Conference Agenda & Session Objectives

This internet enduring program will be released on June 22-23, 2020 in the date and time format noted below. Some presenters will be available at those times for interactive, live chats. After June 22-23, all presentations will be available for on-demand viewing through December 31, 2020.

Individuals must complete an evaluation form for each presentation for which they want CEU/CME. Upon completion of an overall program evaluation, certificates will be issued. The program offers up to 29.25 hours of continuing education credits in most fields.
JUMP TO AGENDA FOR MONDAY, JUNE 22

MONDAY, JUNE 22, 2020

Jump down to agenda
for Tuesday, June 23
8:00am Welcome & Administration

Elizabeth F. Howell, MD
[CME Course Director, University of Utah Department of Psychiatry]
Keynote Address: Challenges in the Treatment of Opioid Use Disorder Including Opioid-Related Overdose Deaths, Illicit Fentanyl, and the High Mortality Risk When Patients Stop or Replace Buprenorphine

Jeff N. Wilkins, MD, DFAPA, DFASAM
[Supported By The Opioid Response Network]
The goal for this speaker is to provide you with an evidence-based formulation of the clinical and basic science of the assessment and treatment of opioid use disorders, the role that clinical decisions play in the preventing of opioid use disorders in persons manifesting chronic nonmalignant pain, and the well-established link between methamphetamine and opioid use disorder. This opening talk and the two breakout sessions Dr. Wilkins offers will cover a number of topics and perspectives including historical, basic science of the µ (mu) opioid receptor and its responses to full and partial µ opioid agonists, opioid overdose, clinical care treatment including pharmacotherapy of adults, adolescents, pregnancy and newborns, psychosocial therapy with a focus on contingency management of methamphetamine use disorders, and neurobiological basis for select DSM5 criteria of opioid use disorder. After listening to this nationally recognized expert, you will be able to: 
(1) Trace the history of opioids in the U.S. and the neurobiological background for the DSM5 diagnosis of opioid use disorder; and,
(2) Explain the basic science of the µ opioid receptor relevant to respiratory depression in opioid overdose deaths and the clinical science that informed future treatment of opioid use disorder dating back three & four decades.
9:20am BREAK
9:30am ONLINE SESSION #1
Case Studies in the Treatment of Opioid Use Disorder

Jeff N. Wilkins, MD, DFAPA, DFASAM
[Supported By The Opioid Response Network]
In continuing opioid exploration with this expert, you will be able to:
(1) Outline the sources of prescription opioids intended for non-medical use and the differences between full and partial agonists and the implications for the treatment of opioid use disorder (OUD) including potential precipitations of opioid withdrawal; and,
(2) Discuss the opportunities for prevention and OUD in the treatment of chronic pain and the risks of the parallel trends of non-medical sedative-hypnotic use and opioid use.
ONLINE SESSION #2
Cops, Crisis Systems & Partnerships to Deal with Trends On Our Streets

Brian Redd
This presentation will cover the intersection of homelessness, substance abuse, mental illness, and crime and impacts to the community, individuals, and law enforcement. You will also hear about the Utah Drug Monitoring Initiative and the latest trends in illicit drug trafficking and misuse. You will recognize the benefits of multi-disciplinary collaboration and learn of current efforts in Utah addressing these challenges. When you walk away from this program, you will be able to:
(1) Discuss drug seizure trends, the surge in meth use, and other scenarios which are challenging law enforcement; and,
(2) Trace some of the steps law enforcement is taking on the streets and in connecting to various resources and crisis services to deal with these trends in more therapeutic versus punitive approaches.
ONLINE SESSION #3
Moving Toward Evidence-Based Programs: Medication Assisted Treatment (MAT) for Opioid Use Disorder in Utah

Samantha Ball, MPP, PhD; Alyssa Doom, MS; Jeannie Edens, BA; Lauren Prest, DO; Bryan Teuscher, LCSW
While medication-assisted treatment for opioid use disorder has positive, evidence-based effects, large-scale adoption of treatment programming is relatively new. In this presentation, the Gardner Policy Institute and the Pew Charitable Trusts will share their recent research on the gaps in services and barriers to accessing and providing care for opioid use disorder in Utah. This presentation will be followed by a panel discussion for experts in the field. After participating in this presentation, you will be able to:
(1) Provide a detailed explanation of the availability & accessibility of Medication-Assisted Treatment (MAT) for Opioid Use Disorder in Utah; and,
(2) Review a recent report and the views of various stakeholders involved in addressing Utah's Opioid Epidemic.
11:00am BREAK
11:15am ONLINE SESSION #1
The Current Rise in Meth Use by Persons with OUD & Case Discussions of Acute Stabilization & Abstinence Goal Treatment of Meth Use Disorder Using Contingency Management

Jeff N. Wilkins, MD, DFAPA, DFASAM
[Supported By The Opioid Response Network]
As a result of listening to this program, you will be able to:
(1) Trace the history of methamphetamine use in the U.S. and across the globe together with the relevance of the current rise in amphetamine use in persons with opioid use disorder; and,
(2) Delve into the challenges and opportunities of applying contingency management to persons with methamphetamine or combined methamphetamine and opioid use disorder and the extant rollout of CM across US Veterans Administration hospitals and clinics in recent years.
ONLINE SESSION #2
The Psychological Autopsy & Other Methods for Understanding Fatal Drug Overdose

Megan K. Broekemeier, MPH, CHES
[Eligible for 1.25 Suicide Prevention Credit]
The Utah Department of Health created a unique position at the Office of the Medical Examiner aimed at addressing substance use. This position is tasked with improving fatal drug overdose surveillance. Objectives to meet this goal include conducting psychological autopsies (PA) and providing real-time monitoring of drug overdoses. This presentation will discuss both objectives, including the work undertaken to apply the PA methodology to drug overdose and collaborative efforts to make fatal drug overdose data available to decision makers in Utah. At the conclusion of this presentation, you will be able to identify the strengths and weaknesses of PA as a data collection tool and understand what data are available to you and other professionals for making decisions and understanding this public health problem. Once you have heard about the work of this presenter, you will be able to:
(1) Describe statewide drug overdose monitoring tools; and,
(2) Explain the psychological autopsy method and how it has been applied to drug overdose in Utah, including strengths and weaknesses of the tool and lessons learned.
ONLINE SESSION #3
Trifecta is the Judge: The Enigmatic Nexus Between Mental Health & the Law

Mark A. Augustine, BSW; Daniel Lancaster, LCSW; Kristina Swickard, MCJ; Angie Zuehlke, LCSW
Overall, once you hear the perspectives of various experts, you will be able to:
(1) Discuss the issues of competency in mental Health; revised competency rules; lawsuits on 'restoring'; comparisons of medical and forensic / legal models; competency evaluations; legal reviews of evaluations and related matters; then,
(2) Explain why judges 'are the trifectas' and the pros, cons, and potential gaps of this phenomenon.
12:30pm LUNCH BREAK
1:30pm ONLINE SESSION #1
Adverse Childhood Experiences (ACE’s) and Adult Mental Health & Substance Use Disorders: What I Have Learned by Spending 6 Months of My Life in Jail

Edward Redd, MD
Join this great presenter as he covers the following topics:
(1) Research data from studies looking at ACE’s and life-long mental health outcomes and SUD problems;
(2) De-identified typical case scenarios seen in a jail population of patients with SUD including use of substances to self-medicate ongoing mental health challenges related to past traumas;
(3) The effects of ACE’s on brain structure and function and how this may result in a predisposition to develop mental health challenges and SUD; and,
(4) Strategies that can be used to discuss ACE’s with people who have a substance use disorder pitfalls to avoid.
More specifically, once you have participated in this program, you will be able to:
(1) Compare and contrast the use of cannabis for self-medication of mental health disorders and/or trauma versus physical pain such as peripheral neuropathy; and,
(2) Outline the status of cannabis policies, procedures and its connection to ACEs.

ONLINE SESSION #2
The Young, New Face of Systemic Infections & Updates of Those Diseases & IV Drug Related Infections

Dean Mayer, MD, FACP
After hearing from this local expert, you will walk away able to:
(1) Discuss the complexities and most current updates associated with infectious diseases and IV drug-related infections connected to substance use / abuse; and,
(2) Assess individuals for these issues and design treatment plans for such individuals at various ages and stages of life.
ONLINE SESSION #3
Addressing Opiate Addiction from the Inside Out

Todd R. Wilcox, MD, MBA, FACCP
This program will discuss the design and implementation of a comprehensive Medication Assisted Therapy (MAT) program in a large urban jail. You will review staffing and operational issues, treatment issues, and security issues associated with running a program like this in a secure environment. You will also review our 1.5 years of data regarding clinical outcomes, costs, and community successes. You will also review benefits to patients, correctional system, and the community. As a result of connecting with this program, you will be able to:
(1) Provide an outline of the various MAT options and protocols currently believed to be most effective. This shall include indications for use, contraindications, expected courses of treatment, red flags, history, and other elements; and,
(2) Discuss the program components which need to be in place for the greatest efficacy of outcomes along with current studies and potential future directions of MAT.
3:00pm BREAK
3:15pm ONLINE SESSION #1
Real Life Lessons About Expanding Perinatal Addiction Services to Rural Areas

Marcela C. Smid, MD
This local experts will share insights and review real life experiences of expanding perinatal addiction services in rural areas. You will review lessons of an academic and community partnership to improve addiction services for pregnant and postpartum women in a rural community. This will facilitate the ability of you to: (1) Describe the resource and treatment gaps for addiction treatment and specialty pregnancy issues in rural areas along with the unique rural consequences and potential solutions; and, (2) Identify what specialty pregnancy issues exist among substance using clients in rural and urban areas and the added roles and responsibilities which fall to clinicians treating these individuals.

ONLINE SESSION #2
Oral Health Tips for the Non-Dentist Provider to Enhance Treatment

Jeri Bullock, DDS
This lecture is designed to provide non-dentist providers evidence-based, practical applications to identify the most common oral conditions, and the systemic links associated with oral conditions. It will also review how to discuss findings and risk factors with patients and when to refer to a dentist. After learning about the latest findings in this area, you will be able to: (1) Assess the dental needs of clients in various phases of addiction recovery and create a plan that addresses both the dental and recovery needs in tandem for improved long-term recovery outcomes; and, (2) Apply oral health tools along the treatment / recovery course which can enhance patient compliance and success.
ONLINE SESSION #3
HIV-AIDS Updates Related to the Addiction World

Susana Keeshin
After hearing from this expert, you will be able to:
(1) Discuss the complexities and most current updates associated with HIV/AIDS (pre and post exposure) in clients using / abusing substances; and,
(2) Assess these individuals and design treatment plans for them. This shall include considerations specific to various ages and life stages.
4:45pm END OF DAY ONE

TUESDAY, JUNE 23, 2020

Jump back to agenda
for Monday, June 22
8:00am Welcome Back!

Utah Department of Professional Licensing
Utah Division of Substance Abuse & Mental Health
Keynote Address: Addiction: It Isn't All A Brain Disease – Getting Back To Biopsychosocial

David Mee-Lee, MD
There is much information about neurobiology, medication assisted treatment, and addiction as a "brain disease". But what has happened to a biopsychosocial - spiritual perspective addiction and treatment? This presentation highlights advantages and disadvantages of addiction as "brain disease". It argues for holistic multidimensional perspectives. At the end of this keynote address, you will be able to:
(1) Review the current trends to emphasize addiction as a "brain disease" with the pros and cons of this perspective and the clinical implications; and,
(2) Design a treatment plan which incorporates concepts and technologies that bring balance back to understanding and treating addiction.
9:15am BREAK
9:30am ONLINE SESSION #1
ASAM Criteria & How It Drives State & Future Directions

David Mee-Lee, MD
This presentation will review the underlying concepts and the six dimensions of the ASAM Criteria as well as identify what is included in the ASAM Criteria continuum of care. It will discuss what clinical, systems and policy changes are needed to truly implement the spirit and content of the Criteria. As a result of participating in this session, you will be able to:
(1) Outline and describe ASAM Criteria; and,
(2) Discuss the connections of the ASAM Criteria with the science, policies and treatments.
ONLINE SESSION #2
Restoring Neurobiology After Trauma: Supporting Recovery

Susie Wiet, MD
Dr. Wiet will address why understanding the basics of neurobiology of healing are important for recovery from any trauma and any addictive process. This talk will provide an overview of the 5 Pillars of Resilient Health - a framework concept that Dr. Wiet has developed and utilizes for her work with her own clients. She will explain how and why developing these pillars assist with minimizing the need for medication, while restoring health of mind, body, and soul. After hearing from this expert in addictions and trauma, you will be able to:
(1) Explore the neurobiology of homeostasis and survival of stress management and reinforcement as well as the neurobiology of distress and escape; and,
(2) Trace the pathways to resolution and contentment of emotional mastery ((re)regulation pathway) and resiliency (recovery pathway).
ONLINE SESSION #3
Integrating Addiction & Primary Care Services

Jessica Arbogast, FNP; Erika Bunnel, BSN; Shasta Galyon, Advocate; Vale Nielson, Advocate
After gaining insights from these two presenters, you will be able to:
(1) Present the rationale and driving forces supporting the integration of addiction treatment into primary care, private practice settings, jails and other settings and trace its movement and connection in the ACA and Utah Medicaid; and,
(2) Outline the considerations for integration, answer administrative questions and design plans to 'make it happen'.
11:00am BREAK
11:15am ONLINE SESSION #1
Motivating and Engaging Hard-To-Reach People into Accountable, Collaborative Treatment

David Mee-Lee, MD
In the past, helping people change has too often depended on seeing "resistance" as negative, client pathology, "breaking through denial" and strategies that have disempowered and disrespected people. This presentation will focus on how to develop a participatory treatment contract and engage hard-to-reach people in taking responsibility to actually change. As a result of attending this program, you will be able to:
(1) Discuss the issues of client treatment and recovery motivation, engagement and "resistance"; and,
(2) Assess these characteristics in clients and apply techniques to address these issues to improve treatment outcomes.
ONLINE SESSION #2
The Colors of Treatment: Use & Implications of Psychedelics

Paul Thielking, MD
[Eligible for 0.25 Ethics Credit]
Join this expert then be able to:
(1) Provide an overview of the history of psychedelic research in the U.S., the extended moratorium on psychedelic research, the recent resurgence of research, and the latest science around the use of ketamine, psilocybin, and MDMA for psychiatric conditions including depression, PTSD, and SUDs. Then discuss other psychedelic medications including Ayahuasca and Ibogaine; and,
(2) Discuss future research directions and the need for clinical research to better clarify the role of psychedelic medicines in treating substance use disorders and the implications, potential risks and ethical considerations of using psychedelics as a treatment modality for addicted individuals.
ONLINE SESSION #3
U of U Intensive Outpatient Clinic – A Comprehensive Care Model

Stacy Bank, MD; Ryan Morgan, MPH, LCSW
Participants in this session will be able to:
(1) Describe an integrated care model, inclusive of medical and behavioral health; and,
(2) Describe trauma-informed care in a clinical model and review outcomes of interdisciplinary approaches.
12:30pm LUNCH BREAK
1:30pm ONLINE SESSION #1
The Risks & Benefits Of Sucking on a Battery in Your Free Time

Sean Callahan, MD
This expert in the trenches will talk with you about thee history of vaping in the U.S., how it's evolved in the past decade, and its acute and chronic health effects. Specifically, he will discuss e-cigarettes' role as a means to facilitate traditional, combustible tobacco use cessation. Case presentations will likely be included in this conversation. After you've heard all this and more, you will be able to:
(1) Trace the usage patterns of e-cigarettes over the past decade along with the acute and chronic risks of e-cigarette usage; and, trend of vaping, pro and con arguments, health effects, risks, and other aspects; and,
(2) Outline the pros and cons of using e-cigarettes to aid in traditional tobacco cessation.

ONLINE SESSION #2
The Neurological Connection Between Brain Injury & Addiction

Brenden Borrowman, PhD; Wendel Smith, LMT, PhD
Damage to the brain - impact (TBI), trauma (PTSD, ECT), chemical (medications, drugs) - looks the same under fMRI disrupting neurocoupling (blood/oxygenation of brain regions). Balancing the brain to 75% of normal is possible and substantiated without meds or classic psychotherapy. Upon completion of this session, you will be able to:
(1) Outline some current research regarding neuroscience and behavior related to brain insults such as addictions, TBI, and other occurrences; and,
(2) Demonstrate how the brain can be 'rebalanced' to improve behavior, emotion, and daily functioning in said circumstances.
ONLINE SESSION #3
Comprehensive Oral Care Improves Outcomes in Patients with Chronic Substance Use Disorders

Bryan Trump, DDS
Using data from a workforce training program funded by HRSA, you will gain a better understanding of the effects of integrated comprehensive oral healthcare for patients with substance use disorder on SUD therapeutic outcomes. Once you have heard this information, you will be able to:
(1) Report the findings of a 3-year HRSA Workforce Grant and the SUD treatment outcomes when comprehensive oral health care is integrated into SUD treatment; and,
(2) Apply principles in directing the overall healthcare of substance use disorder individuals.
2:45pm BREAK
3:00pm ONLINE SESSION #1
New Ethical Dilemmas in the Age of Technology

Christina D. Boyd, LCSW, LCAC
[Supported By The Opioid Response Network]
[Eligible for 1.5 Ethics Credit]
Technology has brought about an era of incredible possibilities for enhancing behavioral health treatment. With this technology expansion comes a new era of ethical dilemmas that we did not face merely a few decades ago. Social media and the internet have opened our views of the world, and the world’s view of us. This training will examine how technology is impacting our work and how we can respond to the uncertain situations that result. This program will include didactic information and review of new standards coming out in the field to help guide clinicians.
Once you have gleamed information from this program, you will be able to:
(1) Identify positive and negative factors that impact adoption of technology and describe how involvement with social media sites may impact clinician self-disclosure; and,
(2) Name three risks associated with texting / emailing patients and cite at least one media policy implication as it relates to those providing behavioral health services.

ONLINE SESSION #2
Treating the Whole Human with Substance Use Disorder: Complementary & Lifestyle Medicine Therapies in Recovery

Amy De La Garza, MD
Complimentary & Lifestyle Medicine are becoming increasingly relevant in the treatment of chronic conditions including diabetes, autoimmune disease, heart disease and depression / anxiety. Substance Use Disorder is a chronic disease affecting the brain, and therefor may respond favorably to similar interventions. This presenter will discuss various complementary modalities. Nutrition and exercise and hormone considerations as adjunct therapy in SUD.
After enjoying this program, you will be able to:
(1) Identify and discuss risks and benefits of complementary therapies for substance use disorder including medications, acupuncture, yoga, meditation; and,
(2) Discuss the role of nutrition in recovery and the opioid induced androgen deficiency and the role of hormones in recovery.
ONLINE SESSION #3
We’re All in this Together: Lessons from Coalition Building in Tooele County

Kevin L. Neff, CHES; Heidi L. Peterson
As the saying goes, "It takes a whole village to raise one child." Addiction affects us all to some degree, and in our efforts to meet this pressing issue we often have multiple agencies independently trying to address the issue in their own way. Tooele County has a long, storied history of effective coalition-focused prevention and intervention efforts, and through this lecture you can know how you can better be involved with a coalition in your area to combat addiction and the harmful effects. Join these presenters and learn how to form a coalition (or learn how to find one in your area); use data to form a strategic plan; recognize effective evaluation processes; and overcome hurdles in the coalition process. Furthermore, you will walk away from this program able to:
(1) Outline and discuss the gaps in behavioral health and addiction treatment in rural areas as well as the pitfalls and challenges coalitions can face in rural areas and how those challenges can be overcome; and,
(2) Demonstrate skills and diagram best practices for building local public-health related coalitions - with a focus on those concerned with behavioral health and/or addiction.
4:30pm END OF DAY TWO