Is this your first time at the Rx Summit, or are you a returning attendee looking to optimize your time at the conference? Join us for an informational session on getting the most out of your Rx Summit experience, including navigating the event venues, accessing conference information, selecting sessions, visiting special features onsite, and exploring the exhibit hall.

Location: A311-312 GWCC - Grant funds can be critical to implementing responses to the opioid and addiction epidemic. This two-session workshop will provide the practical tools, techniques, and insights needed to craft compelling grant proposals that stand out and secure funding for your projects. The instructor is a grant writer with decades of experience, who has brought in more than $100 million in competitive grant funding over a six-year period. While designed for intermediate learners, these sessions will have something for everyone. <br><br>Part 1: Learn how to create data-supported statements of need while also incorporating narratives that connect with and resonate emotionally with funders.<br><br>Part 2: Discover the impact of using visual elements (graphics, charts, schemes, and visuals) strategically to enhance readability and highlight key information within funding proposal space constraints.

Location: Grand Ballroom ED OMNI - Funded by the Washington/Baltimore High Intensity Drug Trafficking Area (HIDTA), two HIDTA communities in West Virginia and Virginia joined forces to respond to significant substance use and behavioral health needs identified in their justice-involved youth. The Juvenile Justice Probation Office and Court Services Unit are the two primary referral sources to a program the communities have titled CATALIST, which stands for Community-based Assessment and Treatment for Adolescents and families to Launch Interventions for Substances and Trauma. The mission of CATALIST is to offer early intervention, treatment, and recovery services for justice-involved youth ages 12 to 17 with substance use or co-occurring disorders and their caregivers with similar needs. The communities leveraged their individual infrastructures and resources in unique ways to implement the model while maintaining fidelity to its evidence-based strategies. Berkeley County, West Virginia, operationalized its CATALIST program within its Berkeley County Community Corrections Day Report Center. The City of Winchester in Virginia integrated its model ultimately into its established healthcare system.<br><br>This session will describe the different journeys the two communities took to arrive where they are today in making a difference for justice-involved youth. Core components of the CATALIST model will be discussed, and outcomes from the first two years of operation will be presented.

Location: International Ballroom F OMNI - The Drug Abuse Warning Network (DAWN) is a nationwide public health surveillance system that captures data on emergency department (ED) visits related to recent substance use directly from the electronic health records of participating hospitals. Key objectives of DAWN are to monitor and identify trends in substance-related ED visits; provide timely data and serve as an early warning system identifying emerging and novel psychoactive substances and/or combinations of substances; and provide national estimates. <br><br>This session will cover:<br><br>1. Introduction ― DAWN background and vision.<br><br>2. Methodology for hospital selection for early warning ― The DAWN design ensures representation from areas characterized by social vulnerabilities of high-risk populations. Hospital selection utilized geographic characteristics to support epidemiologic investigations, better allocation of resources for prevention, treatment, and recovery for policymakers and public health officials. <br><br>3. National estimates of substance-related ED ―DAWN captures detailed substance data with more specificity compared to traditional methods. This section will provide an overview of national drug-related ED estimates and types of surveillance findings available for public health. <br><br>4. Innovative surveillance analytic methods ― Drug surveillance is continuously evolving with increased need for flexible systems to monitor emerging trends. This section will summarize DAWN’s utilization of unstructured text data and applications of natural language processing.

Location: A313-314 GWCC - Substance use disorder (SUD) presents a multifaceted challenge due to the combination of risk factors contributing to its development and its co-occurring conditions. Recovery housing and other recovery support services connect individuals to services and supports that build recovery capital. Meaningful employment has been shown to be an important factor in building recovery capital, and impacts recovery outcomes such as abstinence and quality of life. As individuals in recovery often face substantial barriers to employment―such as past criminal justice involvement, gaps in employment history, lack of employer-required documentation, upskilling, and employers’ lack of recovery awareness―innovative and comprehensive approaches to reduce these barriers are needed.<br><br>This session will discuss a comprehensive, grassroots workforce development pilot program centered on employment coaches and community partners implemented in six recovery houses across the United States, as well as the role of a State Chamber of Commerce in supporting recovery to work. Presenters will discuss key program components, such as employment coach qualifications and objectives including identifying, educating, and supporting recovery-friendly employers and building employer-recovery home relationships, strengthening residents’ employability factors via use of innovative technological tools, and identifying and addressing employment barriers. Further, they will present preliminary data from 132 participating residents and six employment coaches. Lastly, as second-chance employment initiatives are best supported when entities from all levels of communities are engaged and working together, they will share state-level best practices from the state of Kentucky, where substantial progress in this arena has been made.

Location: International Ballroom A-D OMNI - For many, a courtroom can feel like the end of the story. But in Eastern Kentucky, walking into a courtroom can provide individuals with the opportunity to start a new chapter. Here, community stakeholders are collaborating to improve outcomes for justice-involved individuals impacted by substance use and other behavioral health conditions. This model has proven successful in connecting one of our most vulnerable populations with the evidence-based treatment, clinical care, and comprehensive services they need to lead healthier lives and recover from substance use disorders.<br><br>In this session, participants will hear from some of the individuals behind this collaboration and learn the steps to take to bring these successful programs and initiatives to their own communities. Presenters will incorporate data at both the national and state levels. The session will be relevant to anyone working with or in support of justice-involved individuals―particularly those who are looking for ways to better bridge the gap between substance use disorder and behavioral health providers and the court system.

Location: A412 GWCC - Youth substance abuse prevention messages have traditionally emphasized the need to “Just Say No” in the face of pressure. A new generation demands a new approach to drugs and alcohol: the encouragement to say YES to a life that is better without substances.<br><br>The BETTER WITHOUT IT™ initiative (@betterwithout.it) meets Gen Z (primarily ages 13 to 25 years old) where they are ― not only with clear, objective information about the dangers of drugs and alcohol, but also a critical message of empowerment. Used as social marketing and social norms campaigns, BETTER WITHOUT IT™ helps teens and young adults understand that their minds, their bodies, and their relationships are already better without illicit substance use. <br><br>Using BETTER WITHOUT IT™ as a case study, this session will provide insights into the values of Generation Z and discuss the opportunity of engaging them via a positive youth development approach. Presenters from CTS Agency will share practical takeaways from directing this youth engagement campaign with the goal of shining a light on young people’s strengths. The executive director of the Brevard Prevention Coalition will present the principles behind these approaches and how to build partnerships that further utilize these strategies.

Location: Grand Ballroom A-D OMNI - The illicit drug supply is highly variable and subject to change in terms of its potency and the range of adulterating substances that are intermixed with the major drug components. Over recent years, a wide variety of substances have been identified in the illicit drug supply including a number of veterinary drugs, most notably xylazine. However, other drugs―such as medetomidine, dipyrone, levamisole, acetaminophen, phenylbutazone, and gabapentin―have been identified as toxic adulterating substances in drugs being sold and distributed on the street.<br><br>This session will review the most recent data on the prevalence and toxicity of these substances, their effects, and their potential for interaction with fentanyl, cocaine, and other popular recreational drugs. Presenters will discuss in depth the effects of xylazine, a veterinary tranquilizer associated with both significant contributory sedative effects and severe wounds and lesions reported in street opioid users. They also will consider the effects of levamisole an adulterant of both the opioid and illicit stimulant supply. Levamisole is a popular anti-worming agent that can cause vasculitis and immune system effects. The presence of these drugs has multiple implications for patient safety, harm reduction, determination of cause of death, drug scheduling, and education of people who use drugs.

Location: A411 GWCC - In this session, representatives of the Substance Abuse and Mental Health Services Administration (SAMHSA) and Drug Enforcement Administration (DEA) will describe several key overdose prevention strategies and collaborative federal efforts to expand access to medication for opioid use disorder (MOUD).<br> <br>In 2021, 9.2 million people 12 and older misused opioids and more than 16.5% of the population met the criteria for a substance use disorder (SUD). More than 107,000 people lost their lives to a drug overdose that year. As the numbers of people dying by opioid overdose continue to increase, harm reduction provides a practical and transformative approach that incorporates community-driven public health strategies to saving lives and promoting health. SAMHSA, in collaboration with other federal, state, and community partners, is focused on several key overdose prevention strategies. These include the development and public release of a harm reduction framework to inform SAMHSA’s overdose prevention efforts, and a policy academy with states to strengthen access to opioid overdose reversal agents. Presenters will describe these activities, their development, and highlight key actions and lessons learned from them.<br> <br>Presenters also will address how the DEA and SAMHSA are working to make MOUD readily and safely available in response to elimination of the DATA-X waiver in Section 1262 of the Consolidated Appropriations Act, 2023 (the CAA). Section 1263 of the CAA separately instituted a one-time eight-hour training requirement for all DEA-registered practitioners, with the exception of practitioners that are solely veterinarians, on the treatment and management of patients with OUD or other SUDs. As Congressionally mandated, DEA’s roughly 2.1 million registrants have a new role to help patients fighting to sustain recovery and prevent opioid overdoses. DEA and SAMHSA are committed to collaborating with the medical community broadly to ensure safe, easy, and swift access to lifesaving medications for MOUD. Presenters also will discuss collaborative efforts to expand access to methadone treatment in Narcotic Treatment Programs/Opioid Treatment Programs (NTPs/OTPs). This is in an effort to expand MOUD beyond the new opportunities afforded by the Act.

Location: International Ballroom E OMNI - Maintenance medications are often part of treatment plans for patients with chronic diseases, including addiction. Yet few patients being treated for addiction are receiving these medications. Both clinicians and patients need to know the options available to develop the best individualized treatment plan. This session will review the current opportunities for use of Medications for Opioid Use Disorder (MOUD), Alcohol Use Disorder (MAUD), Stimulant Use Disorder (MStUD). Presenters will discuss the recommendations from documents such as the new “Clinical Practice Guideline on the Management of Stimulant Use Disorder (StUD)” that was developed by American Society of Addiction Medicine (ASAM) and the American Academy of Addiction Psychiatry (AAAP); recommendations for MAUD from the Veteran’s Administration, as well as other ASAM and SAMHSA recommendations for the use of MOUD. The national recommendations include “on-label” and “off-label” medication uses as well as oral and injectable formulations. Appropriate goal setting for the use of pharmacotherapy in treatment will be discussed, and operational considerations will be covered in addition to clinical effectiveness data. Attendees will leave the session better able to understand and advocate for improved evidence-based use of pharmacotherapy in addiction treatment.

Location: A311-312 GWCC - Grant funds can be critical to implementing responses to the opioid and addiction epidemic. This two-session workshop will provide the practical tools, techniques, and insights needed to craft compelling grant proposals that stand out and secure funding for your projects. The instructor is a grant writer with decades of experience, who has brought in more than $100 million in competitive grant funding over a six-year period. While designed for intermediate learners, these sessions will have something for everyone. <br><br>Part 1: Learn how to create data-supported statements of need while also incorporating narratives that connect with and resonate emotionally with funders.<br><br>Part 2: Discover the impact of using visual elements (graphics, charts, schemes, and visuals) strategically to enhance readability and highlight key information within funding proposal space constraints.

Location: A313-314 GWCC - The telehealth-only model of opioid use disorder (teleOUD) treatment with buprenorphine was made possible only by COVID-era exceptions to the Ryan Haight Act, which otherwise require an in-person visit for treatment. The result of this change was staggering. Several large groups formed which now collectively treat tens of thousands of patients in the telehealth-only model, confirming a severely unmet demand for flexible, convenient, and patient-centered OUD treatment. <br><br>This session, featuring research directors and leaders at four large telehealth provider groups, will be a deep dive into the teleOUD model. Presenters will cover the history of teleOUD treatment, literature evaluating patient outcomes, description of logistics including urine drug screen monitoring, and recent DEA regulations pertaining to telehealth prescribing of buprenorphine. They also will discuss challenges, such as limited pharmacy availability of buprenorphine and pharmacists’ apprehension to fill prescriptions generated by telehealth providers. The session will include a discussion about predictions for the future of this treatment modality, as well as workforce and provider wellness issues. Overall, they will describe how this new means of treating opioid use disorder fits into the existing treatment framework, including for vulnerable populations such as those on Medicaid and justice-involved individuals.

Location: A411 GWCC - The opioid and synthetic drug crisis is evolving. Messaging needs of yesterday may no longer be relevant as new and timely threats emerge, additional support resources become available, and policies are amended in communities. Developing communication efforts can be expensive and require a long development period, therefore not being as effective as they should be to deliver timely messaging. <br><br>In this session, presenters will discuss findings from research studies designed to inform harm reduction messaging across Vermont, Illinois, Prince William County, Virginia and, Washington State. Using interviews and focus groups with both teens and adults, they identified knowledge gaps, as well as a pervasive perception that pills obtained from friends or familiar dealers were safe and unlikely to be laced with fentanyl. This allowed at-risk individuals to believe they were not at-risk for overdose. Messaging approaches must personalize the risk of overdose, empathize rather than judge, and provide clear, explicit harm reduction steps that individuals can take. The presenters will share examples of effective messaging strategies, such as introducing powders into communication efforts focused solely on pills, introducing test strips, and naloxone training as more policies make these harm reduction tactics more readily available, and how to develop and implement timely, location-based information about the synthetic drug landscape.

Location: Grand Ballroom ED OMNI - Police deflection programs focus on connecting individuals to substance use resources in the field without criminal justice involvement, beyond contact with an officer or first responder in the field. This session will provide a detailed overview of police deflection programs in small and mid-size communities in Village of Liberty, New York, Shakopee, Minnesota, and Jeffersontown, Kentucky. These programs focus on deflecting individuals from traditional criminal justice and emergency health care resources to immediate substance use and mental health resources.<br><br>Representatives of each program will discuss:<br>1. The Shakopee (Minnesota) Police Department's Recovery Assistance Program, which has connected community members to treatment through scholarships. <br>2. The social-work unit embedded within Jeffersontown (Kentucky) Police that specializes in providing services to victims of crime, people experiencing substance misuse, mental health issues, and houselessness. <br>3. The Village of Liberty (New York) Police Department's Hope Not Handcuffs program, which assists people suffering from drug addiction.<br><br>The Police Assisted Addiction & Recovery Initiative (PAARI) representative will present best practices around stakeholder building, buy-in, and deflection practices at the national level. This national overview will highlight effective deflection programs that have strong public safety, public health, and behavioral health partnerships dedicated to saving lives in this opioid epidemic.

Location: International Ballroom F OMNI - Medication for opioid use disorder (MOUD) has been proven to be effective and save lives. While patients who receive longer term treatment with MOUD have improved outcomes, there are substantial barriers to retaining patients and delivering psychosocial interventions. Increased access to digital tools has created new opportunities for delivering immediate, effective support in patients’ moments of need, as well as keeping patients connected and accountable in their treatment journey. <br><br>This session will share a framework to successfully implement digital tools in opioid treatment programs. Presenters will cover the five components of effective implementation: introduction on intake, connection for accountability, protecting clinical boundaries, using progress data to inform care and outreach, and documentation for reimbursement. Particular attention will be paid to clinical skills for building rapport digitally, as well as the specific ways that digital tools can be used to prevent dropout and keep patients moving forward in their healing. Evidence-based digital treatment will be taught in a lively, interactive manner: including learnings from a large-scale clinical trial, clinical case examples, technology demonstrations, role-plays, discussions, and opportunities for questions and answers. Attendees will gain a deeper understanding of how digital innovations can enhance medication assisted treatment, paving the way for improved patient outcomes, evidence-based practice, and increased treatment participation.

Location: International Ballroom E OMNI - Several database analyses have reported elevated rates of suicide or mental health crises after taper or stoppage of long-term prescribed opioids in patients with chronic pain. Suicide is a complex tragedy. It cannot be fully understood through statistics. As with airplane crashes, detailed case investigation offers important and actionable insights. For suicide, these investigations are termed "psychological autopsies." An ongoing research project to carry out more than 100 psychological autopsies has been funded by the Department of Veterans Affairs, titled CSI:OPIOIDs (Clinical Context of Suicide Following Opioid Transitions). It is the only such effort in the world at this time. Research of this nature requires confronting major challenges related to recruitment, community distrust, data security, ethics, and the development of trustworthy data. For many audiences, this presentation will be the first exposure to psychological autopsy as a method of gaining new insight to a tragic outcome of changes to health care.<br><br>This session will include:<br>1) Case summary for why psychological autopsies are required to understand suicides after prescription opioid stoppage.<br>2) Summary of the methods of study design.<br>3) Review of specific challenges raised through family recruitment.<br>4) Summary of preliminary findings on suicides.

Location: A412 GWCC - The increasing presence of potent illicit drugs demands for innovative and successful primary prevention programs to reduce the risk of overdose deaths. This session will showcase a novel program by the Warren Center for Neuroscience Drug Discovery at Vanderbilt University, designed for adolescent-aged children and young adults. The program empowers youth with knowledge about their developing brain, how substances impact the brain, the importance of self-compassion, and the practice of mindfulness as a means of substance use prevention. To deliver this information to youth, a website and an educational documentary film were created. The website contains short teachings on adolescent brain development (with quizzes), lessons on the neurobiology of addiction, interviews with young adults in recovery, crisis hotlines, along with mental health and addiction resources. For demonstration, the panel will present clips from the short documentary film "Speaking Through Me." Panel members will include a child and adolescent psychiatrist, a young adult from the film (who is in recovery from heroin addiction), and the filmmaker/mother/outreach program director, who lost her son to an accidental overdose after developing cannabis-induced psychosis. Lastly, a brief evaluation of the program’s effectiveness, challenges, and future directions will be discussed.

Location: Grand Ballroom A-D OMNI - Two agencies responsible for identifying emerging drug trends will explain their approaches and share their latest findings. <br><br>The Office of National Drug Control Policy’s (ONDCP’s) Emerging Drug Threats team is a part of the agency’s Office of Translational Research. It works with partners in the federal government and outside advisors to identify emerging drug threats and to prepare interagency response plans to designated drug threats. As the drug supply and use patterns continue to evolve, ONDCP seeks to align policy, programs, and budgets to the current and emerging drug threats that the country faces. <br><br>The National Emerging Threats Initiative (NETI) plays an important role in monitoring emerging threats for the network of High Intensity Drug Trafficking Area Programs (HIDTA). By analyzing data at national and local HIDTA levels, NETI provides intelligence that informs the strategic response to drug trafficking. The correlation of seizure data with overdose death statistics offers a realistic measure of the drug threat landscape. This integration allows NETI to forecast potential threats and inform policies to mitigate the effects of drug trafficking on communities across the nation.<br>

Location: International Ballroom A-D OMNI - Most illicit drugs consumed in the United States originate beyond our borders. Understanding and disrupting that supply chain is critical to the nation’s battle against the addiction epidemic. This session will explore which drugs are entering the country, where and how they are coming in. Participants will gain greater insight into the international drug smuggling trends that ultimately impact their communities.

Location: A3 GWCC

Location: A2 GWCC

Location: A310 GWCC

Location: Grand Ballroom ED OMNI - Due to the overdose epidemic in the United States, there has been a need to build public health and public safety partnerships to assist in interdiction, prevention, and response. In 2016, the Office of National Drug Control Policy (ONDCP), through the High Intensity Drug Trafficking Areas (HIDTA) and the Center for Disease Control and Prevention (CDC) program, launched the Overdose Response Strategy (ORS), pairing a Drug Intelligence Officer (public safety professional) and a Public Health Analyst in each state to reduce fatal and nonfatal overdoses in their area of responsibility. Upon the program's inception, the New England HIDTA designated that their ORS teams would be positioned within their state fusion center. In Connecticut, the CT Intelligence Center (CTIC) has become integral to fostering collaborations between public safety and public health partners, providing intelligence, sharing information, and implementing multiple overdose prevention and response strategies. The CT ORS team and CTIC work closely together to recognize emerging drug threats, mitigate harm to public safety and the general public, and further the mission of both entities.<br><br>This session will showcase best practices of how overdose prevention and response fits into the role of fusion centers by highlighting a few examples from Connecticut. Those examples will include:<br>• Surveillance, Drug Intelligence Sharing/Reporting, and Communication <br>• Drug Testing <br>• Felony Arrest Notifications (FANs) and Domestic Highway Enforcement (DHE) <br>• Intelligence and Analytical Resources <br>• Situational Awareness and Public Health notices <br>• Overdose Spikes and Critical Incidents, including first lab-confirmed case of marijuana and fentanyl <br>• Opioid Rapid Response Program (ORRP) actions

Location: A313-314 GWCC - In 2018, the State of Michigan brought together leadership from all Michigan medical schools. The meeting was to address the lack of addiction medicine (AM) education for students. The barrier to solving this gap in education was identified at this meeting: there was no AM board-certified faculty at any school except Michigan State University. Students could not be trained in AM if there was no one to train them. The Michigan Collaborative for Addiction Resources and Education Systems (MI CARES) developed to support training one AM-certified faculty member at each medical school in MI. Once faculty were trained, the next step was to train medical students and residents, therefore addressing the gap in the current workforce while also building a pipeline of future doctors with a strong AM curriculum. Currently, MI CARES has nearly 1000 enrolled participants, has disseminated curriculum to over 300 students at six medical schools, is in 49 states, and is growing internationally.

Location: Grand Ballroom A-D OMNI - Drug overdose deaths involving illicitly manufactured fentanyl are increasing across the nation, driven by the growing presence of counterfeit fentanyl pills configured as prescription medications (e.g., oxycodone, benzodiazepines). The escalating rates of overdose among the youth and young adult population aged 15 to 25 across the United States and in Oregon have raised serious concerns. While knowledge, attitude, and beliefs have been documented among the adult population, less is known about how youth and young adults aged 15 to 25 are navigating this crisis. <br><br>This session will report on findings from a mixed methods study that explored knowledge, risk, action, and harm reduction behaviors concerning fentanyl and counterfeit pills. The presenters invited youth and young adults in Oregon to participate in an online survey and follow-up interviews. They used social media advertisements to recruit for the survey (N = 897) and completed interviews (N = 30) with survey participants who reported any illicit lifetime pill use. They collected responses about their awareness of fentanyl and non-prescribed pills. They heard from participants about their knowledge of fentanyl, harm reduction strategies, and overdose symptoms and response. Additionally, participants shared their insights into their trusted sources for seeking treatment and obtaining accurate and reliable information about fentanyl. A better understanding of youth perceptions is needed to effectively develop tailored educational campaigns, interventions, and youth-specific services. This session will report the survey and interview findings, offering in-depth insights into the youth's perceptions of fentanyl and counterfeit pills.

Location: International Ballroom F OMNI - Between February 2022 and February 2023, there were a predicted 109,940 drug-related fatalities. Until the development of the Overdose Detection and Mapping Application (ODMAP), a gap in cross-jurisdictional, near real-time data collection for fatal and non-fatal overdose events existed. ODMAP enables users to monitor this information to mobilize a data-driven, collaborative overdose response in their communities. Recognizing that overdoses and drug trafficking trends are not confined to state and county lines, ODMAP released version 4.2, which allows agencies to create spike alerts for customized geographic areas of interest. The importance of these new features is highlighted by the formation of an I-81 workgroup.<br><br>This workgroup was formed in response to an increase in overdoses in Tennessee, Virginia, and West Virginia, identified along I-81 on ODMAP. Stakeholders in these areas observed related spike alerts and overdose activity along the interstate and neighboring jurisdictions. Through the Overdose Response Strategy (ORS) network, contacts in the region met briefly to review the ODMAP findings and then met with additional stakeholders where they discussed the need for further collaboration and information sharing. The result was the formation of a workgroup that includes stakeholders from public safety and public health agencies across the region with the goal of implementing strategies informed by the data available on ODMAP. This practical application of ODMAP provided insights into the interconnectedness of regional overdose trends and threats which has led participants to meet on an ongoing basis to strengthen regional overdose response and prevention activities.

Location: International Ballroom A-D OMNI - Overdose deaths have increased, reaching all-time highs in recent years. Harm reduction-focused vending machines, delivering naloxone, fentanyl test strips, and other public health items, represent a potential non-stigmatizing, low-barrier approach to harm reduction that may increase access and engagement with underserved populations, as well as reduce overdoses and health disparities related to substance use disorder.<br><br>From 2021 to 2023, a team at the Penn State College of Medicine worked with academic, public health, and community partners, including SOS Berks, to implement harm reduction-focused, community health-oriented vending machines. These vending machines will be placed in diverse health and community settings in Central Pennsylvania: one outside an emergency department in an urban environment, another in a community organization in a predominantly Hispanic community, with a third planned for a rural community. Given increasing interest and popularity of harm reduction vending machines in recent years, this session will provide experiences, lessons, and strategies learned for future communities considering these vending machines, and highlight barriers and facilitators to vending machine implementation.

Location: A411 GWCC - Law enforcement and public health tend to approach the overdose crisis from different angles, and for the most part, use different strategies to address the crisis. With worsening overdose death rates, and an increasingly dangerous illicit drug supply, coordination among the multiple sectors working to address the crisis from demand and supply sides is critical. The Opioid Rapid Response Program (ORRP) was initiated in 2018 as a cross-sector collaboration designed to mitigate risks among patients impacted by federal strike force closures of clinics illegally prescribing opioids. Today, ORRP has grown to a federal, interagency program covering all 50 states, Washington DC, and Puerto Rico. The program relies on coordination and partnership among federal law enforcement and federal health officials, along with capacity building and technical support to state and local health officials responding to disruptions in patients access to medications on which they are dependent and may have difficulty accessing. These complex situations can present acute and long-term care access needs for hundreds of patients at a time. This session will present a model case study of public health and public safety partnership examining the impact disruptions have on patients, pre-event coordination, and rapid response strategies implemented to facilitate continued access to medication for opioid use disorder.

Location: A311-312 GWCC - Johns Hopkins University’s “Principles for the Use of Funds from the Opioid Litigation” establishes a nationally accepted framework for states and local governments for the investment of settlement funds, but translating these broad principles into actionable programs is challenging. To this end, the Virginia Opioid Abatement Authority (OAA) has collaborated with numerous stakeholders to develop policies, initiatives, and evidence-based programs that put the rubber on the road.<br><br>This session will describe Virginia’s journey in this process and describe both the successes and remaining challenges in implementing the principles. Presenters will review the OAA’s voluntary “gold standard” incentive program for cities and counties. This standard restricts the use of settlement funds even more strictly than required by any of the settlements. Specifically, 100% of funds must be spent on abatement, recovery of prior costs is not allowed, there can be no supplanting, and no indirect expenses are allowed. Cities and counties that adopt the gold standard are eligible for a 25% increase in distributions from the state’s settlement fund. The response from cities and counties has been positive.<br><br>The session will also review the OAA’s “Abatement Academy,” an educational program marketed to municipal leaders with a focus on de-stigmatizing opioid use disorder and offering examples of real-world model programs with proven records of success. Finally, the presenters will describe the OAA’s partnership with various statewide organizations to provide a “toolkit” of evidence-based interventions that can be implemented by local governments, and to offer technical assistance in the implementation of these programs.

Location: A412 GWCC - Prevention efforts are most effective when they are trauma-informed, recovery-oriented, and equity-based. This session delves into emotional first aid and scientific insights about trauma and the impact of our environments to foster empathy and dispel stigma in prevention and recovery efforts. Participants will be able to highlight the need for becoming trauma-informed to respond to adverse childhood experiences, adverse community environments, and adverse collective historical events. Utilizing emotional first aid, participants will glean practical tools to regulate themselves and others before, during, and after a traumatic event. Participants will gain practical tools for how to respond when a coworker, community member, or loved one is facing a crisis in a way that promotes healing and prevents further traumatization. <br><br>Trauma is framed as a “gateway drug,” leading individuals to cope with overwhelming stress through substance use. Trauma can no longer be ignored as a social determinant of health impacting community members and responders. Preventing and addressing trauma as a root cause of overdose is far more effective than short-lived fixes to reoccurring symptoms. Anxiety, depression, burnout, and escapism tendencies have become prevalent, yet most leaders do not feel equipped to respond to the mental health needs of those they lead. In the time of “The Great Resignation” due to burnout and toxic stress, how a leader responds matters. Organizations who cannot sustain their employees lose a considerable amount of money. Developing healthy leaders, healing cultures, and helpful responses to mental health needs and substance use disorders are crucial for organizational sustainability.

Location: International Ballroom E OMNI - Contingency management (CM) is a behavioral therapy for treating stimulant use disorders. CM is based in operant conditioning, which reinforces desired behaviors with rewards, such as cash or prizes. New technologies afford potential for adoption of CM and related evidence-based practices as an adjunct to conventional treatment. Independent evaluation and research demonstrate consistent improvement in outcomes across many substance use disorders and diverse populations. This session will help attendees understand the advantages, challenges, implementation strategies, and funding opportunities that are now becoming feasible for routine adoption of CM.<br><br>Robert Childs will provide context by making clear the need for CM amidst changing drug use trends, including the rise of the use of stimulants when consuming fentanyl and xylazine, as well as the need to overcome stigma associated with CM. In particular, the rise of stimulant consumption calls for progress in the adoption of CM, because of the lack of any FDA-approved medication treatments.<br><br>David Gastfriend will explain the scientific basis for CM in enhancing motivation for treatment attendance, retention and effort, and the evidence for its clinical- and cost-effectiveness, including for enhancing medication for opioid use disorders, best practices for its delivery, obstacles and guardrails for avoiding fraud and abuse and how it can advance access to care for a variety of urban and rural populations. Emerging research on adoption, implementation, and retention is examining how CM can be introduced into publicly and commercially insured populations, offering practical guidance for success at the provider, system, county, and state level.

Location: A3 GWCC

Location: A2 GWCC

Location: Grand Ballroom A-D OMNI - Xylazine is a veterinary sedative that is being added to opioid street drugs. It has made rare appearance over the past 10 years in the drug supply and in overdose cases but in 2020 began to increase in prevalence. Because it effectively sedates large animals, xylazine is a useful medication in veterinary applications, however, its misuse in humans is associated with numerous health concerns. These include complications of oversedation, painful wounds and skin infections, and complex withdrawal management. Across the country, xylazine presence is on the rise, with places like Philadelphia tracking over 90% and Massachusetts seeing upwards of 30% of opioids containing xylazine. Hospitals and treatment programs typically do not test for xylazine, and detection with test strips is uncommonly employed.<br><br>In this session, presenters will weave together and synthesize three major data sources. First, they will provide new data and research on xylazine from ongoing surveillance of the community drug supply and two current studies among people who use drugs. Second, they will share critical analysis of the validity of available xylazine detection tools (test strips, other devices) for community use. Finally, they will present results of a community response development and strategy implementation project from six communities in New England with rising xylazine presence. While understanding xylazine mechanisms and development of effective treatment are actively being researched, this session will equip attendees with critical information on tools and responses to date and actionable today.

Location: A412 GWCC - With the popularity of vocational-technical schools increasing over the past decade, they are avenues to reach trade workers at risk for overdose. In this session, presenters will explain how to tailor prevention messaging to trade students. Rather than relying on a "one and done" conversation, you must recognize the needs of this specific population and talk in their language, meeting them where they are. The presenters will describe how they instituted a unique prevention strategy called “Shop Talks." They used individualized small group discussions, talking with students in their grade’s shop group and recognizing workforce culture. Therefore, they were able to have conversations that emphasized student participation and honesty while honing in on the family-like group they had established. All together these conversations allowed the presenters to provide primary prevention initiatives through conversations focusing on shop safety and involving them in an ongoing conversation that was not happening otherwise.

Location: Grand Ballroom ED OMNI - As the population of individuals in the United States who have been convicted of a drug or drug-related crime grows, the number of those who are released from incarceration or probation and parole supervision also grows. Communities in which these individuals are released have a strong interest in properly reintegrating them into society. However, collateral consequences, the “legal and regulatory restrictions that limit or prohibit people convicted of crimes from accessing employment, business and occupational licensing, housing, voting, education, and other rights, benefits, and opportunities,” often prevent them from successfully reintegrating into their communities. While some collateral consequences (e.g., keeping firearms out the hands of those who committed violent offenses) are appropriate, many do not take into account the person’s rehabilitation efforts since the conviction, like those who are now in recovery from drugs and alcohol. It has been increasingly difficult to mitigate the impact of collateral consequences, and traditionally marginalized communities have been hit the hardest. These consequences have a disproportionate impact on these communities, leading to additional barriers in a society in which they already face a number of obstacles. With funding from the White House Office of National Drug Control Policy, the Legislative Analysis and Public Policy Association (LAPPA) has drafted a model law addressing the issue of collateral consequences of drug and drug-related convictions for states to use to mitigate the impact of such consequences.

Location: International Ballroom F OMNI - Prescription stimulant use for ADHD in New York State (NYS) has shown consistent growth over the past two decades. NYS Prescription Monitoring Program (PMP) data from 2018-2022 indicated prevalence and growth rates were higher among young and early middle-aged adults. Rates for women over 18 years rose sharply. Male children under 18 years received over twice the prescription rate of females. The NYS PMP data reveals a shift in patient demographics (age, gender), indicating a need for further investigation into the drivers behind the overall increase in prescriptions.<br><br>The expansion of diagnostic criteria in the DSM-5 marked the beginning of a gradual shift in ADHD diagnoses. With an increased focus on ADHD in adults, especially females, prescriptions for patients over 18 years old also increased. Historically, ADHD diagnoses skewed towards males, leading to underdiagnosis among females due to variations in symptom presentation. As prescriber perspectives evolved, a corrective trend began to emerge. The COVID-19 pandemic significantly accelerated ADHD prescribing trends, with its impact on mental health, increased demand for mental health care, and widespread adoption of telehealth services. This rise in prescriptions has resulted in concern due to the inherent potential for stimulant medications and other controlled substances to result in misuse. Attention is also directed toward supply challenges that have resulted from the inability of manufacturers to meet the growing demand.<br><br>NYSDOH has explored these data and based on findings from the PMP, has developed recommendations for relevant stakeholders to better understand the complex issues involved in prescription stimulant trends.<br>

Location: A313-314 GWCC - All people should have access to community-based substance use disorder (SUD) treatment, harm reduction, and recovery support services. While Tribal and rural populations often have disproportionately high rates of SUD, accessing services to support treatment and recovery can be challenging. In this session, the panelists represent broad expertise and experience working with Tribal and rural populations and will discuss how they work within their Tribes, rural communities, and organizations to increase access to culturally responsive care, reduce barriers, and promote high-quality, life-saving, and effective treatment, harm reduction, and recovery support services.

Location: A411 GWCC - The worsening overdose crisis in the United States means that harm reduction organizations are being expected to provide services to growing, more diverse, and geographically dispersed populations. Now more than ever, harm reduction programs need accessible and timely information to inform allocation of services that are in growing demand. In this context, PROVIDENT — a partnership between researchers, a state health department, and local harm reduction organizations in the state of Rhode Island — was implemented to develop, implement, and evaluate a machine learning-based forecasting tool to predict future overdose deaths at the neighborhood level. The developers worked collaboratively to guide harm reduction resources to communities that the model identified as being at highest risk of future overdose deaths. Key successes included the validation of a forecasting model that successfully predicted the top 20% of neighborhoods statewide in which over 40% of overdose deaths occurred in the six months following predictions, and the implementation of an interactive web tool to visualize the model predictions and guide resource allocation. Key challenges included addressing ethical concerns about the reallocation of urgently needed overdose prevention resources based on modeled predictions, translation of machine learning predictions to frontline harm reduction practice, and limited organizational capacity in light of unprecedented and escalating COVID-19, economic, and housing crises. In this session, presenters will discuss how they addressed these challenges using a community-engaged research approach and the usefulness of machine learning models for harm reduction funding, policy, and practice.

Location: International Ballroom A-D OMNI - For too many individuals with serious mental illness, substance use disorder, or both, the justice system is the de facto entry point for obtaining treatment and services. There are many causes, including the lack of alternative approaches and resources to support the diversion of individuals from the courts and into treatment. Kentucky has worked to improve outcomes for individuals experiencing mental illness and substance use by providing enhanced services through Specialty Courts programming and establishing the Kentucky Judicial Commission on Mental Health which seeks to strengthen community responses, minimize criminal justice involvement, promote early intervention and effective management of court cases, and institutionalize alternative pathways to treatment and recovery and improve outcomes. This session will take a closer look at Kentucky's efforts in decriminalizing behaviors associated with substance use and mental illness and provide guidance on implementing systemic changes that promote a recovery-oriented system of care model across agencies that serve as court partners.

Location: International Ballroom E OMNI - Rural communities offer many advantages for living, including beautiful landscapes, outdoor activities, and a sense of community. Inversely, many rural communities pose challenges when it comes to resources, accessing treatment, and high rates of substance use and overdose deaths. By implementing medication for opioid use disorder (MOUD) across a rural healthcare system and into a continuum of care with a “no wrong door” approach, patients can receive a comprehensive range of health services. Essentia Health, a healthcare system across the upper Midwest, began working with providers in 2018 to implement MOUD care with a system-wide 24/7 substance use disorder referral line managed by registered nurses, assisting individuals seeking treatment to schedule priority appointments for office-based opioid treatment (OBOT). With a system approach, provider education, collaboration within individual communities, and patient care coordination, MOUD services are provided in more than 36 clinics with plans to add locations.<br><br>The 2022 Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing Opioids for Pain recommends that clinicians offer or arrange treatment with evidence-based medications to treat patients with OUD. Recent changes to federal regulations now allow all practitioners who have a current Drug Enforcement Administration registration that includes Schedule III authority to prescribe buprenorphine for OUD in their practice if permitted by applicable state law. The CDC developed resources to support clinicians with patients diagnosed with SUD/OUD, including MOUD patient treatment. CDC developed an Addiction Medicine Toolkit and Buprenorphine for the Treatment of OUD and Assessing and Addressing OUD online modules.

Location: A311-312 GWCC - This session will inform participants of the purposes, limits, and methods of advocating for local and state legislation, regulation, and appropriations. Erin Jamieson Day, MPH, will share her perspective as the CEO of a state-funded, statewide substance misuse prevention organization and the former director of a recovery community organization. She will give tips on the use of technology and contrast advocacy with lobbying under federal not-for-profit rules. Ms. Day will also share valuable insight from the receiving end of advocacy as a member of a county alcoholic beverage control commission. Karen Kelly will offer her viewpoint as a state lobbyist; former district director for the chairman of the U.S. House Appropriations Committee, Rep. Hal Rogers (R-KY-5); and former head of two not-for-profit organizations, including the Rx Summit’s educational partner, Operation UNITE. She will discuss state lobbying rules, methods of establishing credibility, and the benefits of advocacy collaborations between commercial and not-for-profit organizations. As a former congressional staff member and previous appointee to the Kentucky Opioid Abatement Advisory Commission, Ms. Kelly will also provide pointers on seeking appropriations and other funding. The session will conclude with ample time for Q&A and discussion.

Location: A313-314 GWCC - <i>Silence on the Streets</i> is a ground-breaking documentary that explores the journey of addiction through the perspective of inner-city minorities and Native Americans. Award-winning Playwright Sharece Sellem skillfully intertwines personal narratives with expert insights from the fields of addiction, trauma, psychology, prevention, and harm reduction alongside individuals with firsthand experiences, uncovering the many factors that contribute to the distinct life experiences of black, brown, Latin X, and Native Americans, profoundly shaping their struggles with addiction throughout their lifetimes and their road to recovery. The documentary's intent is to invite community members to have meaningful conversations and to serve as a catalyst for change in how we perceive and address addiction within marginalized communities. <br><br>The National Emerging Threats Initiative (NETI), in partnership with the New England HIDTA, the Overdose Response Strategy (ORS) and Playwright Sharece Sellem, is hosting a pivotal screening intended to impart a crucial message to Summit attendees engaged in addiction, prevention, public health, and public safety sectors. After the screening, Summit attendees looking for further information for their organizations or those interested in arranging a community screening with a panel discussion to delve into the film's core themes can count on Robert Lawlor and Anna Gasinski to be available on-site to guide and enhance these discussions.<br><br>This Vision Session non-CME presentation is taking place during the Rx Summit. The opinions and recommendations expressed do not necessarily reflect the views of the Rx and Illicit Drug Summit or HMP Global. This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE. By entering a Vision Session and having your badge scanned, you opt-into share and receive information from industry sponsors. If you wish to opt out, please speak with a conference representative.<br><br>This Vision Session is sponsored by HIDTA NETI

Location: A311-312 GWCC - Tennessee is set to receive $1 billion over the next 18 years from the various opioid settlements. The Tennessee Opioid Abatement Council, the Council Chair and the Executive Director have committed to being transparent with meetings, decisions, data and documents since day-one. The council chair and executive director will present a timeline demonstrating how these decisions were made, the tools used to create transparency, and the plan for ensuring transparency for the future.

Location: International Ballroom A-D OMNI - People who have lost a friend or family member to an overdose have unique and complex needs that have largely gone unstudied and unmet as overdose rates sore across the United States. In late 2022, the New York City Office of Chief Medical Examiner (OCME) launched a program to support New Yorkers who have lost a loved one to overdose. Since the program began, OCME has supported hundreds of individuals and gained groundbreaking insight into the ways that overdose and drug use affect family systems, social circles, and communities.<br><br>In this session, presenters will share lessons learned and findings from the implementation of this novel program. This session also will provide attendees with information about how they can support people who experience overdose loss in their communities. Presenters will share insights into the specific challenges and opportunities associated with serving this population, including:<br>1. An overview of the ways overdose loss can lead to isolation, shame, and marginalization.<br>2. How pre-existing hardships can be exasperated by losing a loved one to overdose.<br>3. How engagement with families after an overdose death can lead to meaningful policy change and social connectedness.<br><br>This session will draw on qualitative and quantitative data collected during the first 18 months of program implementation and will present specific case studies that showcase both positive and negative life trajectories for individuals and families affected by overdose.

Location: A411 GWCC - Overdose is a top killer of perinatal patients in the United States. Many pregnant women with substance use disorder (SUD) avoid prenatal care and put themselves and their babies at risk due to fear of stigma and child protective service (CPS) involvement. The United States is an outlier in its high maternal mortality rate, due in large part to preventable overdose and systematic failure to provide treatment to pregnant persons with SUDs. <br><br>This session will discuss the critical need for birthing hospitals to provide SUD treatment and harm reduction and create therapeutic environments for pregnant persons with SUD. Presenters will discuss how two Colorado programs have helped close the treatment gap and advance addiction care in Colorado birthing hospitals. The MOMs initiative has succeeded in enrolling more than 50 birthing hospitals in naloxone distribution, providing harm reduction services, and addressing stigma. The MOMs+ program has enrolled over a dozen birthing hospitals and revolves around the pillars of connection, treatment, and community. MOMs+ trains perinatal staff to provide trauma-informed care, treat all SUDs with evidence-based medications (including medications for opioid use disorder), and connect patients to community through peers, addiction treatment networks and directly engaging with CPS to decrease unnecessary referrals. <br><br>MOMs and MOMs+ provide real world examples of how hospital systems and states can build maternal addiction services. This session will educate and provide perspectives of a mother in recovery (now a peer coach), a pharmacist, and an addiction physician, providing diverse views and an example of the power of multidisciplinary teams.

Location: A412 GWCC - In the midst of an overdose crisis fueled by a surge in fentanyl, escalating substance use, and the challenges of mental health, effective communication becomes a lifeline. With no room for ineffective campaigns, we must deploy messaging that is not only relevant but also specific, aiming to drive intentional behavior change. Rescue has collaborated with public health departments nationwide to develop evidence-based communications campaigns dedicated to preventing and reducing overdoses. In this session, we will explore comprehensive approaches designed to navigate the complexities associated with opioids, meth, and even cannabis. Discover how to tailor messages, avoid common pitfalls, and reinforce behavior change initiatives for improved health outcomes in your community.<br><br>This Vision Session non-CME presentation is taking place during the Rx Summit. The opinions and recommendations expressed do not necessarily reflect the views of the Rx and Illicit Drug Summit or HMP Global. This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE. By entering a Vision Session and having your badge scanned, you opt-into share and receive information from industry sponsors. If you wish to opt out, please speak with a conference representative.<br><br>This Vision Session is sponsored by Rescue | The Behavior Change Agency

Location: A402 GWCC - What if providers approached addiction like a relay in the handoff of care? Aware’s Dr. Lauren Grawert and Cassaundra Bingaman will inspire you to think about addiction treatment as a team sport that includes all providers, at every level of care. They’ll share Aware's vision of overcoming common hurdles and how stretching the continuation of care with relentless collaboration is the ultimate win. <br><br>In this short presentation, you’ll also learn how Aware’s innovative in-home model is designed to assist provider and client alike, in reaching the finish line of treatment and the starting line of each client's path to recovery. <br><br>Let's go for the GOLD, together!<br><br>This Vision Session non-CME presentation is taking place during the Rx Summit. The opinions and recommendations expressed do not necessarily reflect the views of the Rx and Illicit Drug Summit or HMP Global. This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE. By entering a Vision Session and having your badge scanned, you opt-into share and receive information from industry sponsors. If you wish to opt out, please speak with a conference representative. <br><br>This Vision Session is sponsored by Aware Recovery Care

Location: International Ballroom F OMNI - Join Kelly Juleson, former CT State Legislator who now co-leads Connecticut non-profit The Governor’s Prevention Partnership, to learn how to access seemingly inaccessible federal opportunities and turn them into easy-to-execute local action. In this session, you’ll learn why/how laying the groundwork for programs BEFORE a funding stream is available or apparent is imperative to success while also learning how: <br><ul><li> Focusing on Prevention helps in future long-term plans</li><br><li>Leveraging local moments creates points of connection with your constituents and communities through Personalized Programs, Partnerships, and Public Relations creating a Pathway for Success</li><br><li>Mapping federal, state and local funding oPPortunities can generate support for your program</li></ul><br><br>Attendees will receive a step-by-step implementation guide with best practices.<br><br>This Vision Session non-CME presentation is taking place during the Rx Summit. The opinions and recommendations expressed do not necessarily reflect the views of the Rx and Illicit Drug Summit or HMP Global. This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE. By entering a Vision Session and having your badge scanned, you opt-into share and receive information from industry sponsors. If you wish to opt out, please speak with a conference representative. <br><br>This Vision Session is sponsored by Deterra Systems

Location: A311-312 GWCC - There is a powerful but unused tool to help address the opioid overdose epidemic that elected officials should embrace. Syringe service programs (SSPs) and other treatment and prevention service providers save lives and protect communities. Unfortunately, local governments across the country too often oppose SSPs and other harm reduction providers because of misconceptions and stigma against them and the people they serve. This is not only bad public health policy but also often violates federal civil rights laws.<br><br>Ensuring that people with substance use disorder receive the health services they are entitled to under the nation’s civil rights laws is now a top priority of the U.S. Department of Justice (DOJ). Likewise, one of the key objectives in the White House’s 2022 National Drug Control Strategy is to increase the number of SSPs across the country, especially in counties with none. Therefore, DOJ investigations and settlements in this area should be expected.<br><br>This session will: (1) explore how federal civil rights statutes protect SSPs and other harm reduction providers from NIMBY-driven discriminatory zoning and safety restrictions; (2) discuss one specific SSP, the Harm Reduction Institute, which was the last SSP in Orange County, California, before the City of Santa Ana forced it to close; and (3) provide a roadmap for steps that SSPs and other treatment and prevention service providers can take to ensure they can operate.

Location: International Ballroom F OMNI - Faced with a prescription opioid epidemic compounded by the influx of fentanyl and other synthetics, opioid litigation funds present a unique opportunity for state and local policymakers to address gaps in our substance use disorder treatment system. However, effectively deploying these funds necessitates an empirical approach that carefully balances considerations of system needs and capacity, equity, and value. Pursuing an evidence-based approach may assist policymakers with rapidly deploying funds while navigating competing stakeholder interests. Leveraging data and evidence for substance use disorder decision-making is challenging because of variability in data quality and accessibility, especially comprehensive data providing a systems perspective. <br><br>This session will highlight the role of data in informing policymakers’ critical steps in determining community needs and present a suite of data tools developed by the Duke-Margolis Center for Health Policy and Third Horizon Strategies. The primary tool in the suite leverages publicly available data from often-over looked domains (economic stability, education, built-environment, and social context) to generate a need index score for a state or county that is paired with priority areas for investment. A companion guide and measurement toolkit help policymakers operationalize a data-driven approach to assessing need, collaborating to implement spending decisions, and evaluating effectiveness of programs over time. Participants will hear from the tool creators along with Van Ingram, Executive Director of the Kentucky Office of Drug Control Policy and Christian Arthur, Senior Policy and Strategy Specialist with the Boston Public Health Commission on the utility of tools like this to support their response efforts.

Location: A411 GWCC - The opioid crisis in the United States entered a new phase, characterized by the proliferation of psychotropic adulterated pills, notably those containing fentanyl. Widespread adoption of smartphones and social media platforms facilitate online marketing, distribution, and consumption of illicit drugs; they are a driving force behind the surge in opioid-related overdoses and fatalities observed in the fourth wave. Consequently, traditional public awareness campaigns, e.g., those utilizing TV, radio, billboards, etc., while important for certain demographics, fall short in reaching the most vulnerable groups, including individuals aged 13 to 18 and college-age populations.<br><br>Addressing the crisis unfolding in this fourth wave demands a substantial shift in approach, necessitating close collaboration and implementation of robust social media-based prevention campaigns. This comprehensive nine-year longitudinal study employs innovative spatiotemporal analysis and natural language processing techniques to delve into social media data at a granular behavioral level. Drawing from a dataset of approximately 5 billion tweets originating from eight U.S. college-centric locations, the study scrutinizes drug-related discourse patterns, identifies geographical hotspots associated with drug activity, and isolates opioid-related posts that exhibit statistically significant prevalence within overdose-prone areas.<br><br>Findings offer invaluable insights for crafting precisely targeted social media campaigns and interventions. They illuminate the path toward combatting the fourth wave of the crisis, emphasize the importance of a multifaceted strategy hinging on collaborative endeavors, strategically tailored social media initiatives, and innovative data surveillance methodologies. Such an approach is essential to address the dire consequences of psychotropic adulterated pills and mitigate their devastating impact on public health.

Location: Grand Ballroom ED OMNI - The First Responder Resource Engagement Specialty Team (R.E.S.T.) is a resource for first responders in their work with individuals with substance use disorder. First Responder R.E.S.T. covers a 14-county, mostly rural area in southcentral Tennessee. The program provides training to first responders, uses a peer recovery support model to connect individuals to the behavioral healthcare system, and provides harm reduction resources. First Responder R.E.S.T. is grant-funded by the Tennessee Department of Mental Health and Substance Abuse Services and is operated by a nonprofit community coalition. The program’s care coordinators, who are certified peer recovery specialists, work with a wide variety of service providers to best meet the needs of each individual referred. <br><br>Utilization of care coordination services by first responder agencies was one of the biggest challenges of the program during implementation. To increase engagement with the care coordinators, the program implemented a multi-step approach to meet the needs of the individual first responder agencies. Specialized education that was peer led and first responder focused reduced stigma surrounding substance use disorder, as well as address the needs of the responders themselves. Targeted, consistent follow-up by the care coordinators that allowed for flexibility based on agency specific structure and needs resulted in an increase in commitment to the program by the first responders. <br><br>The success of First Responder R.E.S.T. care coordination is evident in the increase in referrals received from first responder agencies along with substantive feedback from personnel that illustrated their willingness to continue to utilize these services proactively.

Location: Grand Ballroom A-D OMNI - The Metropolitan Bureau of Investigation (MBI), an organized crime task force based in Orlando, has been investigating opiate-related crimes since 1978. In the mid 2000s, pain clinics in Orlando led the nation in oxycodone over-prescribing and overdose-related deaths. MBI agents made numerous criminal cases against corrupt doctors and pharmacists. These criminal investigations and implementation of the prescription drug monitoring program led to a marked decrease in oxycodone abuse but also a return to and sharp incline in heroin abuse. MBI agents then saw fentanyl enter the illicit drug market, at first as a cutting agent that volumized heroin stockpiles, to being sold disguised as heroin, to eventually being sold and marketed as fentanyl. These investigations brought agents into contact with violent drug trafficking organizations that were being sourced by Mexican cartels. This session will give the audience the law enforcement perspective on the opiate trends from American pain clinics and doctors to domestic organized crime as fueled by Mexican cartels and the investigations that made the difference.

Location: A412 GWCC - Despite efforts to reduce fatal and nonfatal overdoses, national overdose trends continue to remain at record-breaking highs. State and local public health agencies receive federal funding from the Center for Disease Control and Prevention's Overdose Data to Action (OD2A) award to provide essential overdose prevention programs and services. The Association of State and Territorial Health Officials (ASTHO) is a national public health organization representing state and territorial health officials and health agency staff. ASTHO provides technical assistance to health agencies implementing OD2A strategies and collects evaluation results around these efforts. <br><br>In 2022, ASTHO conducted a Health Equity Needs Assessment (HENA) to identify health agency priorities and needs to incorporate health equity strategies into overdose surveillance and prevention efforts. The assessment, achieving a 79% response rate, found that the most important environmental, social, and economic condition impacting health among populations served by health agencies’ OD2A overdose prevention programs was stigma surrounding addiction and drug use. ASTHO received further indication that stigma serves as a lead barrier to overdose prevention during a 2023 convening of public health and public safety partners to prevent overdose and 2021 and 2022 OD2A Recipient Meeting evaluation data. Areas of stigma-related need shared by health agencies include general stigma training and resources, relationship building, community engagement, incorporating people with lived experience, and using inclusive language. ASTHO will share key findings on how stigma remains a barrier to overdose prevention for health agencies and their partners and highlight stigma reduction efforts that aim to improve overdose prevention for health stakeholders across the country. <br>

Location: A313-314 GWCC - Substance use disorders (SUD) can profoundly affect families — especially those involved within the child welfare system — who often face complex needs. This session will review data supporting the implementation of a family-centered approach with peer support. This technique enhances engagement and retention in treatment, fosters sustained recovery, and promotes family functioning and well-being. Family-centered approaches use a comprehensive array of clinical treatments and related support services that meet the needs of each family member, not just the individual diagnosed with a SUD. This session will highlight the essential ingredients to implement peer support through a family-centered lens.

Location: International Ballroom E OMNI - As the drug overdose crisis continues to evolve in the United States, strategic partnerships between public health and healthcare systems have become increasingly important. Health systems and clinicians can prevent non-fatal and fatal overdose by ensuring safer and more effective pain care through guideline-concordant care as well as improving linkages to and retention in evidence-based treatment for opioid use disorder (OUD). Electronic clinical decision support tools (CDS) continue to be a promising health system strategy that can provide accurate and timely information to help advise clinical decision-making by alerting clinicians to information contained in the electronic health record (EHR). This session features facilitators, barriers, and lessons learned from a CDS collaborative, and the successful partnership between Houston Methodist Hospital and the Centers for Disease Control and Prevention (CDC) to improve patient safety by making science more accessible and thus actionable during the patient encounter.<br><br>Clinicians from Houston Methodist Hospital will provide real-world insights on how they effectively designed and integrated electronic CDS tools into their EHR. Speakers will describe their approach to building CDS internal to their system, how they addressed implementation challenges and created solutions, and will share outcome results from 2016 to 2022. CDC speakers will highlight ways it is supporting clinicians and health systems across the U.S. to support closer partnerships between public health and healthcare systems. Session attendees will learn from the hands-on experience of the panelists and the receive practical tips can be applied to their own health systems that will accelerate their replication efforts.

Location: International Ballroom A-D OMNI - Psychedelics are certain drugs that can cause hallucinations and/or altered mental states including feelings of expanded consciousness. Common psychedelics include, but are not limited to, 3,4-Methylenedioxymethamphetamine (MDMA sometimes called “ecstasy” or “molly”), Lysergic acid diethylamide (LSD, sometimes called “acid”), N, N-Dimethyltryptamine (DMT, the main chemical in ayahuasca, a mix of plant derived substances that also can be made in laboratories), psilocybin from certain mushrooms, mescaline from the peyote cactus, and ibogaine, a naturally occurring substance found in the Iboga plants. Scientists have been researching some psychedelics as possible treatments for substance use disorder (SUD), post-traumatic stress disorder (PTSD) and depression. Under the Federal Controlled Substances Act (CSA), most of these drugs are classified as schedule I drugs and so trafficking and possession pose strict penalties under federal law. However, some states have begun either proposing to decriminalizing or legalize these drugs under various regulatory schemes and more are expected to follow. At least one psychedelic, mescaline, is used as part of indigenous American Indians religious activities under an exemption law. When these drugs are given for treatment along with specific psychotherapy protocols administered by trained practitioners, use is considered “psychedelic-assisted therapy.” This session will cover the status of recent research on psychedelics for medical indications, an overview of state laws, potential regulatory models for personal use, and information on psychedelic-assisted psychotherapies.

Location: A411 GWCC - Region 1 - Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont<br>Region 2 - New Jersey, New York, Puerto Rico, and the Virgin Islands<br>Region 3 - Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia<br><br>Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: A412 GWCC - Region 4 - Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee<br><br>Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: A402 GWCC - Region 5 - Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin<br>Region 7 - Iowa, Kansas, Missouri, and Nebraska<br><br>Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: International Ballroom E OMNI - HHS Region 6 - Arkansas, Louisiana, New Mexico, Oklahoma, and Texas<br>HHS Region 8 - Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming<br><br>Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: International Ballroom F OMNI - HHS Region 9 - Arizona, California, Hawaii, Nevada, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, and Republic of Palau<br>HHS Region 10 - Alaska, Idaho, Oregon, and Washington<br><br>Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: A311-312 GWCC - Rx Summit attendees are invited to view an innovative education documentary with an opportunity to discuss it with those involved in the project. <br><br><i>Speaking Through Me</i> was created to empower children and teens with knowledge and awareness about the most precious and amazing supercomputer they will ever own: their developing brain. With the increasing cases of depression, anxiety, substance use disorder, overdose, self-harm, and suicide amongst our youth in the United States - a paradigm shift is needed. The film follows a grieving mother/scientist, along with three brave young adults who have suffered with either severe depression and anxiety, anorexia and bulimia, or drug addiction; their stories will touch your heart, uplift your soul, and demonstrate how YOU ultimately possess the power to change your story to the positive.<br> <br>The documentary has been selected to screen at film festivals both nationally and internationally. The film was awarded "Best Amateur Documentary < 40 minutes" at the Raw Science Film Festival in Los Angeles and is up for an award at the Tromsø Educational Film Festival in Norway. The film has been selected as a finalist in the Best Shorts Awards and the Tarzana International Film Festival, and semi-finalist status at film festivals in Paris, Melbourne, Detroit, Kansas City, and Nashville.<br><br>This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE.

Location: A310 GWCC

Location: International Ballroom F OMNI - Social determinants of health (SDH) are vital components to addressing inequities for people who use drugs. By focusing on geospatial relationships between overdose and inequities, the Kansas Overdose Response Strategy (ORS) team developed three SDH tools to improve action plans at the local level: (1) Overdose Fatality Review (OFR) equity tool; (2) Overdose Hotspot Profile infographics; and (3) Naloxone Vending Machine suitability analysis.<br><br>The OFR Equity tool measures the distance between the decedent's residence and the location of mental health services, medication-assisted treatment, health departments, and clinics. Additionally, the OFR tool allows the user to set up a 15-minute walk time around the decedent's home to view 19 indicators of the nearby neighborhood including economic stress, crime, and civic engagement. Interactive hotspot profile infographics allow Overdose Detection Mapping Application Program (ODMAP) users in Kansas to view 16 data indicators in high-density overdose areas at the census tract level, including frequent mental health distress, poverty, age group distribution, and other demographics. A naloxone vending machine suitability analysis shows the ideal locations to place the vending machines based on factors found to be related to a higher density of overdoses, including the number of lodging facilities, poverty rates, percentage of households without a vehicle, and educational attainment rates.<br><br>In this session, presenters will demonstrate these SDH tools and explain how the Kansas ORS team, Reno County Health Department, and Kansas Recovery Network are using these strategies to address overdose at the local level.

Location: A411 GWCC - The devastating consequences of overdose deaths necessitate a comprehensive response. Local multi-sector collaborations can use the complimentary frameworks of Overdose Fatality Review-Public Health and Safety Teams (OFR-PHASTs) to investigate overdose fatalities from a granular perspective, offering insights that can inform targeted and contextually relevant interventions. Integrating the findings of local OFR-PHASTs into prevention efforts at various levels of governance is crucial for addressing the epidemic in a coordinated and impactful manner.<br><br>Local OFR-PHASTs typically involve collaborative efforts among stakeholders, including medical examiners, law enforcement agencies, public health departments, healthcare organizations, and community organizations. These reviews delve into the circumstances and contributing factors surrounding overdose deaths, examining drug types, demographic patterns, socioeconomic influences, and gaps in service provision.<br><br>The information yielded from local OFR-PHASTs can be instrumental in guiding overdose prevention activities and setting priorities. At the local level, insights into high-risk populations, overdose hotspots, and specific drugs implicated in fatalities can facilitate targeted harm reduction initiatives, treatment expansion, and awareness campaigns. State-level policymakers can employ aggregated data from multiple local OFR-PHASTs to inform statewide prevention strategies, resource allocation, and legislative interventions. Additionally, national agencies can synthesize data from diverse localities to identify overarching trends and formulate evidence-based policies.<br><br>Local OFR-PHASTs have grown in use and have demonstrated that is an important foundational element for shaping effective overdose prevention activities and priorities at the local, state, and national levels. By integrating local insights into the broader prevention framework, policymakers, and practitioners can create a harmonized approach, transcending geographical boundaries to combat the opioid epidemic.

Location: International Ballroom E OMNI - The 2016 the Centers for Disease Control and Prevention (CDC) released the <i>CDC Guideline for Prescribing Opioids for Chronic Pain</i> , which resulted in the creation and enforcement of algorithmic payer and state policies aimed at reducing opioid related harm. Tasked with identifying potentially inappropriate opioid prescriptions, pharmacists became de facto enforcement personnel. As access to opioid medications was restricted and synthetic opioid overdoses increased, the CDC reversed course, revising its guidelines in 2022 to encourage providers to make rational prescribing decisions for patients maintained on opioids for chronic pain. At the same time, however, several national pharmacy chains and pharmaceutical wholesalers were financially impacted by opioid-related multidistrict litigation leading to reactionary restrictions on opioid purchase and dispensing.<br><br>Pharmacists are at the intersection of clinical necessity and corporate liability avoidance. At this difficult nexus, employer pressure and fear of liability often force pharmacists to choose self-preservation over patient care. <br><br>In this session, presenters will discuss recent qualitative work aimed at developing a grounded theory of pharmacists’ response to environmental pressure by explaining how the delicate interplay between conflict avoidance, trust, communication, and algorithmic thinking impact clinical decision making at the point of care. From there, two experts in drug policy enforcement with direct involvement in recent opioid litigation will discuss practical actions that pharmacists, pharmacy organizations, and prevention providers can take to preserve access to opioid medication while preventing opioid related harm. Participants will leave with evidence-based tools that they can use to encourage pharmacists in their community to become agents of prevention rather than agents of restriction.

Location: Grand Ballroom ED OMNI - Police and Peers (PNP) is a grant-funded program aimed at sharing the workload placed on law enforcement when responding to a nonviolent, non-law enforcement-specific incident. The concept of PNP is to pair an embedded or co-responding peer recovery support specialist (PRSS) with law enforcement to assist with social service needs encountered during a domestic response. PNP is a progressive, fast-response program aimed at confronting the substance use disorder (SUD) issues law enforcement face when responding to an incident.<br><br>The PRSS is specially trained in overdose reversal, case management, and motivational interviewing and can help control and de-escalate sensitive behavioral health, substance-related, or domestic situations. Law enforcement is then able to focus on the enforcement aspect of public safety. The PRSS has access to resources and outreach capabilities linking individuals to substance use disorder treatment centers, social services, and programs, such as quick response teams and West Virginia Department of Health and Human Resources continuum of services, including family assistance, housing assistance, and Child Protective Services, as well as veteran social services. PNP teams are also trained in the Handle with Care model―which promotes school-community partnerships aimed at ensuring that children who are exposed to trauma in their home, school, or community receive appropriate interventions to help them achieve academically at their highest levels despite whatever traumatic circumstances they may have endured.

Location: A313-314 GWCC - Hospitalization represents a reachable moment for people with substance use disorders (SUD). The over 6,000 hospitals in the United States are uniquely positioned to integrate robust prevention, treatment, harm reduction, and recovery strategies driven by multidisciplinary teams. Yet, hospitals are rarely considered stakeholders in SUD interventions and need technical assistance to empower systems improvements. This session with leading hospital addiction care experts will focus on the challenges faced by acute care and share evidence-based and real-world examples that are improving care, patient experience, and clinical outcomes.<br><br>The impact of SUD on communities and the hospitals serving them is staggering: approximately one in 11 emergency department (ED) visits and one in nine hospitalizations are related to SUD, accounting for up to 33% of all admissions in safety net settings. Up to 15% of patients who present to the ED after an opioid overdose die within one year, a number that far exceeds the number of patients who die from heart attacks. Opioid use disorder alone costs hospitals $95 billion per year, nearly 8% of all hospital expenditures.<br><br>Building models of SUD care in hospitals has been shown to improve mortality, reduce hospitalizations, decrease overdoses in the community, and be cost effective. Implementing strategies for addiction care re-establishes trust between patients with SUD and hospitals while also improving patient and staff/clinician satisfaction. Hospitals are uniquely positioned to address patients and communities in acute crises and to provide comprehensive interventions that can foster recovery.

Location: Grand Ballroom A-D OMNI - Synthetic cathinones, sometimes referred to as bath salts, are an emerging threat to public health, as overdose deaths linked to these novel psychostimulants have increased in recent years. Synthetic cathinones are chemically manufactured stimulants designed to mimic other illicit drugs such as cocaine and amphetamine-type stimulants like methamphetamines and methylenedioxymethamphetamine (MDMA). Synthetic cathinone toxicity is associated with the sympathomimetic toxidrome, which includes a wide range of psychological, behavioral, and physical adverse effects including hallucinations, psychosis, seizures, cardiac arrest, and death.<br><br>In Palm Beach County, Florida, deaths involving synthetic cathinones have increased dramatically. Preliminary data shows that deaths increased 1,800% from three in 2021 to 57 in 2023. Despite the rise in deaths in Florida and across the United States, little is known about the population affected by this potent psychostimulant.<br><br>Presenters from the Florida Department of Health in Palm Beach County will review the increasing incidence of overdose deaths involving synthetic cathinones (both alone and in combination with other drugs) from 2021 to 2023. They will discuss trends, characteristics, substance use history, social determinants, and circumstances surrounding these deaths. They will also discuss barriers in conducting overdose surveillance relating to novel substances including synthetic cathinones. Increasing the foundational understanding of the population affected by this emerging public health threat can better guide prevention efforts.<br>

Location: A412 GWCC - In this session, presenters will share a set of wrap-around prevention programming for schools that they developed and implemented based on the principles of Moral Reconation Therapy (MRT) and peer support. Staff in middle and high school are trained in substance use disorder (SUD) recognition, mental health red flags, Narcan use, and obtaining services for themselves. The staff use these skills to refer students to the school counselor, who can then refer to them to the presenters' team before they are suspended or expelled. Ongoing juvenile MRT programming is offered in both middle and high schools. Students participate in juvenile MRT as a diversion from possible suspension or alternative placement. The program also works with Juvenile probation and parole for students who already have formal drug charges. They can go into MRT as a probation alternative to being incarcerated. These programs have been expanded to include the parents of the juveniles for MRT. In addition, a high school internship program now supports peer mentorship and outreach across campus. Finally, training is offered for 8th grade peer mentors that includes how to recognize possible SUD, mental health, or suicidal ideation red flags, as well as how to prevent bullying. These mentors create a WEB (Where Everyone Belongs) support group and work with 5th grade students under the supervision of school counselors. The goal of this program is to reduce challenges in the upper grades in the years to come. This session will describe the evolution of this comprehensive program, as well as its effectiveness.

Location: A311-312 GWCC - Since 1990, the Americans with Disabilities Act (ADA) has protected the rights of people with disabilities, including people with substance use disorder, from discrimination. Historically, however, the ADA has been an underutilized tool for people with addictions. In August 2020, the U.S. Equal Employment Opportunity Commission (EEOC) published technical assistance addressing “Use of Codeine, Oxycodone, and Other Opioids: Information for Employees” and “How Health Care Providers Can Help Current and Former Patients Who Have Used Opioids Stay Employed.” In April 2022, the U.S. Department of Justice released guidance, titled “The Americans with Disabilities Act and the Opioid Crisis: Combating Discrimination Against People in Treatment or Recovery,” that clarifies the protection that the ADA affords to people with opioid use disorder who are in treatment or recovery. Presenters will use this information to describe the legal rights and remedies for people with substance use disorder who experience unlawful discrimination due to their disability. Presenters will then articulate opportunities for stakeholders, including local and state governmental leadership, private and public sector employers, health care providers, and advocates, to implement policies to protect the rights of people with substance use disorder and ensure compliance with the ADA.

Location: International Ballroom A-D OMNI - Many states have gone down the road of legalization of cannabis for medical and/or recreational reasons. This session will help attendees to navigate the evolving landscape.<br><br>Alana Vivolo-Kantor of the Centers for Disease Control and Prevention will provide an overview of cannabis and its prevalence in studies across the United States. She will also review cannabis policies and discuss efforts to better monitor and disseminate information on these policies.<br> <br>Susan Weiss, National Institute on Drug Abuse, will briefly review the state of the science on cannabis, focusing on its adverse effects ― what we know, what we don’t know, and what we are most concerned about. This includes the proliferation of high delta-9 THC concentrates and intoxicating hemp products and the impact on populations who may be at greatest risk, such as pregnant people, youth, and those with a mental illness (especially psychosis).<br> <br>Kenneth Finn of the International Academy on the Science and Impacts of Cannabis will describe the complex relationship between opioids and cannabinoids as it relates to our worsening drug crisis. He will outline public health and safety concerns related to expanded promotion and commercialization of cannabis.<br>

Location: A311-312 GWCC - In this session, Commissioner Kevin Tanner of the Georgia Department of Behavioral Health and Developmental Disabilities and Chair of the Behavioral Health Reform and Innovation Commission, joined by others involved in the process, will share how Georgia, in a bipartisan manner, has implemented historic reforms to transform the way Behavioral Health is addressed. Participants will learn how state and local governments partner together with the executive, legislative, and judicial branches to set the stage for law enforcement, medical, faith, education, and peers and families to join in a coalition to move away from the status quo and implement modern and effective programs to serve the needs of those impacted by behavioral health medical issues.

Location: A411 GWCC - Most people who die from overdose are alone at the time of use. Real-time monitoring of drug use events and rapid connection to a trained responder could save lives if widely adopted by people who use drugs. This session will describe the rationale for remotely supervised drug use via overdose prevention technologies and provide examples for how these programs are working in the United States and Canada. The panel includes leaders from two of the leading overdose detection programs in North America that have worked collaboratively since 2022 to establish a network of U.S. and Canadian partners to share best practices and resources: The Massachusetts Overdose Prevention Helpline and Brave Technology Co-op. Each presenter will describe their history, how the program works, lessons learned, and current challenges. Publicly available data also will be shared about other existing overdose detection technologies including Never Use Alone and the National Overdose Response Service.<br><br>Collectively, these organizations have launched telephone hotlines, smartphone applications, motion detectors, and overdose alert buttons, have been utilized more than 36,000 times since 2019, and reversed more than 350 overdoses. Furthermore, their operators have successfully made referrals to naloxone, syringe services programs, and drug treatment. These services are endorsed by many government agencies, including the Centers for Disease Control and Prevention, as well as state and local health departments, universities, and community organizations.<br><br>This session will review the latest science on these services, including their utilization across North America. While initially designed primarily to provide spotting for people intentionally using opioids, the caller-base has grown to include people who primarily use cocaine, methamphetamine, or counterfeit pills and are concerned with potential fentanyl contamination or other stimulant-related medical events.

Location: International Ballroom E OMNI - This session will be geared for the attendee who seeks to understand more about the intersection of pregnancy and substance use disorders. Presenters will review the national recommendations for perinatal substance use treatment, as well as explore the unique barriers and risks experienced by pregnant people with substance use that affect their access to care. Two clinical presenters will share evidence-based guidelines for perinatal substance use disorders care, as well as present the specific “Hub and Spokes” model recommended in settings where resources are not widely accessible. Two research presenters will then share the findings from a recent mixed-methods, multi-aim study conducted in Southern Appalachia. This study explored patient-centered outcomes with a focus on the experiences and perspectives of participants that met criteria for opioid use disorder and sought perinatal care. Together this multi-part presentation will inform best practices and evidence-based recommendations for policy, clinical care, and social services to support pregnant and parenting people seeking substance use disorders care. Participants will have the opportunity to expand their knowledge and skills related to perinatal substance use disorders care.

Location: International Ballroom A-D OMNI - Overdose prevention centers (OPCs) — sometimes referred to as “supervised consumption sites” — are the subject of a federally funded study to see if they may help prevent overdose death and provide savings in the health and criminal justice systems. The study focuses on three sites in the United States where individuals can consume pre-obtained drugs in a hygienic environment under clinical or peer supervision to intervene in case of an overdose. Two sites opened in New York City within the syringe service program OnPoint NYC in November 2021, and one is expected to open in Providence Rhode Island later this year.<br><br>This facilitated discussion will present perspectives on the New York OPCs so that attendees can make decisions for their communities. Topics will include how OPCs operate, current epidemiological evidence, and their footprint in the community.

Location: Grand Ballroom ED OMNI - In 2017, Hamilton County suffered 570 overdose deaths. As of February 2024, Hamilton County has witnessed a nearly 30% decrease. This decrease is attributable to our collaborative, multi-sector, community response. Creativity and innovation are encouraged, and they are seeing promising results. <br><br>Hamilton County combats the overdoses and overdose death crisis by utilizing cross-sector planning and collaboration. In April 2023, Hamilton County took a significant step forward by expanding and enhancing its existing deflection programming. This initiative marked the launch of a pioneering pilot program that integrated all six deflection pathways into a single, law-enforcement led, co-responder program. These pathways include self-referral, active outreach, intervention, prevention, post-overdose response, and community-based response.<br><br>Hamilton County's Quick Response Team (QRT) embodies a collaborative, law-enforcement led, co-responder approach designed to aid individuals facing substance use disorder, mental health disorder, co-occurring disorders, or homelessness. This initiative employs a dedicated team comprising law enforcement and peer navigators. Together, they forge community-based pathways to crucial services such as treatment, recovery support, housing, case management, and other essential resources.<br><br>In this session, presenters will highlight the innovative method to identify and catalog services in target areas and how to create a coordinated pathway to care by sharing and maximizing outreach data. The presenters will discuss the development of the initiative, the data collection, sharing mechanisms, and talk about the key metrics of success for the work.

Location: International Ballroom F OMNI - The opioid epidemic continues to challenge health services and systems in the United States. In response, health systems have instituted multiple interventions to reduce patient risk, many focusing on decreasing unsafe opioid prescribing among patients viewed as high-risk. However, there are limited tools to identify who is truly at risk of overdose, leading to burdensome interventions targeting an overly broad population or missing key high-risk individuals. <br><br>The presenters' group has conducted pivotal work that addresses this challenge by developing overdose risk prediction tools using machine learning and building the foundation for implementing these tools in practice. In this session, they will review three overdose risk prediction tools in development and implementation geared toward: (1) Individual released from jail, who are at particularly high risk of overdose death; (2) individuals included in a state prescription drug monitoring program; and (3) patients in primary care in a large health system. They will demonstrate how they developed these models, evaluated algorithmic fairness, and worked with stakeholders and community partners to implement them and test using randomized controlled trials. They will review lessons learned from these three development and implementation projects.

Location: A313-314 GWCC - The Recovery Ecosystem Index (REI) was designed as a tool to measure the strength of rural, county-level recovery ecosystems. Scores range from 1 (strongest) to 5 (weakest) for both the REI total score and each subcomponent. The index and an interactive mapping tool were made publicly available in Fall 2022 to support community partners working to establish or improve recovery ecosystems in their areas. <br><br>In this session, presenters will share: (1) findings from user focus groups describing how the REI tool can be used to support community planning and recommendations for improving the REI; (2) results from quantitative analyses designed to validate tool outputs by associating REI scores to overdose mortality rates, including maps that show regions where recovery ecosystems remain weak; and (3) an on-the-ground example of how strong recovery ecosystems can affect community outcomes―specifically the example of Letcher County, Kentucky, which has reinvented existing substance use disorder programming to expand services to justice-involved individuals experiencing substance use disorder, and now mental illness, including the establishment of the first Behavioral Health Conditional Dismissal Program.

Location: Grand Ballroom A-D OMNI - Today’s illicit drug market is the most lethal one the United States has ever faced. Part of this dynamic is the dangerous combination of substances many people who use drugs are now consuming. Around the country polydrug use, whether with pills or powders, has become a common occurrence, involving opioids, stimulants, and other drugs and additives that threaten the health and safety of consumers. The Office of National Drug Control Policy (ONDCP), under the SUPPORT Act enacted by Congress in 2018, is charged with assessing evolving and emerging drug threats and formally designating those substances which pose the greatest threat to the country. Two substances have been designated to date, methamphetamine and xylazine―a veterinary sedative not approved for human use―generally combined with fentanyl. Note that methamphetamine was designated by federal legislation and signed into law by President Biden on March 14, 2022.<br><br>Methamphetamine, although a longstanding challenge, is now available in more potent form produced by Mexican cartels and is causing a record level of fatal drug overdoses, both when used alone and when combined with fentanyl. There also have been reports associating high potency methamphetamine consumption with psychosis. Xylazine, a non-opioid, has previously been identified as a substance of misuse in Puerto Rico in the early 2000s, more recently emerged as a problem in Philadelphia, has now spread nationwide. The combined addiction of xylazine and fentanyl is difficult to treat and there is no antidote, like naloxone for an opioid overdose, that can immediately reverse a xylazine-related overdose.

Location: A412 GWCC - The overdose crisis disproportionately impacts people during their prime years for growing a family. This session will summarize recent findings on associations between parent opioid misuse and substance use disorders (SUD), parenting behaviors, and child outcomes and highlight promising intervention strategies to support families impacted by SUD.<br><br>Dr. Adams will review findings from an analysis of parent-child dyad data collected through the 2020 National Survey on Drug Use and Health. Results show an estimated 3.95% of fathers and 3.73% of mothers reported past-year opioid misuse. The presenter will report on associations between parent-reported opioid misuse and child-reported parenting behaviors (e.g., checking on homework and talking about substance use).<br><br>Dr. Cioffi will present data on the interface between substance use, mental health, and parenting in a sample of parents receiving treatment for SUD. She will contextualize the mental health-parenting-substance use associations in a sample of fathers and a sample of postpartum mothers. She will summarize best practices based on learnings from the Family Check-Up Online for rural parents at risk for substance misuse and the Fathering in Recovery interventions.<br><br>Dr. Cruden will discuss a hybrid effectiveness-implementation trial of an evidence-based intervention for parents involved with child welfare due to substance use. PRE-FAIR (Families Actively Improving Relationships) retains FAIR’s core components, including evidence-based in-vivo parenting coaching, contingency management, and cognitive-behavioral strategies, and supports addressing poor social determinants of health. She will describe multi-level implementation strategies that supported the achievement of a 100% pre-implementation activity completion rate.

Location: Grand Ballroom A-D OMNI - The magnitude and complexity of the evolving U.S. overdose crisis is rendering classical approaches to drug testing, surveillance, and monitoring outdated and ineffective. The illicit drug supply is rapidly changing, with fentanyl analogs and other novel psychoactive substances increasing risk of adverse health outcomes and overdose among people who use drugs. Current drug surveillance infrastructure lacks the capability to detect novel and emerging substances and relay that information to clinical providers, public health officials, harm reduction and recovery organizations, and individuals on a timeline that allows effective change in practice. <br><br>This session will present the implementation and findings of a collaboration between academic researchers, community outreach harm reduction teams, toxicology laboratory, and the Rhode Island Department of Health to develop and refine a statewide local drug supply surveillance and rapid data dissemination system. Results of comprehensive toxicology testing of donated drug samples and used paraphernalia is combined in real time with ethnographic data examining the impact of the changing drug supply to generate focused harm reduction messaging. This data product is rapidly disseminated to people who use drugs, the general public, health care providers, and outreach teams via state-wide across platforms including multimedia, social media, print, and through Rhode Island Department of Health’s website and email alert system. Presenters will review lessons learned and discuss how implementing similar infrastructure in other jurisdictions can expand understanding of drug supply changes and inform policy response that is attentive to evolving health needs of people who use drugs.

Location: A313-314 GWCC - Mobile opioid treatment units offer an alternative to brick-and-mortar facilities and have the potential to overcome numerous barriers to accessing medications for opioid use disorders (MOUD). In 2021, the U.S. Drug Enforcement Administration removed an effective moratorium on new mobile health units (MHUs), dramatically decreasing barriers to their implementation.<br><br>In this session, presenters will provide an overview of MHUs including: (1) U.S. historical perspective, federal regulations, and the evolving Opioid Treatment Program (OTP) landscape; (2) a review of European experiences with MHUs/mobile opioid treatment programs; (3) a discussion of current gaps in treatment access in the United States and role of MHUs; (4) a case study description of an MHU in Rhode Island,; and (5) future directions for MHUs, including opportunities for research and policy evaluation.<br><br>The presentation will describe the first methadone-prescribing MHU in Rhode Island and provide details on how to implement a similar program for others to replicate. This includes discussion of the physical layout of the van, services offered, patient flow protocols, facilitators, and barriers to successful treatment, challenging cases, and development of innovative solutions to address unique issues in this setting (e.g., implementation of a portable phone-based EKG machine). The presenters include the two physicians that provide clinical services on the MHU.

Location: A412 GWCC - Location: A412 GWCC - Hospitals and emergency departments (ED) are key partners in addressing the opioid crisis. Nearly half of patients who die of overdose visited an ED in the three months prior. Patients with substance use disorders access EDs and hospitals frequently for care. Each visit represents an opportunity for intervention with harm reduction, naloxone, and treatment. However, hospitals have been slow to adopt naloxone distribution programs in a way that is efficient, equitable, and sustainable.<br><br>This session will demonstrate the integration of harm reduction and naloxone distribution into EDs and hospitals by sharing the innovations and successes of The Naloxone Project (TNP). TNP is a nonprofit that has revolutionized naloxone distribution in Colorado and is spreading nationally. TNP passed Colorado legislation that reimburses hospitals for naloxone distribution, stripped regulation limiting hospital naloxone distribution, and spearheaded an effort to recruit, train, and assist key hospital staff to dispense naloxone. As a result, more than 99% of Colorado EDs and more than 90% of birthing hospitals dispense naloxone. In the coming year, efforts are underway to dispense naloxone through hospital wards and via EMS, police, and fire agencies. TNP and Colorado Representative Brittany Pettersen are introducing federal legislation replicating the reimbursement language present in Colorado via the Hospitals as Naloxone Distribution Sites (HANDS) Bill.<br><br>This session will show how EDs and hospitals can build sustainable, equitable, and efficient naloxone distribution systems, providing tangible examples of training, regulation, legislation, and lessons which attendees can take home and implement in their communities and states.

Location: Grand Ballroom ED OMNI - Southern Nevada hosts a constant influx of visitors to the entertainment capital of the world and mainstay population of nearly 2.3 million in the Las Vegas Metropolitan Statistical Area. First responders servicing the various jurisdictions have experienced their fair share of overdose response and behavioral health crisis both on and off the famed Las Vegas Strip. This regional panel will explore overdose trends in and around Clark County, current program and policies working to combat these issues, and innovative approaches to improving health and safety outcomes.<br><br>The session will include both mental health and law enforcement professionals, their lived experiences, perspectives, and lessons learned, including:<br>(1) A data driven look at overdose trends both pre and post pandemic.<br>(2) A case study review of Nevada’s largest law enforcement agencies’ response to crisis intervention and how diversion programs have helped reshape the way mental health and substance abuse are addressed in Las Vegas. <br>(3) An early look at the suburb of Henderson’s newly piloted Mobile Crisis Intervention Team and how a unique co-responder approach offers both deflection and service connection.<br><br>The presenters will discuss the benefits of a mental health approach on the front line, initial program successes and challenges. Other discussion topics will include panel insights on how to effectively leverage resources, locate creative funding sources, and identify key metrics for sustainable program growth.

Location: International Ballroom F OMNI - In response to clinical trials research in San Diego published in 2018 showing a 9.7% decrease in opioid prescriptions after physicians were routinely notified of patients’ death and supported with safe prescribing tools, the Ventura County Medical Examiner, with support from County Behavioral Health and community-based organizations, began a death notification letter project—sending more than 295 letters to prescribers whose patients died from overdose since 2019. However, as local trends shifted from prescribed medications to illicit fentanyl overdoses, new directions were pursued. <br><br>Ventura County witnessed a 445% increase in illicit fentanyl fatalities in just three years. Medical professionals were forced to reconsider their roles in this now largely illegal drug crisis. The Office of the Medical Examiner expanded inter-agency efforts to inform and engage a wide range of physicians and other prescribers. Working closely with local addiction medicine doctors and law enforcement, the Prescribers Care Discussion Series was launched, providing a physician-led series of forums about the fentanyl crisis. The series features panel discussions led by local emergency room physicians, addiction medicine experts, behavioral health providers, medication-assisted treatment providers, law enforcement, and of course, the medical examiner. It has become a crucial forum for health professionals to discuss and learn from each other, as well as local review of best practices in combating the opioid crisis. These providers―who are “Connecting because we care. For our Patients, and for our community”―have joined the fentanyl fight, expanded treatment, and invested opioid settlement funds in new data-informed and community-supported ways.

Location: A311-312 GWCC - Over the last decade, the United States has experienced an unprecedented and complex overdose epidemic driven by new synthetic drugs, primarily fentanyl. However, to fully understand and efficiently address this epidemic, it is critical to be aware of the constantly changing composition of fentanyl and how it contributes to overdose<br><br>This presentation will provide data from several Colombo Plan/CFSRE projects using state of the art technologies to test wholesale and retail-level drugs, uncovering hidden factors that drive overdose and chronic health problems. It will identify the changing and emerging fentanyl patterns that drive overdose (fentanyl powder drug mixtures; lethal composition of today’s fentanyl pills; new xylazine patterns; and new, liquid forms of fentanyl that could take this epidemic to another level). Implications for fentanyl test strips and naloxone will also be addressed.<br><br>Upon completion of this session, participants will be able to:<br>· Identify the major constituents of fentanyl powder and pills contributing to mortality (overdose) and morbidity (health problems) over the last decade<br>· Understand an emerging threat of liquid forms of fentanyl that can cause further mortality and prolong the current overdose epidemic<br>· Recognize the need to improve current and develop new technologies to prevent overdose<br><br>This Vision Session non-CME presentation is taking place during the Rx Summit. The opinions and recommendations expressed do not necessarily reflect the views of the Rx and Illicit Drug Summit or HMP Global. This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE. By entering a Vision Session and having your badge scanned, you opt-into share and receive information from industry sponsors. If you wish to opt out, please speak with a conference representative.<br><br>This Vision Session is sponsored by The Colombo Plan

Location: A411 GWCC - Join Dr. Caleb Alexander and Dr. Bill Padula, Principals of Stage Analytics and abatement experts for plaintiffs in the federal (MDL) opioid litigation. They will present how to make evidence-based opioid settlement investment decisions with Stage CARES: Community Abatement Resources Economic Solutions.<br> <br>Built on a foundation of evidence, patent pending analytics, and community opioid abatement experience, Stage CARES provides custom community roadmaps, budgets, dashboards, and evaluation tools. Stage CARES supports communities navigating this critical window of opportunity presented by the influx of opioid settlement dollars to make custom, coordinated, and evidence-based decisions to reduce opioid-related harms. Stage CARES helps clients plan, execute, report, and evaluate opioid settlement allocations over time in a comprehensive manner that meets local and state settlement requirements.<br><br>This Vision Session non-CME presentation is taking place during the Rx Summit. The opinions and recommendations expressed do not necessarily reflect the views of the Rx and Illicit Drug Summit or HMP Global. This program is not intended or eligible for continuing education (CME/CE) credits and does not meet guidelines governing CME/CE. By entering a Vision Session and having your badge scanned, you opt-into share and receive information from industry sponsors. If you wish to opt out, please speak with a conference representative.<br><br>This Vision Session is sponsored by Stage Analytics

Location: A411 GWCC - Georgia has been heavily impacted by preventable drug overdose deaths and HIV/viral hepatitis C infections. In 2021, Georgia lost 2,500 people to a drug overdose and had 23.5% age-adjusted death rate. In 2020, there were 57,561 people living with HIV in Georgia and 1,977 of which were newly diagnosed with HIV. Georgia had a 5.4% prevalence of chronic hepatitis C virus (HCV) infection and an estimated 150,000 persons living with chronic HCV infection. HIV, viral hepatitis, and overdose are all preventable, thus it is important to ask people who use drugs (PWUD) across Georgia about their risks, needs, and experiences. <br><br>In this session, presenters will describe their needs assessment of PWUD, which developed and disseminated a survey at several sites (Atlanta Harm Reduction, Georgia Access Point, and three medications for opioid use disorder centers). The 40-question survey was conducted between September and December 2022. They collected 201 survey responses from individuals residing in 25 Georgia counties, with rural, suburban, and urban representation. Results identified that 77% of PWUD use multiple substances, 39% reported using stimulants to counter the strength of fentanyl, 47% of people used alone, and 91% reused syringes. Of those surveyed, 33% had overdosed in the last year and 62% had overdosed multiple times. Drug checking devices were being used by only 17% of those surveyed. The survey also looked at why people were using and what they would like to see from service provider to enhance their care.

Location: A412 GWCC - The opioid overdose crisis continues to affect the lives of millions of people in the United States, with approximately 2.1 million people dependent on opioids and more than 47,600 opioid-related overdose deaths in 2017. In 2017, Pennsylvania had the third highest rate of drug opioid overdose deaths (ODD) among all 50 states and 84.7% of Pennsylvania’s ODD involved opioids. Although overdose deaths have continued to increase across identity characteristics (e.g., race, ethnicity, gender, justice involvement), the impact has not been felt equally by all groups. Despite growing recognition for the need to include community members impacted by overdoses in designing, implementing, and evaluating prevention and interventions, these communities generally remain underrepresented in key decision-making and collaborative roles.<br><br>In 2016, the Pennsylvania Opioid Overdose Technical Assistance Center (ORTAC) was developed to respond to the need for community-level coordination and support across Pennsylvania to reduce ODD. The PA ORTAC built coalitions, evaluated readiness to work collectively, assessed systemic resources and barriers, established real-time data-collection and reporting tools (e.g., OverdosefreePA.org; Williams, Freeman, & Mirigian, 2017) and provided ongoing tailored technical assistance (Mirigian et al., 2018). This session will describe the evidence of impact (e.g., 30% reduction in ODD between 2016-2019; Cloutier et al., 2023), as well as the development of the PA ORTAC and the practical strategies/programs within it to foster replication.

Location: A311-312 GWCC - America's drug-related overdose and death epidemic is deadlier than ever. Overdose and death related to illicit fentanyl are driving the current epidemic, while cocaine and methamphetamine-related overdose and death are also rapidly increasing. While death related to heroin and prescription opioids have both decreased, access to evidence-based treatment for opioid use disorder has negligibly increased. Meanwhile, patients with pain continue to report challenges in accessing comprehensive, multidisciplinary care as well as opioid therapy when clinically indicated. <br><br>Progress has been seen with respect to increased access to naloxone and efforts to decriminalize drug checking technologies (e.g., fentanyl test strips). Implementing evidence-based prevention, harm reduction, multimodal pain care, and evidence-based treatment initiatives to meaningfully increase access to care and improve outcomes, however, has been elusive. Stigma continues to limit and prevent full utilization of syringe services programs and overdose prevention sites. Payers continue to use prior authorization and other utilization management protocols to delay and deny care for substance use disorders and mental/behavioral health conditions. And despite the CDC removing numeric thresholds from its 2022 opioid prescribing guideline, policymakers, payers and pharmacy chains continue to support numeric thresholds as inflexible policies. <br><br>This session will explore these issues and present a practical way forward for policymakers and other stakeholders to reduce barriers to care and improve health outcomes. The session will also highlight the role that physicians and other health care professionals must take to secure positive changes and detail the consequences if these changes are not pursued.<br>

Location: A313-314 GWCC - Project SAVE is a Camden County, New Jersey, innovative substance use program generated with the municipal courts, police departments, the county’s health department, and a New Jersey Licensed Mental Health and Substance Use Treatment provider. The program entails the strategic placement of a Certified Alcohol and Drug Counselor (CADC) inside the municipal courtroom to offer voluntary direct accessibility to treatment services to nonviolent defendants facing substance use-related charges. If accepted, the CADC, known as the SAVE Advocate, acts as a personal case manager and court liaison-bridging the gap between the courts, enrolled participant, and treatment services.<br><br>Since its countywide launch, Project SAVE has proven to be an influential early intervention, producing results inside and outside of the courtroom. From 2019 until 2023, 9,981 referrals were submitted by local police, court staff, and self-referred defendants. Of those referred, SAVE Advocates were able to greet 55% in court, enroll 3,269 in Project SAVE, link them to 3,206 treatment admissions, confirm 32% completed treatment and 49% were still engaged in treatment (includes medication-assisted treatment), and document 60,940 outreaches made on behalf of all referrals. <br><br>This session will provide multi-sector stakeholders with an overview of Project SAVE, how lessons learned correlated to effective strategy execution to produce results, and how approaches can be tailored to coordinate, sustain, or enhance measures for existing overdose interventions at the local, state, and/ or federal level. Additionally, the audience will hear directly from a Project SAVE participant, and how her interaction with the program has forever changed her life.

Location: Grand Ballroom ED OMNI - In the face of increasing rates of overdose death, partnerships have formed that provide unique opportunities to bridge research and theory into practice settings. This unique panel offers a glimpse into solutions that can be drawn from a variety of disciplines. Panelists include an attorney with lived experience, a national leader in the law enforcement community, and academic and policy professionals. This panel will examine how they have worked together to bridge these various perspectives to arrive at solutions. <br><br>Sheriff Peter J. Koutoujian will discuss his facility’s growth from offering a single medication for opioid use disorder (MOUD) to a multi-MOUD program and the critical use of patient navigators to drive positive recidivism and health changes. Dr. Andrew Kolodny will join him to preview a longitudinal study of this work and discuss the importance of public safety and academic communities coming together to advance research. <br><br>In addition, original research by The O'Neill Institute at Georgetown University Law Center will identify the financial and public health costs resulting from a lack of evidence-based health care in correctional settings. This discussion will provide updates on policies that implement MOUD in corrections and opportunities for the future.<br><br>Suzula Bidon will discuss the importance of evidence-based treatment for substance use disorder through the lens of her legal expertise, as well as her lived experience with addiction and incarceration.<br><br>This session will examine the evidence and legal reasons for improving health care, including care for individuals with substance use disorder, in corrections and will provide practical advice for attendees who are seeking to improve conditions in correctional settings.<br>

Location: International Ballroom A-D OMNI - Oregon became the first state to decriminalize small amounts of drugs for personal use through Ballot Measure 110 (M110), which also allocated approximately $300 million from cannabis taxes to substance use disorder treatment, harm reduction, peer support, housing, and other supportive services for people who use drugs. M110 ended arrests for personal possession in February 2021, with funding for expanded services disbursed starting in Summer 2022. <br><br>This session will review the implementation and possible future of M110 from the public health, law enforcement, and prosecutorial perspectives.

Location: International Ballroom F OMNI - This session will address the benefits and challenges of telehealth from the providers' perspective. First, Jared Augenstein of Manatt Health will explain the current landscape of telehealth across the country, including state and federal telehealth policy, active areas of policy development, and shifting utilization of telehealth services. Then, Sarah Spencer, an addiction medicine physician at the Ninilchik Tribal Council Community Clinic, will share insights gained from her experience using telemedicine to provide medications for opioid use disorder (MOUD) in rural Alaska.

Location: International Ballroom E OMNI - Xylazine adulteration of the drug supply has exploded over the last few years across the United States. Documented cases were seen in the Philadelphia and Southern New Jersey area since 2006. This increasing emergence of xylazine has been accompanied by horrific necrotizing wounds that are extremely difficult to manage.<br><br>This session will review how to identify the early onset of these wounds, specifically what to look for, how they progress, how to manage them, and medication/items that should be available in wound care kits. When these wounds progress surgical intervention is often necessary. This session also will describe the natural history and healing potential of xylazine associated wounds, wound care, and indications for operative management. Through real case scenarios, the changing approach to this new and devastating pathology and potential to promote limb salvage will be discussed. Attendees will leave with an understanding of novel approaches that focus on harm reduction strategies and quality of life for people affected by xylazine associated wounds.<br><br>NOTE: The presentation will contain graphic images of advanced xylazine wounds.

Location: A412 GWCC - Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: A402 GWCC - Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: International Ballroom E OMNI - Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: A411 GWCC - Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: International Ballroom F OMNI - Please join us for the Rx Summit networking and discussion groups on Tuesday and Wednesday evenings. They are designed to foster an open exchange of ideas, experiences, and best practices. These groups are not formal presentations, but rather opportunities to hear what’s working from your colleagues, exchange ideas, and continue the conversation beyond the conference. Bring your business cards and come prepared to share your experiences, challenges, and successes! Open to all registered Rx Summit attendees.

Location: A310 GWCC

Location: A313-314 GWCC - At last year’s Rx and Illicit Drug Summit, Secretary of Veterans Affairs (VA), Denis McDonough, issued this charge: “First, if you’re with law enforcement, let’s get together. We’re partnering with police forces in Coatesville, Pennsylvania; Wilmington, Delaware; Cincinnati and Dayton, Ohio, and other communities to help Vets ... We want to partner with you to help get Veterans who need care, into care, rather than into jail. Reach out to your local VA medical center, and let’s see what we can build, together.” <br><br>This session will guide attendees through opportunities for partnerships with local VA Medical Centers (VAMC) to facilitate access to VA substance use disorder services, among other responsive services, for Veterans who are engaging with local law enforcement. Specifically, presenters will review a training series VA undertook with more than 420 VAMC staff across 18 regions, representing Veterans Justice Outreach (VJO) Programs, Mental Health and Suicide Prevention Services, and VA Police Service from VA’s 140 Health Care Systems, titled, “Training Interdisciplinary VAMC Teams to Partner with Community Law Enforcement-Based Deflection Initiatives.” Presenters also will review an early innovation in Veterans Deflection, Veterans Response Teams (VRT). These teams of specially trained officers aim to deflect Veterans away from arrest and into responsive VA health care services, when a service need is identified. This session aims to connect community law enforcement and deflection initiatives with VA partners in their communities to better serve Veterans and support their communities.

Location: A412 GWCC - Drug checking is increasingly being pursued within overdose prevention responses. As new drug-checking projects emerge, new questions also are being raised about which instruments to pursue and how to scale-up these responses so that they have significant reach and impact for both urban and rural communities. This session will present a distributed model of drug checking that addresses multiple barriers to increasing the reach of drug checking as a response to the overdose crisis. A key component of this model is an integrated software platform that links a multi-instrument, multi-site service design with online service options, confirmatory checking, and a foundational database that provides storage and reporting functions. In small and rural communities specifically, the distributed model can eliminate the need for technicians while still providing point-of-care results with local harm reduction engagement and access to confirmatory testing online along with local and regional public health monitoring data. The project is contributing innovations in drug checking technologies and service design that attempt to overcome current financial and technical barriers towards scaling-up services to a more equitable and impactful level and effectively linking multiple urban and rural communities to report concentration levels for substances most linked to overdose.

Location: A402 GWCC - This session will discuss how academic detailing can be used to improve opioid prescribing practices by leveraging prescription drug monitoring program (PDMP) data. The topics will include: background information on academic detailing and PDMPs; how PDMP data can be used to identify high-risk patients and prescribers; how academic detailing can be used to educate prescribers on safe opioid prescribing practices; and how academic detailing can be used to promote the use of PDMP data in clinical decision-making; and the challenges associated with using PDMP data in academic detailing and strategies for overcoming these challenges.<br><br>The presenters represent the academic detailing programs initiated by the Illinois and Utah PDMPs to improve prescribing and increase prescriber review of patients' PDMP data prior to issuing prescriptions. The academic detailing focuses on Centers for Disease Control and Prevention guidelines and provides one-on-one, face-to-face encounters with clinicians by trained academic detailers to provide current, unbiased evidence-based information. Utah targets academic detailing at prescribers whose patient's death was caused by a prescribed controlled substance or prescribers who have not reviewed PDMP data prior to issuing opioid or stimulant prescriptions. Illinois results indicate that prescribers with academic detailing, when compared to prescribers without it, issue approximately:<br>• 1,500 fewer opioid prescriptions.<br>• 200 fewer high dose opioid prescriptions annually per prescriber.<br>• 400 fewer patients co-prescribed opioids and benzodiazepines. <br><br>

Location: A311-312 GWCC - Sheriff Darin Balaam instituted the Detention Services Unit in 2019 in an effort to bridge the gap of crucial resources for incarcerated individuals transitioning back into the community. The unit enhances law enforcement's role by offering case management services for inmates to connect them with temporary identification for access to medical appointments, medications, applying for state licensure through the Department of Motor Vehicles, applications for treatment programs, transitional living and other housing resources, a community resource list, and activation of Nevada State Medicaid services. The unit also provides direct transportation to substance use programs for individuals who have been court ordered to treatment for substance use. In addition to services, the unit manages two in-house programs. The first is the Veteran Barracks Unit, which offers supportive programming for incarcerated veterans that includes case management, connection to resources through Nation's Finest of Reno, and discharge planning. The second in-house program is the Medication Assisted Treatment (MAT) Program as part of being a licensed and certified Level 1 - Opioid Treatment Program. The MAT Program includes all three medications approved by the Food and Drug Administration to treat opioid use disorder and alcohol use disorder, individual counseling and substance use group counseling, treatment planning, case management, and discharge planning. Narcan kits also are provided at release. The Washoe County Sheriff's Office MAT Program is currently the only one offered in the State of Nevada. In March 2023, the MAT Program established a pilot project with the Nevada Department of Corrections to expand MAT services into the state prison system.

Location: A411 GWCC - In 2023, the rate of overdoses is projected to surpass the figures observed in 2022. Among our youth, there is a prevalent pattern of initiation with alcohol, marijuana, and nicotine/tobacco, often leading to the unfortunate development of substance use disorders (SUD) as usage escalates. The emergence of vaping in 2016 has notably surged among both youth and young adults, offering a novel drug delivery method to attain elevated substance levels in the body, whether legal or illicit. Increasingly, individuals are turning to vaping as a means to achieve heightened euphoria and circumvent traditional injection routes of administration, resulting in a rise in the vaping of illicit substances. <br><br>This session will examine the escalating incidence and prevalence data, demographics affected, and the associated risks linked to the increase of vaping, along with clinical case studies, underscoring the scientific validity of this progression towards vaping illicit substances. Additionally, the discussion will provide valuable insights on how communities and young individuals can identify warning signs, mitigate risks, and access assistance when necessary.

Location: A412 GWCC - This session will address the dire overdose crisis in the United States, which poses a complex, unprecedented challenge. Amid the multifaceted battle, the urgency to preserve the lives of people who use drugs is paramount. Despite their crucial roles, harm reduction and law enforcement harbor deep-seated animosity towards one another, hindering their ability to see that they are more alike than they are different. This mutual contempt and lack of collaboration are significant barriers to effective overdose prevention and response. <br><br>This session will explore the origins of this discord and the unique objectives of each to promote understanding and strategies to cultivate collaboration between law enforcement and harm reduction. Presenters will illustrate how to apply the "6 Cs" (communication, compassion, clear mind, collaboration, commitment to community, and core mission to saving lives) to mitigate conflict and foster effective, open conversations between law enforcement and harm reduction to achieve a synergistic partnership. Through this redefined collaboration, law enforcement and harm reduction can build trust, improve communication and coordination, and combine resources, leading to more effective and comprehensive strategies to address substance use and related issues in our communities.

Location: A402 GWCC - In 2020, an outpatient office-based opioid treatment program initiated a hepatitis C program to address the high risk of bloodborne infections among individuals seeking substance use disorder treatment, many of whom were unaware of their infection status. The program involves comprehensive testing for hepatitis A, B, and C, as well as HIV and syphilis. Patients with a fibrosis score of 0-3 were eligible for treatment through the clinic, while others were referred to specialty care. The program includes the administration of either Mavyret or Epclusa medication, along with coordinated care from dedicated nurse care managers.<br><br>Initially launched in Montana and Washington, the program underwent a redesign in January 2022, expanding to include clinics in additional states, namely Nebraska, Alaska, Oregon, Idaho, New Mexico, Minnesota, and Maryland. From January 2022 to July 2023, the program identified 976 patients who tested positive for hepatitis C. Out of these, 414 patients met the eligibility criteria for treatment at the clinic, and 388 actively participated in the program. Among the participants, 230 have successfully completed the prescribed medication course, leading to 126 patients being confirmed as cured.<br><br>This session will delve into the various components of the program, the roles played by the staff, insurance considerations, and the challenges faced regarding eligibility and the successful completion of the treatment process.

Location: A311-312 GWCC - This session will highlight civil rights protections for parents involved in child welfare services while in medication-assisted treatment (MAT). While the opioid epidemic deeply affects families, a variety of other factors—including discrimination, bias, and misconceptions surrounding opioid use and MAT— create significant barriers for parents in recovery. Presenters will provide an overview of the opioid epidemic, identify barriers to MAT, and explore civil rights protections for parents with an opioid use disorder (OUD). This session will: (1) enhance the understanding of federal nondiscrimination laws, and (2) examine how agencies can ensure federal disability rights compliance for persons with a substance use disorder (SUD) or OUD while maintaining the safety and well-being of children and families. Professionals confronting the opioid crisis must understand the legal framework since it empowers them to advocate for parents’ rights while ensuring the safety, well-being, and permanency of children.

Location: A313-314 GWCC - Federal agencies have significantly ramped up their efforts to increase access to naloxone and other opioid reversal agents (ORAs) in recent years. Representatives of the U.S. Food and Drug Administration (FDA) and the Substance Use and Mental Health Administration (SAMHSA) will describe those actions and activities. Their topics will include research developments, programs designed to reach high-risk populations and communities, and federal grants available to support local and state naloxone saturation efforts.

When the FDA first approved over the counter (OTC) labeling for naloxone (March 2023), numerous uncertainties existed about how, or if, the change would affect the ORA market and ORA users. A year later, some of that uncertainty is gone. However, there remains a wide disparity in how pharmacies and other stores market OTC naloxone and concerns remain about consumers’ ability to pay OTC prices. The Legislative Analysis and Public Policy Association (LAPPA) representative will discuss the multitude of ORA products in the market, recent surveys by newspapers into OTC availability in local pharmacies, the many facets of state ORA access laws, how OTC naloxone may fit into those laws, and recent federal and state legislation expressly addressing OTC access issues.