures in response.

  • Parkside attends conference calls with the Oklahoma Hospital Association (OHA), Centers for Medicaid and Medicare Services (CMS), Tulsa Health Department, and other teleconferences and webinars daily.

Supplies and Facilities:

  • Parkside is monitoring supplies like masks, hand sanitizer and other personal protective equipment and is proactively placing orders for additional supplies, if needed.

  • Parkside’s Environmental Services Department is responding with additional cleaning and sanitation measures.

Telemedicine:

  • All of our outpatient programs are now available fully online, from assessment to treatment. This will take place through secure video conferencing, allowing you or a loved one to receive needed treatment.

  • Telemedicine is also available for inpatient assessments to help prevent the spread of disease and unnecessary travel.

Visitation and Passes:

  • Parkside has limited the number of visitors to immediate family and one visitor per patient.

  • The Adult Unit is closed to visitation until further notice. Child and Adolescent Unit visitors are limited to immediate guardians only.

  • A visitor must follow prescribed protocol, including a short risk-assessment survey, a scan of the forehead to check temperature for any sign of fever, and use of hand sanitizer before visitation.

  • Visitation rooms are cleaned and sanitized after each use.

  • Child and Adolescent passes off campus have been suspended.

  • Parkside will limit the number of persons who accompany those coming for assessment or admission. Please help by not bringing any extra persons or family members.

Frequently Asked Questions (FAQ)

Is Parkside Still Open?

Yes, we are committed to high quality, compassionate care, and that will not change. We remain available 24/7 to screen and accept patients into all of our inpatient and outpatient programs. Mental health and addiction treatment should not wait, and we are taking every precaution possible while continuing to offer needed treatment.

Is Online Therapy Available?

All of our outpatient programs are now available fully online, from assessment to treatment. This will take place through secure video conferencing, allowing you or a loved one to receive needed treatment. Also, our inpatients will be able to use video conferencing for Family Therapy.

My Child Is a Patient of Parkside’s Inpatient Program. Can I Visit Them?

Child and Adolescent Unit visitors are limited to immediate guardians only and one visitor per patient. A visitor must follow prescribed protocol, including a short risk-assessment survey, a scan of the forehead to check temperature for any sign of fever, and use of hand sanitizer before visitation.

My Spouse is a Patient of Parkside’s Inpatient Program. Can I Visit Them?

The Adult Unit is closed to visitation until further notice. We are in the process of building video conferencing on the units in the hopes of moving visitation to virtual visits.

I Suspect That I May Have COVID-19. What Should I Do?

If you develop a fever or cough or have difficulty breathing, or have had close contact with someone who has had a presumptive positive or confirmed positive COVID-19 test result, please seek medical attention by calling your provider’s office. For more information regarding the coronavirus, visit the Centers for Disease Control and Prevention (CDC) website.

For general questions about COVID-19, please call the Oklahoma State Department of Health’s 24/7 call center at 1-877-215-8336. This call center has the capability to connect callers to Spanish-speaking interpreters.

You may also call the Tulsa Health Department at 918-582-9355 during normal business hours for guidance.

What Preventive Measures Can I Take to Avoid COVID-19?

Below is a list of CDC recommendations and preventive measures.

  • Maintain 6ft of distance between others and avoid crowded places.
  • Wash and soap your hands often and for at least 20 seconds; especially after using the bathroom, before eating, and after blowing your nose, coughing or sneezing. Try to avoid touching your face.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with 60–95% alcohol.
  • Routinely clean frequently touched surfaces and objects.
  • Cover coughs and sneezes with a tissue, then dispose of the tissue.
  • Stay home when you are sick with respiratory disease symptoms.

COVID-19 Updates & Resources

https://www.tulsa-health.org/COVID19

https://coronavirus.health.ok.gov/what-you-should-know

Fact-Checking COVID-19

Along with reliable information, there is unreliable information circulating about COVID-19.

Below are two resources to help discern fact from fiction:

Factcheck.org Issues: Coronavirus

Stories tagged ‘COVID-19’ on Snopes.com

Parkside responds to the COVID -19 situation

Parkside is following the evolving COVID-19 situation closely and is actively preparing for any needed response. Parkside always maintains a robust infection control program and is prepared for emergencies.

Here are some of the steps Parkside is taking to manage the COVID-19:

Monitoring patients: Parkside is actively monitoring patients, staff and visitors to quickly identify those with travel-related risk factors or potential contact with infected people. We are disallowing visitors who are sick from visiting the hospital, as is always our practice during flu season.

Coordinating with public health officials: We are working closely with public health officials at the local, state and national levels to monitor the spread of the virus. Public health officials are providing guidance and Parkside is responding to protect the health and safety of our patients, visitors and staff.

Supplies and facilities: Parkside is monitoring supplies like masks, hand sanitizer and other personal protective equipment and is proactively placing orders for additional supplies. Parkside’s Environmental Services Department is responding with additional cleaning and sanitation measures.

Telemedicine:We are expanding plans for telemedicine visits to assist in managing patient care when appropriate. Telemedicine is also available for inpatient assessments when indicated and can help prevent the spread of disease and prevent unnecessary travel.

Visitation and passes: The Adult Unit is closed to visitation until further notice. Adults may attend family therapy. Child and Adolescent Unit visitors are limited to the immediate guardians only and must follow a prescribed protocol including: a short risk-assessment survey; a scan of the forehead to check temperature for any sign of fever; use of hand sanitizer before visitation. Visiting areas are cleaned and sanitized after each use. Child and Adolescent passes off campus have been suspended. Parkside will limit the number of persons who accompany those coming for assessment or admission. Please help by not bringing any extra persons or family members.

Parkside Opens New Facility

Parkside Opens New Psychiatric Hospital and Outpatient Clinic

February 5, 2020 (Tulsa, OK) – Parkside Psychiatric Hospital & Clinic opened their new hospital this week that expands access to mental health care in Oklahoma. The new hospital, located at 1239 S. Trenton Ave., features 80 single-occupancy patient rooms for children, adolescents, and adults experiencing acute mental health crises.

“Our vision to expand world-class mental health care has finally come to fruition,” said Debra Jones, CEO of Parkside. “The new hospital now allows Parkside to increase the number of patients we treat each day and effectively remove barriers to treatment.”

Over the past year, Parkside was unable to serve 486 individuals due to unavailable beds because of patient gender.

“The new hospital serves a critical need for Oklahoma and even surrounding states,” said Darren Sanchez, Parkside’s Assessment and Referral Director. “In the past, our available beds for inpatient admissions were in semi-private rooms and not always open to the gender needs of presenting patients at any given time. However, 80 single-occupancy patient rooms in our new hospital now provides greater privacy for our patients while expanding access to care.”

Also, the new 114,500 square-foot hospital offers secure open-air balconies for each inpatient floor and provides enhanced space for groups and recreation. Combined with Parkside’s Adolescent Residential unit, Parkside now has 120 hospital beds operating in two separate buildings on the same campus.

Serving the community since 1959, Parkside’s mission is to provide outstanding mental health and support services. Parkside is a not-for-profit psychiatric hospital and outpatient clinic that has helped those coping with mental health and substance abuse problems since 1959. In 2018, 2,050 patients were admitted, and 1,305 patients received outpatient care.

Parkside’s Assessment and Referral service is now located at 1239 S. Trenton Ave., and can be reached 24 hours a day at (918) 588-8888. For more information about Parkside, visit www.parksideinc.org.

Parkside to Host Open House at New Psychiatric Hospital

December 3, 2019 (Tulsa, OK) – Parkside Psychiatric Hospital & Clinic is offering a sneak peek of their new hospital that will increase access to mental health care in Oklahoma. Parkside’s community open house is scheduled for Monday, December 16 from 3:00 – 5:00 p.m.

Parkside staff will be on hand to provide tours of the new 114,500-square-foot hospital before it opens for patient care next month. The new hospital, located at 1239 S. Trenton Ave., will feature 80 single-occupancy patient rooms for children, adolescents, and adults experiencing acute mental health crises.

“Our vision to expand world-class mental health care is finally coming to fruition,” said Debra Jones, CEO of Parkside. “The new hospital will allow Parkside to increase the number of patients we treat each day and effectively remove barriers to treatment.”

Over the past year, Parkside was unable to serve 486 individuals due to unavailable beds because of patient gender.

“This will serve a critical need for Oklahoma and even surrounding states,” said Darren Sanchez, Parkside’s Assessment and Referral Director. “Currently, our available beds for inpatient admissions are in semi-private rooms and not always open to the gender needs of presenting patients at any given time. However, 80 single-occupancy patient rooms in our new hospital will provide privacy for our patients and expand access to care.”

In addition, the new hospital will offer secure open-air balconies for each inpatient floor and provide enhanced space for groups and recreation.

Parkside’s open house is free and open to the public, but pre-registration is required. To RSVP for the event, please contact Derek Frazier at (918) 586-4251 or dafrazier@parksideinc.org.

Serving the community since 1959, Parkside’s mission is to provide outstanding mental health and support services. Parkside is a not-for-profit psychiatric hospital and outpatient clinic that has helped those coping with mental health and substance abuse problems since 1959. In 2018, 2,050 patients were admitted, and there were 1,305 patients who received outpatient care.

Parkside’s Assessment and Referral service is located at 1619 E. 13th St. and can be reached 24 hours a day at (918) 588-8888. For more information about Parkside, visit www.parksideinc.org.

Addiction Medicine Expert to Speak in Tulsa

Parkside Psychiatric Hospital & Clinic (Parkside) will host John F. Kelly, PhD, ABPP, from 8:30 a.m. to 3:15 p.m. on November 14 for professional education centered on addiction medicine, evidence-based practice for substance use disorders and related matters of policy and research. The event, which will take place in the Perkins Auditorium at the OU Schusterman Center, is now open for registration. Cost is $109 and provides five continuing education units for mental health professionals and pharmacists. Students can purchase tickets for $79.

Dr. Kelly’s seminar, titled “Substance Use Disorder: 50 years of Policy, Research, and Treatment,” will cover government policy action and impact, changes and advancements in treatment during the past 50 years examining the clinical paradigm shifts that have occurred and a focus on current evidence-based treatments for addressing substance use and related problems.

Dr. John Kelly is the Associate Professor of Psychiatry in the Field of Addiction Medicine at Harvard Medical School. Dr. Kelly is also the founder and Director of the Recovery Research Institute at Massachusetts General and the Associate Director of the Center for Addiction Medicine. Dr. Kelly has served as a consultant to U.S. federal agencies including the White House Office of National Drug Control Policy and the Substance Abuse and Mental Health Services Administration (SAMHSA). He has published more than 140 peer-reviewed articles and currently works with Psychology Today magazine as a monthly contributor.

Parkside is a private, nonprofit, mental healthcare and substance abuse treatment provider offering inpatient and outpatient care to Oklahoma children, adolescents and adults. More information and registration is available at www.parksideinc.org.