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  • October 18, 2022 10:27 AM | Judy Pfeiffer (Administrator)

    Authors: Erin L. Winstanley, Emily P. Thacker, Lyn Yuen Choo, Laura R. Lander, James H. Berry, Babak Tofighi


    Background: While barriers to accessing buprenorphine (BUP) therapy have been well described, little is known about pharmacy-related barriers. The objective of this study was to estimate the prevalence of patient-reported problems filling BUP prescriptions and determine whether these problems were associated with illicit use of BUP. The secondary objectives included identifying motivations for illicit BUP use and the prevalence of naloxone acquisition among patients prescribed BUP.

    Methods: Between July 2019 and March 2020, 139 participants receiving treatment for an opioid use disorder (OUD) at two sites within a rurally-located health system, completed an anonymous 33-item survey. A multivari- able model was used to assess the association between pharmacy-related problems filling BUP prescriptions and illicit substance use.

    Results: More than a third of participants reported having problems filling their BUP prescription (34.1%, n = 47) with the most commonly reported problems being insufficient pharmacy stock of BUP (37.8%, n = 17), pharmacist refusal to dispense BUP (37.8%, n = 17), and insurance problems (34.0%, n = 16). Of those who reported illicit BUP use (41.5%, n = 56), the most common motivations were to avoid/ease withdrawal symptoms ( n = 39), prevent/reduce cravings ( n = 39), maintain abstinence ( n = 30), and treat pain ( n = 19). In the multivariable model, participants who reported a pharmacy-related problems were significantly more likely to use illicitly obtained BUP (OR = 8.93, 95% CI: 3.12, 25.52, p < 0.0001).

    Conclusion: Efforts to improve BUP access have primarily focused on increasing the number of clinicians waivered to prescribe; however, challenges persist with BUP dispensing and coordinated efforts may be needed to system- atically reduce pharmacy-related barriers.

    Read the Article

  • September 22, 2022 2:13 PM | Judy Pfeiffer (Administrator)

    Earlier this year, the Centers for Disease Control and Prevention (CDC) reported that deaths from unintentional drug poisonings in the United States exceeded 100,000 in 2021. This is the largest number of overdose deaths ever recorded in a one-year period in this country. Further analysis of the data reveals that more than 75% of these overdose deaths were due to opioids.

    Lancaster County has not been shielded from this national epidemic of opioid-related overdose deaths. During the 2020 calendar year, our county saw 143 deaths from unintentional drug poisonings, and opioids were implicated in 89% of those deaths. The broad consensus is that untreated, or inadequately treated, opioid use disorder (OUD) is a major factor underlying this crisis.

    Our colleague Tara Tawil, MD, described the evolution of this epidemic over the past 30 years in the pages of this journal in 2019. In that article, which serves as useful background for this manuscript, Tawil also described treatment options for OUD, the emergence of buprenorphine in 2002, and efforts to increase prescribing of buprenorphine within the Penn Medicine Lancaster General Health network of primary care practices. Buprenorphine is a medication approved by the Food and Drug Administration (FDA) to treat OUD; the provision of the medication is associated with substantial reductions in all-cause mortality and opioid overdose deaths.

    In 2020, the American Society of Addiction Medicine (ASAM) released a focused update to their National Practice Guideline (NPG) for the treatment of OUD.6 The release of this document was overshadowed by the COVID-19 pandemic and likely escaped the attention of many providers of buprenorphine treatment. These guidelines contain new recommendations and.... Read the full article.

  • July 28, 2022 9:56 AM | Judy Pfeiffer (Administrator)

    Article: Pittsburgh Post-Gazette

    James R. Latronica: Drug users have human rights, and they include harm reduction the state can supply

    The news was grim. Overdose deaths in 2020 increased across the board, and rose a staggering 44% among Black individuals and 39% among American Indian and Alaskan Native individuals. Perhaps most surprisingly, overdose deaths were higher in areas where opioid treatment programs were available — Having “access” to health care does not mean being able to get it.

    The root causes of this continued epidemic are manifold. As the medical community slowly comes to terms with the role that social determinants of health play in people’s lives, the role of marginalization and dispossession in driving this epidemic has become obvious and inescapable. In its latest report, for example, the Centers for Disease Control and Prevention notes that counties with higher income inequality suffered a disproportionate number of overdose deaths.

    Increasing access to treatment for Substance Use Disorders is a critical part of this struggle, but people arrive to my clinic in various ways and not always in a predictable pattern. Not everyone is ready, able or willing to begin treatment at a given point in their life.

    This is one reason we need increased harm reduction efforts. Medical and public health professionals engage in harm reduction efforts in many arenas. Seatbelts in cars are harm reduction. Medication for high cholesterol is harm reduction. Fatal motor vehicle accidents and heart attacks are devastating outcomes that relatively low-cost, high-impact primary interventions can prevent or mitigate.

    Physicians call this type of intervention “preventive medicine.” As I’ll explain later it is an extension of human rights.

    Two bills supporting effective harm reduction for people who use drugs are currently being considered in the Pennsylvania Legislature. The first, SB926, would permit the establishment of Syringe Service Programs in the commonwealth (They are already legal in 31 states and Washington, D.C.) Explicit legalization is important as these critical public health institutions operate in a legal grey area.

    Syringe Service Programs have been shown to decrease overdose deaths, decrease the rate of blood-borne illnesses like hepatitis C and HIV, decrease the rate of discarded needles in the community and harm to first responders, and increases the rate at which people enter into formal treatment. They are a relatively inexpensive, overwhelmingly positive public health benefit.

    The second, HB1393, which recently passed the full House unanimously, would permit the use of fentanyl test strips across the commonwealth. (They are now only legal within Philadelphia and Pittsburgh city limits). The strips allow people using substances to determine if fentanyl is present or not with a simple color-changing strip, similar to a pregnancy test.

    This is critical as fentanyl is now present in nearly every substance available in the banned drug supply, and users of non-opioid substances are at enormous risk of overdose given the potency of fentanyl. Perhaps most importantly, with amended language, the bill would allow for the testing of a wide range of contaminants and poisons that are now pervasive in the banned drug supply. For example, a significant proportion of seized drugs contain xylazine,  an anesthetic used by veterinarians. Naloxone cannot reverse its effects.

    Available evidence strongly supports interventions like providing syringes and ways to test the drug supply, but there is a deeper, more fundamental reason to legalize these measures. People do not deserve to suffer and die for using a given substance, especially when saving their lives is so easy to do. That is why I consider harm reduction efforts as a matter of basic human rights.

    Human rights constitute an agreement and a promise: the agreement that humans have an immutable dignity that must be protected, and a promise that we strive together to construct and maintain institutions that ensure it. This is true whatever needs they have, even if many people look down on their needs. When we stigmatize harm reduction for people who use drugs, we’re telling them that their lives are not valuable, that they are worth less than other people.

    Harm reduction efforts for people who use drugs are a moral and clinical good and should be argued for on their merits, without prevarication. Lives depend on the passage of the current bills and sufficient funding for harm reduction across the commonwealth.

    James R. Latronica, DO, is an addiction specialist physician and public policy chair of the Pennsylvania Society of Addiction Medicine based in Pittsburgh. He can be found on Twitter @JamesRLatronica.

    First Published July 28, 2022, 12:00am

  • February 17, 2022 2:24 PM | Judy Pfeiffer (Administrator)

    “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death."

    Dr. Martin Luther King, Jr.

    ORN acknowledges February as Black History Month. This, and every month, we recognize the contributions and sacrifices of Black people in the American story.

    Preventing and treating substance use disorders in Black Communities is critical as rates of overdose deaths in these communities are outpacing other populations. Read more about ORN's Black Communities Workgroup's efforts here.

    Medical School Addiction Medicine Curriculum: Designed for Medical Students by Medical Students

    New medical school curriculum developed by winners of the Coalition for Physician Education in Substance Use Disorders (COPE) Medical Student Curriculum Challenge is now available to download at no cost.

    The ORN-funded challenge had medical students use their knowledge and creativity to design learning resources related to the development of the skills and attitudes critical to providing care to persons with substance use disorders. From 36 submissions, there were 8 winners and 4 honorable mentions. Twelve curriculum designs are now available and free of charge on COPE’s website for use by medical schools across the country. See the list and instructions on how to download here.

    For additional evidence-based resources on the prevention, treatment and recovery of opioid use, stimulant use and all substance use disorders, submit a request at

    If an opportunity listed below sparks your interest but you are not sure how to begin or would like more information, email We are here to help you!
    All ORN trainings are provided at no cost. 
    To coordinate a training designed specifically to meet your needs, submit a request today at

    Social Work Chat Live: Spiro Spero - February 28, 2022

    This ORN-funded activity coordinated by the Boston Medical Center is a viewing of a play titled "Spiro Spero." Participants will watch the streamed play from 11:30am - 12:30pm ET on YouTube and then attend a talk-back following. Spiro Spero is a one woman play written and performed by a psychiatric nurse practitioner who specializes in addiction. It explores the lives of five people impacted by substance use disorder and their experiences in treatment, in the community, and in the healthcare setting. A talk back will occur immediately following the stream. Learn more

    Virtual Training: Stimulants 101 - March 10, 2022

    This ORN-funded training from the Boston Medical Center is designed to provide an overview of stimulant use disorders for all healthcare staff including providers, nurses, counselors and other non-clinical staff. The training reviews stigma, identifying stimulant overdose, managing acute stimulant intoxication, de-escalation techniques, and evidence-based treatment for people who use stimulants. Learn more

    Virtual Training: Recovery Ambassador Training - March 22-24, 2022

    This ORN-funded, Faces & Voices of Recovery, Recovery Ambassador Program is a free training that prepares individuals to advance public understanding and appropriate responses to addiction. The training program consists of Our Stories Have Power, Recovery Messaging, the Science of Addiction & Recovery and the Recovery Ambassador curriculum. Course material includes instruction in language and stigma, recruiting volunteers, building messages, organizing community action, engaging policymakers, raising money and effective advocacy. Learn more.

    Reminder: On Demand Webinars Presented by Psychiatric-Mental Health Nurses 

    New ORN-funded webinars from the American Psychiatric Nurses Association have been posted and are available to all at no cost. These include:

    ·     What’s in Grandma’s Medicine Cabinet? – Understanding Substance Use Disorders in Older Adults Explore how age-related physiological and social changes present unique challenges for the identification and treatment of this disorder.

    ·     Substance-Exposed Pregnancies: What to Know As They Grow Discover how substance use during pregnancy impacts maternal/fetal development and increases the neurological vulnerabilities of the neonate.

    A Primer on Stimulant Use Disorder: A Growing Concern 

    Examine neuroscience changes as a result of a substance use disorder, along with the signs and symptoms that often present with the diagnosis as well as potential treatment options.

    Share our mission in your community!

    Opioids, stimulants and other substances have created an unprecedented health crisis so the Opioid Response Network created an unprecedented response. As communities mobilize to address local need, we are here to enhance their efforts. Help us spread the word! Post the video below to your network's social channels. Encourage your network to tell us what they need via the simple request form at  - 401-270-5900  -

  • February 16, 2022 5:06 PM | Judy Pfeiffer (Administrator)

    The Commission on Combating Synthetic Opioid Trafficking, established under Section 7221 of the National Defense Authorization Act for Fiscal Year 2020, was charged with examining aspects of the synthetic opioid threat to the United States—specifically, with developing a consensus on a strategic approach to combating the illegal flow of synthetic opioids into the United States. This final report describes items involving the illegal manufacturing and trafficking of synthetic opioids, as well as the deficiencies in countering their production and distribution, and includes action items directed to appropriate executive branch agencies and congressional committees and leadership.

    Read the report.

  • February 14, 2022 3:14 PM | Judy Pfeiffer (Administrator)

    The CDC draft Clinical Practice Guideline for Prescribing Opioids (update to the 2016 Guideline for Prescribing Opioids for Chronic Pain) has posted in the Federal Register and the 60-day public comment period begins today. Public comment provides valuable insight from the populations that we serve. Please note that the 60-day public comment period will end on April 11, 2022. 

    CDC is committed to supporting safe and effective pain care options for patients. CDC’s National Center for Injury Prevention and Control (NCIPC) is in the process of updating the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. Both healthcare professionals and members of the public who experience acute or chronic pain have expressed interest in understanding the recommendations outlined in the draft updated Guideline, and CDC highly values public and partner engagement and feedback in this process.

    <Visit the Federal Register to provide your comments on the draft Guideline update> 

    Please see our webpage detailing the process of updating the Guideline. Encourage people you know who have direct experience with the role of opioids in pain care and the importance of the patient-clinician relationship to visit the Federal Register, review the draft update to the Guideline, and add their perspectives to the Federal Register Notice.  

    Submitting a Comment

    See below for instructions to submit a comment during the public comment period. More detailed instructions can also be found on the Federal Register Notice (FRN) webpage and in the FRN for this document.  

    To locate the FRN and view the draft of the updated Guideline, you can either:   

    To submit a comment to CDC, please view the methods outlined in the FRN under the "Addresses" heading and select which option you prefer:

    • Electronic comments via the website 
    • Go to and search for "CDC Guideline for Prescribing Opioids"
    • A comment button on the top left of the page will allow you to submit your comments via a webpage with step-by-step instructions
    • Mail
    • Directions for how to submit a comment through the mail are provided in the "Addresses" section of the FRN on

    To ask a question, click on the “For Further Information Contact” heading in the FRN for the agency official contact information. 

    General information about the process to provide a public comment can be found at the following links:  

  • January 24, 2022 1:52 PM | Judy Pfeiffer (Administrator)

    New RI Program will Divert Individuals with Substance Use Disorders from Incarceration and into Treatment

    Training, education and implementation efforts provided by the Opioid Response Network (ORN) has helped to establish a new program in Woonsocket, RI. This program, championed by RI Superior Court Judge Kristin Rodgers, will divert individuals with an opioid or other substance use disorders who have been arrested away from jail and into treatment and recovery support services. An estimated 70 to 100 people arrested every year could qualify to participate in this program, which was recently awarded the funding needed to get it off the ground.

    U.S. Senators Jack Reed and Sheldon Whitehouse and Congressman David Cicilline have announced a three-year $819,109 U.S. Department of Justice’s Bureau of Justice Assistance grant for the Woonsocket Police Department (WPD). Working with the non-profit Community Care Alliance, this will fund the Law Enforcement Assisted Deflection, Engagement, and Retention (LEADER) in Treatment program. ORN, a Substance Abuse and Mental Health Services Administration-funded initiative, will continue providing WPD with education and training support as needed. Read more.

    If an opportunity listed below sparks interest but you have questions or are not quite sure how it could fit into your own plans, email We can help! All ORN trainings are provided at no cost. To coordinate a tailored training with an ORN consultant to meet your specific needs, submit a request at

    New Course: Improving Clinical Practice with Patients who have Stimulant Use Disorder 
    Performance in Practice and Self-Assessment Activity

    This new course is designed to improve the competence, performance, and patient outcomes of physicians, physician assistants, nurses, nurse practitioners and other healthcare professionals. Learners will determine individual practice gaps and address them through a performance improvement plan. Learners will assess and evaluate performance techniques used in their practices. This ORN course was developed by ORN lead organization the American Academy of Addiction Psychiatry. Read more.

    Live Training: Certified Addiction Registered Nurse Exam Review for RNs/NPs - PART ONE: February 7, 2022

    This ORN-funded training from the Boston Medical Center is an exam review course for RNs and NPs working in the addiction field who have an interest in becoming a Certified Addictions Registered Nurse (CARN) or a Certified Addictions Registered Nurse - Advanced Practice (CARN-AP). This course is intended to support nurses studying for the CARN and CARN-AP exam by reviewing material the exam will cover. Read more.

    PLEASE NOTE: This is a two-part training. You must attend both parts to receive continuing education credits. See here for information on PART TWO.

    Live Training: Treating Stimulant Use Disorder
    February 9, 2022

    This ORN-funded training from the Boston Medical Center is designed to be a guide for addiction providers interested in providing and caring for people who use stimulants including cocaine and methamphetamines. The training will review the basic science of addiction related to stimulants as well as evidence-based treatment for people who use stimulants. The session will also talk about the practical implementation of evidence-based treatment for patients who use stimulants in the office-based addiction treatment setting. Read more.

    Live Training: Recovery Community Organization Bootcamp
    February 22 - 24, 2022

    This ORN-funded, Faces & Voices of Recovery activity is a 13-hour free training for new and emerging Recovery Community Organization (RCO) directors, program managers and board members. The training covers all the basics to help build the capacity of small non-profit organizations. Breakout sessions focus on RCO start-up, governance, sustainability, policies and procedures, strategic planning, staff development and more. Read more.

    On Demand Trainings: New Webinars Presented by Psychiatric-Mental Health Nurses 

    New ORN-funded webinars from the American Psychiatric Nurses Association have been posted and are available to all at no cost. These include:

    ·     What’s in Grandma’s Medicine Cabinet? – Understanding Substance Use Disorders in Older AdultsExplore how age-related physiological and social changes present unique challenges for the identification and treatment of this disorder.

    ·     Substance-Exposed Pregnancies: What to Know As They Grow Discover how substance use during pregnancy impacts maternal/fetal development and increases the neurological vulnerabilities of the neonate.  

    ·     A Primer on Stimulant Use Disorder: A Growing Concern Examine neuroscience changes as a result of a substance use disorder, along with the signs and symptoms that often present with the diagnosis as well as potential treatment options.

    Read more.

    Tailored Trainings: Providing Peer Based Recovery Support Services for Pregnant and Parenting Families

    This ORN-funded training opportunity developed by the Addiction Technology Transfer Center prepares participants to meet the diverse needs of pregnant and parenting families in early recovery. Recovery and parenting both occur in the context of relationships. Trainings are designed to help participants build skills to support/ strengthen families as they grow and develop in their roles as nurturing parents. Submit a request for this training topic at Your local ORN Technology Transfer Specialist will connect with you to learn more about your specific needs and help facilitate a tailored, localized training on this topic. 401-270-5900

  • December 22, 2021 12:05 PM | Judy Pfeiffer (Administrator)

    America is confronted with surging overdose deaths in historically and continually marginalized communities. How will we respond?

    December 21, 2021, East Providence, RI --Recent data analysisi bears truth to previously anecdotal reports of surging overdose deaths. This research is also exposing how ongoing structural racism is resulting in disproportionately high rates of overdose deaths within historically and continually marginalized communities. The Covid-19 pandemic is exacerbating this reality.

    The research (Friedman & Hansen, 2021): Black overdose mortality overtook that of White overdose mortality in 2020 for the first time since 1999. Rates were 16.3% higher for Black individuals than White individuals in the same period. American Indian and Alaska Native individuals experienced the highest rate of overdose mortality in 2020. Rates for this populations were 30.8% higher than the rate for White individuals. Why? Health disparities resulting from structural racism spur increased drug overdose mortality within Black and Native communities.ii


    Addressing opioid and stimulant use disorders within Black and Native Communities can't be achieved with a one size fits all approach. To this end, the Opioid Response Network, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), relies on its expansive, diverse array of consultants and workgroups.

    "There has always been a severe gap in efforts to reach Black communities to address substance use disorders. This is alarming in the face of evidence that rates of overdose deaths in these communities outpace other populations. However, just reaching Black communities is not sufficient in-and-of-itself. Engagement must be tailored to meet individual and community identified needs. Working together we can identify and address health disparities and change the direction of these frustrating statistics."

    Opioid Response Network Black Communities Workgroup Co-Chairs: Tracie Gardner, Senior Vice President of Policy Advocacy, Legal Action Center, and Myra Mathis, MD Senior Instructor of Psychiatry, Addiction Psychiatrist, Department of Psychiatry, University of Rochester

    "For over 500 years, Native communities have been faced with relocation, forced assimilation, and attempts at genocide resulting in generations of historical trauma. This set the stage for the current opioid and stimulant epidemics and the increasing rate of mortality from overdose in Native communities that new research has exposed. Recognizing that conventional efforts to address this have been compromised from issues including disparities in healthcare access, it is clear new strategies are needed that center solutions within Native communities and provide consultation and resources to support these efforts. Through culturally informed education and training delivered in partnership with diverse Native communities, we can make a difference."

    Opioid Response Network Indigenous Communities Workgroup Co-Chairs: Holly Echo-Hawk, MSc (Pawnee), and Aimee Campbell, PhD, Associate Professor of Clinical Psychiatric Social Work, Columbia University Irving Medical Center

    "LGBTQ+ people face intersecting racism, discrimination, and stigma that can lead to elevated rates of substance use and mortality from overdose. LGBTQ+ people also often face health disparities as a result of structural racism, which is a key factor in increasing mortality rates in Black and Native communities. Culturally informed education and training, which the Sexuality and Gender Diversity Workgroup supports, is key to addressing increasing overdose mortality rates and for all people with substance use disorders."

    Opioid Response Network Sexuality and Gender Diversity Workgroup Co-Chairs: Jeremy Kidd, MD, MPH, Assistant Professor of Clinical Psychiatry, Columbia University Irving Medical Center & New York State Psychiatric Institute, and Margaret Paschen-Wolff, DrPH, MSW Assistant Professor of Clinical Psychiatric Social Work, Columbia University Irving Medical Center & New York State Psychiatric Institute

    To supplement efforts taking place across the country and U.S. territories to address opioid and stimulant use disorders and the overdose crisis, the Opioid Response Network's coalition of national organizations and individuals is providing no cost education and training. To ensure cultural responsivity and acknowledging and actively working to dismantle the structures which uphold health disparities, Opioid Response Network's workgroups advise on all activities facing historically and continually marginalized communities. Visit for more information and to submit a request for training and education to enhance your efforts and meet your needs. Email with questions.

    About the Opioid Response Network

    The Opioid Response Network (ORN) was established through Substance Abuse and Mental Health Services Administration funding awarded to the American Academy of Addiction Psychiatry working collaboratively with the Addiction Technology Transfer Center Network, at the University of Missouri - Kansas City, Columbia University Division on Substance Use Disorders and 40 national organizations. ORN provides education and training in the prevention, treatment and recovery of opioid and stimulant use disorders at the local level and at no cost.

    For more information, contact:
    Nicholas Canning
    Sr. Project Manager
    Opioid Response Network | 401-270-1173

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