Intermediate
Workshop Session
Lori Karan, MD DFASAM FACP
Professor of Internal Medicine and Preventive Medicine
VA Loma Linda Healthcare System
Laura Martin, MD
Associate Professor, University of Colorado School of Medicine
Medical Director, CeDAR (Center for Dependency, Addiction and Rehabilitation), a Division of University of Colorado Health
Linda Hyder Ferry, MD MPH
Chief, Preventive Medicine
VA Loma Linda Healthcare System
Chad Morris, PhD
Director, Behavioral Health & Wellness Program
University of Colorado, Anschutz Medical Campus
Historically, substance use disorder treatment centers have only offered limited-to-no treatment for tobacco dependence during their programs. Over the last 30 years, significant gains have been made in behavioral management for tobacco dependence, FDA approval of 7 medications, development of outpatient and inpatient treatment protocols, and the establishment of tobacco-free hospitals and behavioral treatment centers. In addition, tobacco price elasticity, increased public health knowledge of risks, restrictions in tobacco marketing, and clean, indoor-air laws have resulted in lower tobacco consumption in the general population. However, these gains have not had enough impact to lower the rates of tobacco-related chronic health diseases in individuals with substance use disorders. Tobacco use is the number one cause of death for people with alcoholism1 .
Furthermore, there are potential threats to the advances already made, including the rapid acceptance of electronic nicotine delivery systems (ENDS) within the last 10 years and the decriminalization and/or legalization of recreational or medical of cannabis use in 30 states over the past two decades.
The increasing awareness of tobacco-related, chronic disorders amongst both the public and medical professionals presents an opportune climate for improving the screening and treatment of tobacco dependence in patients receiving treatment for other addictions. Four potential opportunities include: 1) Dissemination of an increasing number of novel, evidenced-based protocols specifically for individuals with tobacco and co-occurring substance use disorders; 2) Recognition by medical and behavioral health providers of patient satisfaction and improved outcomes when tobacco is addressed during addiction therapy; 3) Identification, training and collaboration of addiction specialists to advance this concept; and 4) Awareness of the potential use of ENDS to intentionally deliver other drugs of abuse and need for education of patients and staff about impact of ENDS products on long-term recovery.
This workshop will offer best practices of current evidence-based protocols and provide tools for creating effective treatment options that can be applied in a variety of settings. The participants will engage in small group, interactive exercises that will develop action plans for addressing tobacco-use disorders within their own treatment settings and on a national level.
Outline:
Review important historical milestones in efforts to treat tobacco dependence in addiction settings
Discuss potential threats for gains already made in the treatment of tobacco dependence over two decades
Discuss potential opportunities and challenges to improve the treatment of tobacco dependence for recovering populations
Each participant will be empowered to develop a personalized Strengths, Weakness, Opportunities and Threats (SWOT) analysis of their program during the workshop.