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Medications for Opioid Use Disorder Save Lives (2019)

Chapter: Appendix B: Public Workshop Agenda

« Previous: Appendix A: Study Approach and Methods
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
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Page 141
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
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Page 142
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
×
Page 143
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
×
Page 144
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
×
Page 145
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
×
Page 146
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
×
Page 147
Suggested Citation:"Appendix B: Public Workshop Agenda." National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. doi: 10.17226/25310.
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Page 148

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Appendix B Public Workshop Agenda Keck Center E Street Conference Room 500 Fifth Street, NW, Washington, DC 20001 DAY 1: OCTOBER 29, 2018 OPEN SESSION 1:00pm Opening Remarks to Public Audience •  Alan I. Leshner, Ph.D., Committee Chair Chief Executive Officer Emeritus American Association for the Advancement of Science 1:10pm Presentation by Sponsoring Agencies • Jack B. Stein, M.S.W., Ph.D. Director, Office of Science Policy and Communications National Institute on Drug Abuse •  Deepa Avula, M.P.H. Director, Office of Financial Resources Substance Abuse and Mental Health Services Administration •  Rebecca Baker, Ph.D.  Special Assistant to the Director National Institutes of Health 1:30pm Sponsor Q&A with Committee • Alan I. Leshner, Committee Chair 141

142 MEDICATIONS FOR OPIOID USE DISORDER SAVE LIVES Time to ask clarifying questions to understand scope and charge of the Statement of Task 2:30pm Adjourn Open Session DAY 2: OCTOBER 30, 2018 OPEN SESSION 8:30am Welcome and Opening Remarks • Alan I. Leshner, Committee Chair Chief Executive Officer Emeritus American Association for the Advancement of Science • Victor J. Dzau, National Academy of Medicine (via video) SESSION 1: FEDERAL INITIATIVES 105-minute session (brief 5- to 7-minute panelist presentations followed by moderated discussion and Q&A) 8:45am  bjectives: O • iscuss current federal efforts to improve treatment for  D ­ pioid use disorder (OUD) and access to medication-assisted o treatment and hear perspectives from the study sponsors, N ­ ational Institute on Drug Abuse and Substance Abuse and Mental Health Services Administration. Moderator: • Alan I. Leshner, Committee Chair Chief Executive Officer Emeritus American Association for the Advancement of Science Panelists: • Nora Volkow, National Institute on Drug Abuse • Deepa Avula, Substance Abuse and Mental Health ­Services Administration • Molly Evans, U.S. Centers for Disease Control and Prevention • Judith Steinberg, Health Resources and Services Administration • Rigo Roca, U.S. Food and Drug Administration 10:30am BREAK

APPENDIX B 143 SESSION 2: CURRENT EVIDENCE AND PRACTICE ON MEDICATION FOR TREATING OPIOID USE DISORDER 120 minutes (25-minute opening presentation followed by moderated panel discussion) 10:45am Objectives: • Discuss current evidence on the effectiveness of specific medications used to treat OUD. • Identify evidence gaps that might contribute to limited effec- tiveness of specific medications or limit the use of medica- tions in treating OUD, i.e., dosing ranges, optimal duration of treatments, discontinuation, optimal duration of tapering medication, and real-world evidence on patient experiences and preferences. • For each medication, examine the regulations, infrastruc- ture, and care settings required for delivery of specific medi- cations for OUD, and explore how this influences patient and provider preference when selecting treatment. • Discuss the evidence for behavioral counseling as a compo- nent of treatment for OUD. Are the current requirements for counseling evidence-based? • Identify barriers to the use of specific medications, includ- ing any long-term side effects of medications for treating OUD and the perception and stigma of treatment ­ ptions by o p ­ atients, providers, the general public, and law enforcement. Moderator: • Kathleen Carroll, Yale School of Medicine Opening Presentation: • Charles O’Brien, University of Pennsylvania Panelists: • Gavin Bart, University of Minnesota • Michelle Lofwall, University of Kentucky • Adam Bisaga, Columbia University Medical Center • John Brooklyn, University of Vermont • Maia Szalavitz, American reporter and author 12:45pm LUNCH

144 MEDICATIONS FOR OPIOID USE DISORDER SAVE LIVES SESSION 3: IMPLEMENTATION AND UPTAKE: OPPORTUNITIES AND BARRIERS 1:45pm Panel 3a: Opportunities and Barriers—Education and Training to Expand Treatment (Brief 5- to 7-minute panelist presentations followed by moderated discussion and Q&A) Objectives: •  Examine the currently required education and training for providers treating OUD, and identify best practices and hurdles to achieving the required workforce to treat OUD. •  Explore the makeup of an ideal OUD treatment workforce, and discuss how this workforce may change based on care settings, populations, regions, and availability of medica- tion for the treatment of OUD. • onsider educational requirements for clinicians (surgical C services, primary care, emergency departments, pharma- cists), counselors, social workers, and others. • iscuss what patient and family education or resources D should be provided. •  Identify best practices and education for policy makers, law enforcement, the public, and other stakeholders. Moderator: Chinazo Cunningham, Albert Einstein College of Medicine Panelists: • Jeanette Tetrault, Yale University • Stephen Patrick, Vanderbilt University • Eugenia Oviedo-Joekes, University of British Columbia • Jules Netherland, Drug Policy Alliance • Kathleen Johnson, Advocates for Opioid Recovery 3:15pm BREAK

APPENDIX B 145 3:30pm Panel 3b: Opportunities and Barriers—Health Care Delivery, Payment Approaches, and Economics Measures to Improve Treatment of OUD 90 minutes (15-minute opening presentation followed by moderated panel discussion) Objectives: • iscuss how health care access and delivery affect patient D access to medications to treat OUD; consider regulations around hospital capacity, administrative burdens, and the tight regulation of medical products. •  Explore the cost, reimbursement, and coverage of medica- tions to treat OUD, and discuss measures to help facilitate quality improvement and access. •  Examine regulatory differences of for-profit versus non- profit treatment providers. Moderator: • Colleen Barry, Johns Hopkins Bloomberg School of Public Health Opening Presentation: • Richard Frank, Harvard University Panelists: • Allan Coukell, Pew Charitable Trust • Katrina King, George Mason University • Yngvild Olson, Medical Director, Institutes for Behavior Resources, Inc. 5:00pm Day 1 Recap and Closing Remarks •  Alan I. Leshner, Committee Chair, Chief Executive Officer Emeritus, American Association for the Advancement of Science 5:15pm Adjourn

146 MEDICATIONS FOR OPIOID USE DISORDER SAVE LIVES DAY 3: OCTOBER 31, 2018 OPEN SESSION 8:30am Welcome and Opening Remarks •  Alan I. Leshner, Committee Chair Chief Executive Officer Emeritus American Association for the Advancement of Science 8:45am Panel 3c: Opportunities and Barriers—Social Determinants of Health and Treatment for OUD (Brief 5- to 7-minute panelist presentations followed by moderated discussion and Q&A) Objectives: •  Explore the impact of comorbidities on treatment and how this may affect the uptake and overall effectiveness of medi- cations to treat OUD. • onsider how pregnancy, age, race, gender, genetic vari- C ables, mental health, chronic pain, and other factors may influence treatment. •  Identify further evidence needed to better deliver culturally appropriate care and serve diverse populations. Moderator: David Patterson Silver Wolf, Washington University •  Panelists: • Helena B. Hansen, New York University • Josiah Rich, Brown University • Anand Kumar, University of Illinois at Chicago • Mishka Terplan, Virginia Commonwealth University 10:15am BREAK

APPENDIX B 147 SESSION 4: KNOWLEDGE GAPS—FUTURE RESEARCH AND NEXT STEPS 90 minute session (brief 5- to 7-minute panelist presentations followed by moderated discussion and Q&A) 10:30am Objectives: • iscuss required research on U.S. Food and Drug Admin- D istration (FDA)-approved and non-FDA-approved medica- tions for the treatment of OUD; consider patient preferences, d ­ elivery mechanisms, patient population (e.g., demographics or severity of OUD), and how different treatment settings may affect the research required. •  Identify patient outcome measures and process measures to facilitate the development of best practices for treating OUD. •  Identify research needs and policy changes to advance treat- ment and recovery. Moderator: • Yasmin Hurd, Icahn School of Medicine at Mount Sinai Panelists: • Sharon Walsh, University of Kentucky • Gail D’Onofrio, Yale University • Jonathan H. Watanabe, University of California, San Diego • Jessica Hulsey Nickel, Addiction Policy Forum SESSION 5: PUBLIC COMMENT 30-minute session 12:00pm Objective: •  embers of the public are invited to sign up to provide M comments on the workshop topic (3 minutes each) Moderator: •  Alan I. Leshner, Committee Chair Chief Executive Officer Emeritus American Association for the Advancement of Science

148 MEDICATIONS FOR OPIOID USE DISORDER SAVE LIVES 12:30pm Meeting Recap and Closing Remarks • Alan I. Leshner, Committee Chair Chief Executive Officer Emeritus American Association for the Advancement of Science 12:45pm Adjourn

Next: Appendix C: Biographical Sketches of Committee Members »
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The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already exist—like evidence-based medications—are not being deployed to maximum impact.

To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

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