Getting Real About C-L Psychiatrists Treating Addiction

As of June 2020, 13% of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19. This has been accompanied by increases in overdoses and other opioid-related mortality and adds to the millions of American adults and adolescents already suffering from comorbid substance use and mental health issues pre-pandemic.

Many of these patients are seen in acute care settings such as emergency departments or hospitals, often making consultation-liaison (C-L) psychiatrists the de facto addiction specialists.

The pre-recorded portion of this workshop will cover a variety of complex addiction-related issues relevant to C-L psychiatrists:

Substance use in pregnancy: Dr. Forray, a reproductive psychiatrist with addiction training, will provide overview of perinatal substance abuse including epidemiology, impact on outcomes, fetal effects and treatment approaches in pregnancy.

Substance use disorders in end-stage medical disease: Dr. Winder, a C-L psychiatrist, will discuss approaches to substance use disorder (SUD) in end-stage medical diseases along with key challenges and opportunities as patients move toward transplant and practical aspects of the needed interprofessional approach to these efforts.

Cannabis for the C-L psychiatrist: Dr. Thant will review cannabis “basics” for medically complex patients in addition to lesser-known topics such as the role of cannabis in altered mental status (delirium, catatonia) and agitation.

Opioid use disorder in the general hospital: Dr. Sidelnik, an addiction psychiatrist, will provide an overview of opioid use disorder in the general hospital including management of withdrawal, treatment of opioid use disorder, treatment of co-occurring pain, harm and stigma reduction, patient directed discharges and the role of C-L psychiatrists in facilitating medical treatment.

Psychedelics: Dr. Suzuki, an addiction psychiatrist, will provide an overview of psychedelics and the presentations in the C-L setting of the harms associated with their use. Additional topics will include the emerging evidence base for psychedelic use in SUD treatment, associated mechanisms and potential roles in the C-L setting.

Speakers will present clinical scenarios often faced by C-L psychiatrists and work with the audience on reviewing the latest data and treatment modalities through case presentations and didactics for group discussion.

The interactive portion of this workshop will engage the audience through complex case discussions highlighting each of the above topics followed by a question-and-answer session. Facilitators will guide audience members through high-yield learning points, practical tips and updates of evolving science related to evaluation and treatment of substance use with the goal of improving participants’ knowledge base and clinical skills

References:
1. https://www.apa.org/monitor/2021/03/substance-use-pandemic
2. Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (2018).