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Compassionate Addiction Medicine

Compassionate Addiction Medicine

Treatment of Opioid Use Disorder and Substance Use Disorder

The WSMA, with the Washington Society of Addiction Medicine, Women and Addiction Group, and CHOICES Education Group, hosted a two-day education series on compassionate addiction medicine in June 2023, which was recorded and now available virtually. Participation in this no-cost, virtual training will meet the new one-time, eight-hour CME requirement for Drug Enforcement Administration-registered physicians and physician assistants, as outlined in the Consolidated Appropriations Act of 2023.

How to Participate and Obtain CME Credit

To participate in this activity, learners must read the objectives, watch the webinar recordings, and complete the activity evaluation. Watching both webinar recordings will take 17.5 hours. The minimum amount a learner may watch in order to claim CME credit is 15 minutes, which is equivalent to 0.25 credits.

To meet the eight-hour CME requirement for DEA-registered physicians and physician assistants, you must watch eight hours of content.

Evaluation and CME credit claim

Complete this CME evaluation and credit claim form after viewing the recorded webinar. After you complete the evaluation, you will be able to download a printable certificate for your records.

Learning objectives

After completing the activity, learners should be able to:

  • Improve knowledge on evidence-based care for substance use disorder.
  • Select appropriate evidence-based tools and strategies to treat and manage patients with opioid or other substance use disorders.
  • Have strategies to reduce stigma, bias, and barriers to treatment for patients with opioid or other substance use disorders.
  • Have strategies to provide compassionate care using non-judgmental communication.

Day 1

Day 2

CME information

Release date: July 12, 2023

Expiration date: July 11, 2026

Accreditation with commendation

This activity has been planned and implemented in accordance with accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Washington State Medical Association and the Washington Society of Addiction Medicine. The WSMA is accredited by the ACCME to provide continuing medical education for physicians.

The WSMA designates this enduring material for a maximum of 17.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


The following faculty have relevant financial relationships to disclose:

  • Catherine Chappell, advisory board for Gilead Sciences and principle investigator for Gilead Sciences and Organon
  • Marcella Smid, principle investigator for Gilead and Alydia/Organon
  • Tricia Wright, consultant for McKesson

All relevant financial relationships have been mitigated. All others in control of content indicated no relevant financial relationships with an ACCME-defined ineligible company. All clinical content will be evidence-based and unbiased.

Agenda & Educational Resources

(Originally recorded June 16 and 17, 2023)

Timestamp denotes start of presentation

Day 1

0:00 - Course welcome and logistics - Vania Rudolf, MD and Jeb Shepard, WSMA

03:14 - Stigma, Challenges, and Opportunities for "No Door" and "No Barrier Care"

  • Person in recovery
  • Charissa Fotinos, MD, MSc, Director, WA Medicaid, WA Health Care Authority

47:24 - Drug Policy, Equity, Access to Care - Caleb Banta-Green, PhD, MPH, MSW, Director of the UW Center for Community-Engaged Drug Education, Epidemiology and Research (CEDEER) at ADAI)

1:09:16 - Harm Reduction, Fentanyl and OD Prevention - Brad Finegood, MA, LMHC, strategic advisor for Public Health - Seattle & King County, WA

1:34:02 - Myths and Truths for Substance Use Disorder: Pharmacotherapy for SUD with a Focus on MOUD (buprenorphine, Methadone, Naltrexone) - Trevor Dickey, MD, MPH, Medical Director Addiction Medicine, SIHB, Seattle, WA

2:19:32 - OUD, Compassionate Care, and Physician Participation in the Legislative Landscape - Representative Lauren Davis, State Representative, 32nd District

2:35:04 - Evidence-Based Care for Opioid Use Disorder, Pharmacotherapy, Protocols and Strategies to Initiate MOUD - Vania Rudolf, MD, MPH, DFASAM, Medical Director, Addiction Recovery Services, Swedish Medical Center, Seattle, WA; Chair, Women and Addiction group (WAG)

3:05:00 - Evidence-Based Treatment with Extended-Release Buprenorphine and Stimulant Use Disorder - Andy Saxon, MD, Professor, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine; Director, Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care System

3:52:45 - Harm Reduction - Liz Wolkin, MSN, RN, NPD-BC, CEN, WA Health Care Authority

4:12:25 - Evidence-Based Treatment for People in Jail and the DOC Systems - Catherine Smith, DO, Department of Corrections, WA

4:59:41 - Sedative Use Disorder – Alcohol and Benzodiazepine Withdrawal Management - Kate Marshall, MD, Kaiser Permanente

5:45:09 - Evidence-Based Treatment for HepC for People Who Use Drugs - Judith Tsui, MD, MPH, Professor of Medicine and Director of Substance Use Research and Education (SURE) Unit, Department of Medicine, University of WA, Seattle, WA & Jocelyn James, MD, Assistant Professor of Medicine, Department of Medicine, University of Washington)

6:29:29 - Innovations in MOUD: Methadone Treatment Flexibilities - Tom Hutch, MD, FASAM, Medical Director, We Care Daily Clinics, Seattle, WA

Innovations in MOUD: Ketamine-Assisted Buprenorphine Initiation - Lucinda Grande, MD, FASAM, Pioneer Family Medicine Practice, Olympia, WA

7:16:51 - General Hospital Care and Co-occurring Disorders in Patients Experiencing OUD

8:00:04 - Pain management in the setting of SUD and OUD - Greg Rudolf, MD, DFASAM, Swedish Medical Center, Chair Pain and Addiction Course, ASAM

Day 2

Dedicated to pregnant, postpartum and parenting people

0:00 - Course welcome and logistics - Vania Rudolf, MD

1:19 - Stigma, Challenges and Opportunities for "No Door" and "No Barrier Care" - Moms in Recovery Panel - Facilitated by Vania Rudolf, MD

52:17 - Drug Policy and Reproductive Health: Harm and Harm Reduction in Pregnancy and Parenting - Mishka Terplan, MD, FACOG, DFASAM, Friends Research Institute

1:32:36 - Myths and Truths for Substance Use Disorder: Evidence, Pharmacotherapy for SUD with Focus on MOUD (buprenorphine, Methadone, Naltrexone) - Hendree Jones, PhD, Professor, UNC

2:24:24 - Evidence-Based Care for Perinatal Opioid Use Disorder: Pharmacotherapy, Protocols and Strategies to Initiate MOUD - Caitlin Martin, MD, MPH, VCU Health

3:13:18 - OUD, Compassionate Care, and Physician Participation in the Legislative Landscape - Representative Lauren Davis, State Representative, 32nd District

3:28:13 - COMPASSION and MOUD - Standardizing Split Dose Protocols and Pain Management in Labor and Postpartum - Vania Rudolf, MD, MPH, DFASAM, Medical Director, Addiction Recovery Services, Swedish Medical Center, Seattle, WA; Chair, Women and Addiction group (WAG)

3:57:58 - Harm Reduction Doula Support and Tips for Labor and Postpartum - Ash Woods, CFSD (BADT), PCD (NAPS)

4:19:41 - Evidence-Based Treatment for Birthing People in Jail and the DOC systems - Andrea Knittel, MD, PhD, FACAG, UNC

5:03:15 - Perinatal SUD: Preparing for Delivery and Postpartum - Jess Gray, MD, Medical Director, Mass General Hope Clinic, MGH, Boston, MA

5:46:35 - Reproductive Justice and Evidence-Based Treatment for HepC for Birthing People Who Use Drugs

  • Marcela Smid, MD, MS, MA, Maternal Fetal Medicine, Salt Lake City, Utah
  • Catherine Chappell, MD, MSc, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburg

6:42:01 - Awareness Among Pediatric Hospitalists and OB Hospitalists About EatSleepConsole (ESC) and Prenatal Substance Exposure: Policy, Advocacy, and Clinical Care - Sharon Ostveld-Jones, MD, Pediatric Critical Care Medicine, Yale

7:27:33 - Sedative Use Disorder in Birthing People: Alcohol and Benzodiazepine Use Withdrawal Management - Tricia Wright, MD, FACOG, DFASAM, UCSF, CA

8:12:13 - Perinatal Mental Health Considerations for the Primary Care Provider - Jennifer Wells, MD, Roanoke, Virginia

Speaker Biographies

Andrea Knittel, MD, PhD, FACAG

Andrea K. Knittel, MD PhD is Assistant Professor and Medical Director for Incarcerated Women's Health at the University of North Carolina at Chapel Hill School of Medicine. She completed her MD and PhD degrees at the University of Michigan, Ann Arbor, and her OB/GYN residency at the University of California, San Francisco. Dr. Knittel is a clinician and researcher focused on illuminating and mitigating the reproductive health disparities facing people who experience incarceration across the life course. In her clinical work, she provides full spectrum OB/GYN care to women, trans men, and gender expansive people assigned female at intake in the NC state prison system. Her current research work addresses the obstetric and gynecologic impact of incarceration, including on pregnancies affected by opioid use disorder, HIV and STI prevention, and experiences of menopause.

Andrew Saxon, MD

Preceding his entry into psychiatry, Dr. Saxon completed an internal medicine internship and worked for 4 years as an emergency room physician. Subsequent to his general psychiatry residency at the University of Washington, Dr. Saxon has more than three decades of experience as a clinical and research addiction psychiatrist. Dr. Saxon is board certified with added qualifications in addiction psychiatry by the American Board of Psychiatry and Neurology. Dr. Saxon sits on the editorial boards of the journals, Drug and Alcohol Dependence and General Hospital Psychiatry and is section editor for substance use disorders for UpToDate. He is a lifetime Distinguished Fellow of the American Psychiatric Association, where he served from 2017-2019 as that organization’s Chair of the Council on Addiction Psychiatry, and a Fellow of the American Society of Addiction Medicine, as well as a member of College on Problems of Drug Dependence and of American Academy of Addiction Psychiatry.

Dr. Saxon’s current research work is supported by the VA, the National Institute on Drug Abuse, and National Institute of Mental Health and involves pharmacotherapies and psychotherapies for alcohol, tobacco, and opioid use disorders, work in co-occurrence of substance use disorders and posttraumatic stress disorder, phenomenology and epidemiology of cannabis use, and treatment of substance use in primary care. He has more than 190 papers published in peer reviewed journals and has done numerous conference presentations.

Ash Woods, CFSD (BADT), PCD (NAPS)

Ash Woods (they/them) is a trans full spectrum doula living on Coast Salish lands in Seattle WA. They provide doula services to those who are unhoused and using substances, or in recovery. They work at the People's Harm Reduction Alliance coordinating the mail order Naloxone program for WA state, at Swedish Providence Medical Center as part of the doula team, and at Harm Reduction Doula Collective.

Caitlin Martin, MD, MPH

Caitlin Eileen Martin is the Director of OBGYN Addiction Services at Virginia Commonwealth University in Richmond, Virginia. She received her B.S. at the University of North Carolina Chapel Hill followed by degrees in Public Health and Medicine from Johns Hopkins. She completed her residency in OBGYN at UNC Chapel Hill. As a board-certified physician in both Obstetrics and Gynecology and Addiction Medicine, she cares for women with substance use disorders through the lifespan. In doing so, she leads the VCU OB MOTIVATE program that provides integrated OBGYN and addiction treatment with wrap- around services to pregnant and parenting people. Lastly, as a physician scientist, her research aims to advance the evidence base informing the individualization of addiction treatments by sex, gender and social determinates of health.

Caleb Banta-Green, PhD, MPH, MSW

Dr. Banta-Green is the director of the UW Center for Community-Engaged Drug Education, Epidemiology and Research (CEDEER) at ADAI, Research Professor at the UW Department of Psychiatry & Behavioral Sciences, Addictions, Drug & Alcohol Institute, and mentors graduate students at the UW School of Public Health. His main area of research is substance use disorders involving opioids and stimulants and interventions to support recovery and reduce substance-related harms. He is particularly interested in developing interventions that are accessible to all people, including those who are most marginalized, such as those who are unhoused, utilizing harm reduction services, or in the criminal legal system. He provides technical assistance and evaluation services for public health and safety interventions including the website, and information for the general public and professionals about effective treatments.

Dr. Banta-Green is an epidemiologist and reports drug trends across WA State, with data available online, has been the Seattle area representative to the National Institute on Drug Abuse’s drug epidemiology work group since 2001, and partners with state and local agencies on drug epidemiology tracking and reporting.

Dr. Banta-Green has an MSW, an MPH, and a PhD in Health Services Research from the School of Public Health, all from the UW. He serves on several local, state, and federal workgroups and committees related to epidemiology, policy, and interventions for those who use illicit substances. He is a member of the U.S. Health and Human Service’s Interdepartmental Substance Use Disorders Coordinating Committee. He served as senior science advisor for the Office of National Drug Control Policy in the Executive Office of the President in 2012.

Dr. Banta-Green is interviewed regularly by local and national news media about substance use, drug trends, and effective interventions.

Gregory Rudolf, MD, DFASAM

Dr. Rudolf has been practicing pain medicine and addiction medicine at Swedish Pain Services since 2004, adding medical acupuncture in 2007. He holds board certifications in these 3 specialties as well as in his initial field of training, family medicine. Dr Rudolf believes that the best outcomes are achieved when patient and practitioner can work together longitudinally to implement a safe, therapeutically sustainable and mutually agreeable plan of care that is centered on the patient as a whole person.

Dr Rudolf is the immediate past president of the WA Society of Addiction Medicine and has served for eight years on its board of directors. He is the current chair of the American Society of Addiction Medicine Pain and Addiction Committee and a member of the ASAM Medical Education Council, and is a clinical associate professor at the UW School of Medicine.

Jen Wells, MD

Dr. Jennifer Wells is Director of the Women’s Mental Health Division of the Department of Psychiatry and Behavioral Medicine for Carilion Clinic in Roanoke VA. She is board certified in Psychiatry and Addiction Medicine and serves as an assistant professor for Virginia Tech-Carilion School of Medicine. She actively teaches both medical students and residents from a variety of disciplines in her role as both an inpatient psychiatric attending and outpatient clinician specializing in reproductive psychiatry. Her focus for the last 10 years has been on treating mental health and addiction disorders in pregnant and parenting women. She currently runs an MAT program with ~ 75 pregnant and parenting women as part of the Carilion Clinic OBAT program.

She graduated from UC Davis as an undergraduate and matriculated to Georgetown University School of Medicine. She then trained as an OB/GYN at the University of CA, San Francisco. After completing her OB/GYN residency, she left medicine to focus on other endeavors and eventually returned to complete an additional psychiatric residency at Virginia Tech-Carilion School of Medicine. Her passion for treating mental health and addiction issues in women was born of both her training and personal experience. In her spare time, she enjoys hiking throughout the US, traveling around the globe for scuba and safari adventures and spending time with her beloved 2 dogs.

Jessica Gray, MD

Dr. Jessica Gray is a dually board-certified family medicine physician and addiction specialist in the departments of Medicine at Massachusetts General Hospital (MGH) and Pediatrics in Massachusetts General Hospital for Children (MGHfC). She is associate program director for the MGH Addiction Medicine Fellowship and Medical Director of the HOPE Clinic at MGH, where she cares for women with substance use disorders and their families from time of conception through the first two years postpartum. She also sees patients at the MGH Bridge Clinic, a low threshold outpatient substance use treatment clinic, is a physician consultant for the State-funded MCSTAP (Massachusetts Consultation Service for Treatment of Addiction and Pain), and is secretary of the Massachusetts Society of Addiction Medicine (MASAM) Board of Directors.

Prior to coming to MGH Dr. Gray completed her family medicine residency and addiction medicine fellowship at Boston Medical Center and worked as a primary care doctor at a federally qualified health center in Dorchester, Massachusetts. She is passionate about caring and advocating for marginalized populations and supporting clinicians and others who care for patients with substance use disorders.

Jocelyn James, MD

Jocelyn James is an Assistant Professor of Medicine at the University of Washington. She practices internal medicine and addiction medicine at Harborview Medical Center in Seattle, providing primary care in the Adult Medicine Clinic and at a satellite clinic at Evergreen Treatment Services, an opioid treatment program. She also attends on the inpatient Addiction Consult Service and is the co-Medical Director of an interprofessional mobile health outreach clinic serving people in emergency housing. Her clinical, teaching, and research interests include hepatitis C treatment and care of people with substance use disorder.

Joseph Merrill, MD, MPH

Joseph O. Merrill, MD MPH is a Professor of Medicine and the Addiction Medicine Fellowship Program Director at the University of Washington School of Medicine. He is an internal medicine and addiction medicine physician who co-directs the Harborview Medical Center Opioid Treatment Network.

Kate Marshall, MD, FASAM

Kate Marshall, MD, FASAM, is a member of the department of addiction medicine at Kaiser Permanente Northwest. She obtained her doctorate at Oregon Health & Science University (OHSU), completed residency and a chief residency in internal medicine at Providence St. Vincent Medical Center in Portland, Oregon, and fellowships in addiction medicine and internal medicine at OHSU. She is currently Vice President of the Oregon chapter of the American Society of Addiction Medicine and will serve as president of the chapter for 2023-2024.

Representative Lauren Davis, 32nd Legislative District

Lauren Davis represents the 32nd Legislative District in the Washington State House of Representatives, which includes Shoreline, Lynnwood, northwest Seattle, south Edmonds, Mountlake Terrace and Woodway. She was the founding Executive Director and is the current Strategy Director of the Washington Recovery Alliance. The WRA is a grassroots movement of individuals and families impacted by addiction and mental health challenges driving large-scale change in public policy and public understanding. Prior to serving in public office, Lauren led efforts to pass 2016’s Ricky’s Law, named after her best friend, which created an unprecedented crisis treatment system for youth and adults with life-threatening addiction. She received her bachelor's degree in Ethnic Studies from Brown University and began her career teaching Head Start preschool at a transitional housing facility. She then spent several years researching education access as a Fulbright Scholar in Ghana, West Africa. While there, Lauren started a small textile business that provides job training for adolescent girls and sustainable revenue for a Ghanaian-run educational NGO. Upon her return to the US, Lauren worked as an international development consultant for the Bill & Melinda Gates Foundation. She then helped to launch Forefront, a suicide prevention nonprofit, where she directed school-based mental health programs. She has also taught mental health policy in the Masters program at the UW School of Social Work. In the legislature, Lauren's work centers on behavioral health treatment and recovery and criminal legal system reform.

Lucinda Grande, MD, FASAM

Lucinda Grande, MD is a partner at Pioneer Family Practice in Lacey, Washington, where she practices primary care with a special interest in addiction and chronic pain. She was a co-founder of the Olympia Bupe Clinic, a low-barrier buprenorphine clinic in Olympia, and served as Medical Director there from 2019 to 2021.

In the past 11 years, Dr. Grande has prescribed ketamine to over 500 patients with chronic pain and/or depression, using a strategy of daily self-administered sublingual microdosing. She developed a protocol for that practice which has been used by 145 prescribers in Washington and Oregon. In the past year she has been adapting that strategy to help patients transition from fentanyl to buprenorphine.

Dr. Grande’s medical degree is from the University of Washington School of Medicine in Seattle. She completed her family medicine residency at St. Peter Family Medicine in Olympia, Washington. She is a Clinical Assistant Professor in the University of Washington School of Medicine Department of Family Medicine. She is first author on a review of evidence on buprenorphine dose limits in press in Journal of Addiction Medicine.

Marcela Smid, MD, MA, MS

Marcela Smid MD, MA, MS is a board certified Maternal Fetal Medicine and Addiction Medicine physician and Assistant Professor at the University of Utah. She is the medical director of the Substance Use & Pregnancy – Recovery, Addiction, Dependence (SUPeRAD) specialty prenatal clinic, a multi- disciplinary clinic for pregnant and postpartum individuals with substance use disorder. She has been a member of the Utah Perinatal Mortality Committee since 2016. Her research focus is on perinatal addiction, interventions for pregnant and postpartum individuals with substance use disorders, hepatitis C, maternal mortality and maternal mental health.

Mark Duncan, MD

Mark Duncan, M.D. is an Assistant Professor at the University of Washington. He has pursued a career at the intersection of mental health and primary care, training in both family medicine and addiction psychiatry. He currently practices at the UW Northgate primary care clinic and the UW outpatient psychiatry clinic. He is the co-medical director for the University of Washington Psychiatry and Addiction Case Conference (UW PACC) a free weekly educational webinar and consultation service for WA state. His focus is around bringing addiction treatment to primary care settings. Dr. Duncan also spends significant time training and supervising medical trainees at all of his clinical sites.

Sharon Ostfeld-Jones, MD

Dr. Ostfeld-Jones is a Med-Peds hospitalist — she spends half her clinical time taking care of hospitalized adults and half taking care of hospitalized kids, including newborns during their birth hospitalization. She is a medical educator, training medical students in their early clinical skills and working with medical students and residents in the hospital, including as one of the faculty leaders of the Race, Bias, and Advocacy in Medicine distinction pathway for residents. She has research and quality improvement interests in diagnostic reasoning, reducing medical errors, breastfeeding medicine, and in improving health disparities. She has been working in prenatal substance exposure for over two years and in that time has collaborated with local and national partners committed to improving care for families affected by substance use and substance use disorders.

She went to Oberlin College for a BA in Politics, University of Rochester School of Medicine and Dentistry for her MD and came to Yale for Combined Internal Medicine-Pediatrics Residency which she completed in 2018. She is a mother to Cliff, age 6, and Pepper, age 1, and is an avid gardener.

Tom Hutch, MD, FASAM

Tom Hutch, MD, FASAM is the medical director of We Care Daily Clinics, an opioid treatment program in Auburn, Washington, with mobile medication units serving Seattle and the Puget Sound region. He completed his medical training in Family Medicine at Swedish Medical Center – First Hill in Seattle, where he then taught residents as a faculty physician before working to address systemic causes of behavioral health disorders and addiction in community health centers and as a county jail physician with Public Health – Seattle & King County. Dr. Hutch is a clinical instructor in the University of Washington Department of Family Medicine and works with the Washington Health Care Authority to expand hepatitis C treatment access.

Tricia Wright, MD, MS

Tricia Wright, MD MS is a Professor of Clinical Medicine in the Department of Obstetrics, Gynecology and Reproductive Health at the University of California, San Francisco where she works both as an Ob Hospitalist and Addiction Medicine provider. Previously she was at the University of Hawai‘i and founded the Path Clinic, a perinatal clinic specializing in the care of pregnant and parenting women with Substance Use Disorders. She is board certified in both Obstetrics and Gynecology and Addiction Medicine and a Fellow of the American College of Obstetrics and Gynecology and a Distinguished Fellow of the American Society of Addiction Medicine. She has published multiple papers on pregnancy and addiction as well as a textbook Opioid Use Disorders in Pregnancy published in 2018 by Cambridge University Press.

Dr. Wright completed her undergraduate degree in Biological Sciences from Stanford University, her MD from the University of Michigan. She completed her residency in Obstetrics and Gynecology from the University of New Mexico and obtained a Master’s Degree in Clinical Research from the University of Hawai‘i.

Trevor Dickey, MD, MPH

Trevor Dickey completed his medical education at Duke University in North Carolina along with a Master of Public Health at University of North Carolina, Chapel Hill. He completed his residency at the Swedish Cherry Hill Family Medicine Residency program in Seattle, WA. He completed a fellowship in Addiction Medicine and a second fellowship in Hospital Medicine, both at Swedish Medical Center. He splits his time in between working as a primary care physician with the Seattle Indian Health Board and working as a hospitalist with Swedish Medical Center. His clinical interests include clinical teaching of residents and medical students. In his free time, he enjoys cooking and being outside with his two sons.

Vania Rudolf, MD, MPH, DFASAM

Dr. Rudolf (she/her) is a primary care and addiction medicine physician who works at the Addiction Recovery Services, Swedish Medical Center, Seattle, WA. She is the current Chair of the National Women and Addiction Group (WAG), part of ASAM, the newly elected president for WSAM and the medical director for addiction services at Swedish. She is a lifelong learner with training in family medicine, completed fellowships in addiction, high risk OB, integrative medicine and public health, skills that help her be a healer and an advocate for transformative frameworks that offer value-based, gender, culturally and racially equitable care with focus on the whole person. She is dedicated to offer compassionate, trauma-responsive care to birthing parents, children and families, and to support people with SUD live full and satisfied lives.

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