Opioids: Conferences and Trainings

7:30 a.m. to 8:30 a.m.: Breakfast and registration

8:30 a.m. to 9:00 a.m.: Welcome and opening remarks (Paul Krupski)
Paul Krupski is the director of opioid initiatives for the Wisconsin Department of Health Services. He will provide an update on the Department of Health Services response to Wisconsin's opioid crisis. 

9:00 a.m. to 10:30 a.m.: Keynote (Bob Forrest, CCDC)
Bob Forrest is perhaps best known as the straight talking, straight shooting counselor on VH1's Celebrity Rehab with Dr. Drew. Forrest had a long journey in his struggle with addiction, visiting rehab facilities 24 times before finding sobriety in 1996. He has spent the last 23 years becoming one of the foremost chemical dependency counselors in southern California, including eight years at Las Encinas Hospital in Pasadena. For five years, Forrest was on the board of the Musicians Assistance Program, now known as MusiCares. He has helped people from around the U.S. and the world get sober and find their purpose. 

“I treat addicts with dignity, love, and compassion. I’m going to be honest with them. I’m not going to be mad at them if they don’t like what I’m trying to help them accomplish. If they fail or stumble or are defiant, I’m not going to get into arguments with them. I just want to love, help, encourage, nurture, and steer people in a more positive direction of life. As the opioid epidemic grew, I listened to the stories of families from across the country about the children they’ve lost. I felt like I was drowning in death and no one, especially the media and government, was willing to acknowledge it. Us drug addicts, we’re all alone. About ten years ago I started telling every addict I met, "don’t die." It was a way of making it real, this plague that was happening around us. Over time it started to catch on and a community came together that was all about caring for each other and acknowledging our situation. Forget getting sober, just please don’t die. "Don’t die" means so much; it means I love you, it means wake up, it means care about each other even when no one else will. The world is beginning to see what’s going on and there’s a lot of awareness now, but we had to start with each other. From one addict to another, don’t die.”

10:30 a.m. to 10:45 a.m.: Break

10:45 a.m. to 12:15 p.m.: Morning workshops

1. A community response to the opioid crisis
Karen Wolownik Albert, LCSW, Gateway Foundation; Chief Eric J. Guenther, Mundelein Police Department

This workshop will focus on how an Illinois county came together to address the opioid crisis. A multi-strategy approach of several interventions has been effective to increase community awareness, build a support network, improve access to treatment, and save lives. The presenters will share personal experiences, current practices, lessons learned, and new ideas from their work with the Lake County Opioid Initiative, including the “A Way Out” program, a Law Enforcement Assisted Diversion Program that has helped almost 450 people access treatment services in just over two years.

Objectives:

• Learn strategies and interventions to increase community awareness and engagement.
• Understand the community involvement in a Law Enforcement Assisted Diversion Program.

2. Opioid diversion and the epidemic 
Laura Reid, Drug Enforcement Administration

This workshop will address opioid trends, diversion, and ways to take part in ending the opioid crisis. 

Objectives: 

• Understand opioid trends.
• Understand opioid diversion.
• Learn steps everyone can take to end the opioid crisis.

3. Naloxone training
Nicole Sornson, AIDS Resource Center of Wisconsin

This workshop will equip attendees with the knowledge and tools to reverse an opioid overdose.

Objectives: 

• Learn how to identify an opioid overdose.
• Learn how to respond to an opioid overdose.
• Learn how to report an opioid overdose reversal.

4. Medication-assisted treatment for opioid use disorders: An update
Ritu Bhatnager, M.D., MPH, UnityPoint Health - Meriter, and David Galibs-Reig, M.D., DFASAM, Ascension All Saints Hospital

This workshop will review basic neuropharmacology of opioid use disorder and treatment. A combination didactic and audience participation format will be used to help understand these issues. There will be discussion on how office-based opioid therapy has been integrated into primary care and behavioral health clinics.

Objectives: 

• Examine the barriers, gaps, and myths regarding medication-assisted treatment. 
• Provide current information regarding Food Drug and Administration-approved medications.
• Explain strategies to increase outreach and collaboration between office-based opioid treatment and behavioral health clinics.

5. Addiction in the 21st century 
Bob Forrest, CCDC 

This workshop will focus on the rise of alternative treatment paths for addiction in the 21st century. The discussion will focus on how to integrate care including harm reduction, medication-assisted treatment, and person-centered services. 

Objectives:

• Understand the techniques to establish collaborative relationships to provide care while working together.
• Understand the importance and role of professional respect while specializing in different modalities.
• Learn the techniques for establishing solution-oriented, nonviolent communication skills.

6. Tools and resources for prescribers and providers
Andrea Magermans and Sarah Bradley, Wisconsin Department of Safety and Professional Services; Randall Brown, M.D., Ph.D, FASAM, University of Wisconsin School of Medicine and Public Health

This workshop will provide an overview and live demonstration of Wisconsin’s Enhanced Prescription Drug Monitoring Program and information on the University of Wisconsin Addiction Consultation Provider Hotline, a new resource that helps health care providers successfully manage patients with addictions. 

Objectives:

• Understand how the Enhanced Prescription Drug Monitoring Program and the University of Wisconsin Addiction Consultation Provider Hotline can be used for clinical decision support. 
• Understand how the Enhanced Prescription Drug Monitoring Program can be used by prescribers as a self-assessment tool. 
• Understand upcoming upgrades to the Enhanced Prescription Drug Monitoring Program.

7. Strategies to address cocaine and methamphetamine use by individuals in medication treatment for opioid use disorder
Richard Rawson, Ph.D., Vermont Center on Behavior and Health and David Geffen School of Medicine at UCLA

This workshop will focus on the impact of stimulant use by individuals on medication treatment for opioid use disorder. The use of cocaine and methamphetamine by individuals on medication treatment for opioid use disorder can greatly reduce the benefits of the opioid use disorder treatment and seriously disrupt patient recovery efforts. There are no medications currently available to effectively treat patients with stimulant use disorders. The behavioral strategy with the most robust evidence of support is contingency management. Other behavioral approaches have also been used with varying success, including community reinforcement, cognitive behavioral therapy, and motivational interviewing. New approaches including mindfulness meditation and physical exercise have shown promise. Data to support all of these approaches will be presented. Challenges in implementation will also be discussed. 

Objectives:

• Understand the extent and impact of stimulant use by patients on medication treatments for opioid use disorders.
• Become familiar with strategies for reducing stimulant use among patients on medication treatments for opioid use disorders.
• Understand the challenges and strategies for implementing these approaches.

12:15 p.m. to 1:00 p.m.: Lunch

1:00 p.m. to 2:30 p.m.: Plenary session - Human dignity: Moving beyond tolerance
Ryan Gorman, human dignity advocate; Patrick Reilly, SAC-IT; and Kevin Schaefer, SAC-CIP

This session is a live recording of Don’t Die Wisconsin, a podcast focused on the opioid crisis. The presenters will describe what stigma means to them as individuals and how they’ve experienced stigma first hand. There will be a demonstration on how stigma forms a barrier to recovery for those suffering from substance use disorders and what can be done to eliminate it. Audience members will be encouraged to participate by asking questions and sharing their perspectives on the topic. 

Objectives:

• Define stigma as it relates to substance use disorders.
• Demonstrate how stigma prevents successful recovery.
• Learn how to eradicate the stigma surrounding substance use disorders. 

2:30 p.m. to 2:45 p.m.: Break

2:45 p.m. to 4:15 p.m.: Afternoon workshops

8. Multiple pathways to recovery: Empowering a self-directed journey 
Adam Kindred, Elevate

This workshop will focus on the essential concepts of long-term recovery from a substance use disorder. There will be a practical conversation about how people can support and empower people in their self-directed journey.

Objectives:

• Reduce stigma around substance use disorders and recovery. 
• Learn about recovery wellness and recovery capital.
• Understand the multiple pathways in recovery and how to support people in their journey.

9. Naloxone training (This is a repeat of workshop 3)
Nicole Sornson, AIDS Resource Center of Wisconsin

This workshop will equip attendees with the knowledge and tools to reverse an opioid overdose. This is a repeat of workshop number 3.

Objectives: 

• Learn how to identify an opioid overdose.
• Learn how to respond to an opioid overdose.
• Learn how to report an opioid overdose reversal.

10. Overdose to recovery: ED2Recovery 
Panel of participants in the ED2Recovery program, including hospital staff, recovery coaches/peer support specialists, and people helped by the program

This workshop will focus on a program managed by Wisconsin Voices for Recovery that helps opioid overdose survivors avoid another overdose and encourages them to stay engaged in treatment. ED2Recovery connects people taken to an emergency department for an opioid overdose with program staff living in recovery from opioid addiction trained to offer support. This program is available at 22 hospitals in Wisconsin through a partnership with 12 organizations that employ more than 100 recovery coaches/peer support specialists. 

Objectives:

• Understand the ED2Recovery Program and how it works in Wisconsin. 
• Understand the role of recovery coaches and peer support specialists in Wisconsin.
• Learn how hospital systems and recovery coaches are working together to provide quality care to people with an opioid addiction.

11. Integrating pharmacists with medication-assisted treatment
A panel of pharmacists from Ho-Chunk Nation, Hometown Pharmacy, and the Wisconsin Department of Health Services

This workshop will focus on how three pharmacists are collaborating with primary care providers to support medication-assisted treatment in their communities. This model can be replicated in other communities to increase access to medication-assisted treatment across Wisconsin. There will also be a discussion about the rules and regulations of providing medication-assisted treatment in a pharmacy setting.  

Objectives: 

• Learn how pharmacists, physicians, and behavioral health providers are working together to address the opioid crisis.  
• Understand the developing role of pharmacists in the urban, rural, and tribal settings across Wisconsin.

12. Faith leaders: Key partners in ending the opioid crisis
Tracy Johnson and Carl Alves, MBA, LADC, TTJ Group

This workshop will provide an overview of the Wisconsin Department of Health Services initiative to engage, inform, and mobilize faith-based groups, organizations, and individuals to assist in ending Wisconsin's opioid crisis. The discussion will focus on how faith-based groups, organizations, and individuals can support prevention, intervention, treatment, and recovery activities. This is a follow-up to the 2018 Faith-Based Summits on Opioids held in Milwaukee, DePere, and Rice Lake. 

Objectives:

• Understand the purpose of the Wisconsin Department of Health Services faith-based initiative. 
• Learn the methods presented at the 2018 Faith-Based Summits on Opioids.

13. Wisconsin Opioid Project ECHO® mock experience
Randall Brown, M.D., Ph.D., FASAM, University of Wisconsin School of Medicine and Public Health

This workshop will provide a description of the Wisconsin Opioid Project ECHO® (Extension for Community Healthcare Outcomes) and its potential usefulness to community providers. A new virtual continuing education initiative led by the University of Wisconsin Department of Family Medicine and Community Health, this project connects addiction medicine experts with providers statewide to improve treatment for patients with opioid-use disorders. With support from the Wisconsin Department of Health Services, this project offers free, monthly videoconferences to help providers—especially those in primary care and who prescribe medication-assisted therapy—reduce the risk of opioid-related complications. Each session consists of collaborative case discussions followed by a didactic presentation from a member of multidisciplinary specialist panel.

Objectives:

• Review the philosophy and components of the ECHO model of shared clinical learning.
• Discuss the importance of innovative educational strategies to reduce opioid related impacts in rural and underserved areas.
• Discuss strategy for the wider dissemination of ECHO to providers caring for patients with substance use disorders.

14. Using a hub and spoke system to expand access to medication treatment for opioid use disorder
Richard Rawson, Ph.D., Vermont Center on Behavior and Health and David Geffen School of Medicine at UCLA, and Deborah Hamilton, MBA, Fashion Valley Comprehensive Treatment Center

This workshop will provide a brief overview of the framework and content of the hub and spoke system developed in Vermont to expand access to medication treatment for opioid use disorders. Data from an evaluation of this system will be provided. The emphasis of this workshop will be on the effort to adapt and implement the Vermont hub and spoke system in California. Data on the efforts in California will be presented.

Objectives:

• Learn how to implement a hub and spoke system.
• Provide an overview of the data to support the hub and spoke system in Vermont.
• Understand the challenges to the hub and spoke implementation in California.
• Understand how to create a cohesive referral system. 

7:00 p.m. to TBD: Recovery meeting 

7:00 a.m. to 8:00 a.m.: Breakfast

8:00 a.m. to 8:30 a.m.: Welcome and opening remarks
(To be announced: State and federal officials invited)

8:30 a.m. to 10:00 a.m.: Keynote (Andre Johnson, MA)
Andre Johnson is President/CEO of the Detroit Recovery Project. Since its inception in 2005, the Detroit Recovery Project has devoted more than $15 million to its mission to help people who were once on the streets become drug-free, productive citizens. He has over 23 years of professional work experience in the field of substance abuse. He was recognized by President Obama as a 2016 Champion of Change for Prevention, Treatment, and Recovery.

10:00 a.m. to 10:15 a.m.: Break

10:15 a.m. to 11:45 a.m.: Morning workshops

15. 24/7 access to  medication-assisted treatment services and collective impact
Michael C. White, MCJ, Community Medical Services

This workshop will focus on the development, implementation, and framework of the nation’s first opioid treatment on demand clinic in Arizona, including organizational and staffing needs. There will be a review of data on the clinic’s clients to show how the clinic is serving community needs. There also will be a discussion about how audience members can identify community treatment needs that 24/7 services could support.  

Objectives:

• Understand the opioid treatment on demand model.
• Learn how to partner with child protective services, hospitals, jails, prisons, problem-solving courts, and police for client referrals. 

16. SAMHSA opioid update: Progress, opportunities, and resources
Commander Karen Hearod, MSW, LCSW

This workshop will provide an overview of the current national picture of the opioid crisis. Federal priorities will be shared and current national data will be provided. Progress will be discussed, as well as opportunities for additional impacts. Available SAMHSA resources related to prevention, treatment, and recovery also will be shared.

Objectives:

• Gain understanding of current national opioid data and trends.
• Review federal priorities related to addressing the opioid crisis.
• Identify free federal opioid resources.

17. Wisconsin harm reduction programs
Scott Stokes, Wisconsin Department of Health Services; Philomena Kebec and Shannon Schutte-Kauppila, Gwayakobimaadiziwin Bad River Needle Exchange; Sarah Johnson, LPS, Public Health Madison & Dane County, and Mat Hazelburg, AIDS Resource Center of Wisconsin

This workshop is a panel discussion about several harm reduction programs in Wisconsin. 

Objectives:

• Provide a working definition of harm reduction.
• Provide three examples of harm reduction programs provided in Wisconsin.
• Learn resources available to assist in implementing harm reduction programs.

18. The impact of the opioid epidemic on children and families
Andre Johnson, MA, The Detroit Recovery Project

This workshop will explore how the opioid epidemic has impact the lives of children and families. 

Objectives:

• Understand how children are impacted by the opioid epidemic.
• Understand how families are impacted by the opioid epidemic.

19. Movie discussion: "Bob and The Monster"
Bob Forrest, CCDC

This workshop will focus on "Bob and the Monster," a 2011 film by Keirda Bahruth that profiles Bob Forrest. The film follows Forrest through his life-threatening struggle with addiction to his transformation into one of the most influential and controversial drug counselors in the U.S. There will be time for the audience to ask questions. 

Objectives:

• Understand the challenges of opioid use.
• Gain perspectives regarding the journey from active opioid use to long-term recovery.

20. Helping overdoses through prevention and education
Chief Jonathan Westendorf, MPA, and Lt. Katie Williams, RN, EMT-P, Franklin (Ohio) Division of Fire and EMS

This workshop will focus on how evidence-based research and a will to make a difference is changing the culture of a police and fire department in small town America that suddenly faced urbanized substance use challenges. Franklin, Ohio, launched Project HOPE on March 1, 2018, to help people with substance use find treatment after an overdose.  

Objectives:

• Understand how to create a fire-based emergency medical services quick response team, including how to address political challenges.
• Demonstrate the positive impact of quick response teams.
• Learn how to utilize software as a solution to track an individual’s interactions and progression with the quick response team and to measure overall program performance and outcomes. 

21. Overdose response network: The Massachusetts experience
Carl Alves, MBA, LADC, TTJ Group

The rate of fatal opioid overdose has steadily increased across the nation for the past two decades often leaving communities frustrated with finding ways to reverse this deadly trend. In this workshop we will explore how communities can leverage existing resources to improve outcomes for people experiencing an overdose while also strengthening community resiliency and capacity to address the issue. 

Objectives: 

• Understand the evolution of overdose follow-up programs. 
• Learn protocols associated with effective overdose follow-up programs.

11:45 a.m. to 12:30 p.m.: Lunch

12:30 p.m. to 1:30 p.m.: Plenary session - Strengthening the delivery of harm reduction services: Embracing inclusion to reduce stigma
(Jon Zibbel, Ph.D., RTI International)
This session will focus on how to build an effective harm reduction program. Managers of many harm reduction programs lack the understanding of the concrete challenges faced by the population of people who use drugs. It is important to involve the population of people who use drugs in programmatic outreach, peer support, service navigation, and service delivery. This principle of inclusion is a central tenet of harm reduction and based on the logic that people who use drugs have direct experience with the conditions under which people consume drugs. They are in a better position than non-consumers to recognize the population’s unique health needs and barriers to accessing care. 

Objectives:

• Learn the history of harm reduction and the role that people who use drugs have played in the creation of needle exchange, overdose education with naloxone, peer navigation, fentanyl test strip distribution, and other programs.
• Understand the challenges and benefits associated with involving people who use drugs in program development and service delivery to address the opioid epidemic.
• Learn how to operate and govern a community-based organization where people who use drugs play a central role in goal setting, organizational development, staff hiring, board membership, and service delivery. 

1:30 p.m. to 1:45 p.m.: Break

1:45 p.m. to 3:15 p.m.: Afternoon workshops

22. Multiple pathways to recovery: Empowering a self-directed journey (This is a repeat of workshop 8 on day one)
Adam Kindred, Elevate

This workshop will focus on the essential concepts of long-term recovery from a substance use disorder. There will be a practical conversation about how people can support and empower people in their self-directed journey. This is a repeat of workshop 8 on day one. 

Objectives:

• Reduce stigma around substance use disorders and recovery. 
• Learn about recovery wellness and recovery capital.
• Understand the multiple pathways in recovery and how to support people in their journey.

23. Building healthier communities
Panel of staff from the State Targeted Response Technical Assistance Consortium and the Wisconsin Department of Health Services

This workshop will provide an overview of the training and technical assistance opportunities on topics related to Wisconsin’s opioid crisis offered by the Substance Abuse and Mental Health Administration and the Wisconsin Department of Health Services. There will be time for audience members to ask questions and share information about training and technical assistance needs. 

Objectives:

• Understand how the State Targeted Response Technical Assistance Consortium supports the implementation of evidence-based prevention, treatment, and recovery services.
• Understand the supports offered by the Wisconsin Department of Health Services and who to contact to schedule a training or technical assistance session. 

24. The twin epidemics of hepatitis C infection and opioid addiction: National and state trends
Jon Zibbell, Ph.D., RTI International; Ruth Koepke, MPH, and Kailyn Mitchell, MPH, Wisconsin Department of Health Services

This workshop describes the synergistic epidemics of hepatitis C and injection drug use in the context of America's opioid epidemic. Wisconsin's experience with hepatitis C will be highlighted. This includes epidemiological trends and prevention and treatment resources.

Objectives:

• Learn current epidemiological trends regarding the syndemic of viral hepatitis and injection drug use in the context of America's opioid epidemic.
• Understand behavioral and structural risk factors associated with disease transmission and up-to-date strategies for reducing transmissions and prevention infection.
• Understand Wisconsin's epidemic of hepatitis C, its connection to the opioid epidemic, and the hepatitis C prevention and treatment resources available in Wisconsin.

25. Opioid use disorder: Pregnancy and the neonate
Cresta Jones, M.D., University of Minnesota Medical School

This workshop will provide an overview of the diagnosis and treatment of opioid use disorder during pregnancy, including best practices in obstetric and addiction care. There also will be a discussion about neonatal opioid withdrawal syndrome.

Objectives:

• Identify pregnancy complications associated with opioid use disorder.
• Discuss best practices for opioid use disorder treatment in pregnancy.
• Review diagnosis and treatment of neonatal opioid withdrawal syndrome. 
   

26. Heroin and human trafficking: What's the connection?
Debbie Lassiter, D.Div, and Sarah Demerath, Convergence Resource Center; S. Michele Cohen, Ph.D., M.A., LPC, LCPC, Choice Consulting and Counseling Services  

This workshop will define human trafficking, provide the perspective of someone with lived experience, and share the psychological impact of substance abuse on a human trafficking survivor. The control human traffickers have over their victims will be explained by providing insight into the most common questions: Why don't they just leave? How do individuals get involved in human trafficking? 

Objectives:

• Understand the various types of human trafficking.
• Understand the relationship between opioids and human trafficking.
• Understand the psychological impact of human trafficking on survivors.

27. Recovery and crisis intervention using police/provider relationship
Chad Stiles, RN, CCEMT-P, Milwaukee Police Department and Milwaukee Area Technical College

This workshop will focus on how law enforcement can deliver people to crisis/mental health, homelessness, and alcohol and other drug abuse services in a dignified and respectful manner. A key to success is building partnerships with service providers. 

Objectives:

• Learn about opportunities for law enforcement engagement. 
• Learn how to create partnerships with crisis intervention, homelessness, alcohol and other drug abuse services.
• Identify positive outcomes for individuals in crisis intervention, homelessness, alcohol and other abuse as a result of a law enforcement and provider partnership.

7:30 a.m. to 8:30 a.m.: Breakfast and registration

8:30 a.m. to 9:00 a.m.: Welcome and opening remarks (Paul Krupski, Wisconsin Department of Health Services)

9:00 a.m. to 10:30 a.m.: Keynote (Honorable Rev. Everett D. Mitchell, M.Div., Th.M., J.D.)

This presentation will explain how courts in Wisconsin can respond to the growing intersections between trauma and addiction. As courts have learned, the criminalization of addiction has led to mass incarceration and the decline in communities of color. Therefore, courts are approaching addiction through the lens of trauma. By addressing trauma, families are given the tools to reengage trauma, emotional numbness, shame, torn inner maps of the world, and emotional flooding. Through these ongoing experiences, courts can engage families with a trauma lens to ensure families are given an opportunity to have a safe return home. 

10:30 a.m. to 10:45 a.m.: Break

10:45 a.m. to 12:00 p.m.: Plenary session 1 - Human trafficking, trauma, and opioids
(Dr. S. Michele Cohen, Dr. Thelma Newby, Dr. Debbie Lassiter)

12:00 p.m. to 1:00 p.m.: Lunch

1:00 p.m. to 4:00 p.m.: Plenary session 2 - The brain, addiction, and trauma
(Carol Ackley)

7:00 a.m. to 8:00 a.m.: Breakfast and registration

8:00 a.m. to 8:30 a.m.: Welcome and opening remarks (Scott Webb, Wisconsin Department of Health Services)

8:30 a.m. to 11:45 a.m.: Keynote (Mishka Terplan, M.D.)

This presentation will review substance use and addiction through a historical and cross-cultural lens and focus on contemporary understandings of addiction as a disease process and our current societal response. Adverse childhood experiences (ACEs) will be discussed in the context of the war on drugs. Alternative public health approaches to drug problems will be provided.

11:45 a.m. to 12:45 p.m.: Lunch

12:45 p.m. to 3:00 p.m.: Plenary session 3 - Stories from the field: Moving toward a trauma-informed practice 

• Waupaca County
• Walworth County