ASAM Practice Pearls

ASAM Education
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Season 1 | Season 2 Join ASAM Practice Pearls for in-depth discussions on addiction prevention, treatment, and recovery. Geared toward healthcare professionals and individuals seeking knowledge, this series explores the latest evidence-based approaches to addiction medicine. Listen to interviews with leading experts as they delve into critical topics and share practical tools you can use to improve patient care and promote public health.

  1. FEB 9

    Understanding Medetomidine: Emerging Challenges for Addiction Medicine

    In the Season 2 premiere of ASAM Practice Pearls, Drs. Stephen Taylor and Jeanmarie Perrone follow up on Season 1’s episode, Emerging Illicit Substances: What Clinicians Need to Know. Together, they discuss how medetomidine has continued to spread to different regions and what has changed over the past year. They explore strategies for managing medetomidine withdrawal, keeping patients safe, and preparing for this growing public health threat.  ----more---- Looking for this episode's transcript? Download it HERE Get credit for listening! Claim your 0.5 CMEs HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board-certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states. Expert Jeanmarie Perrone, MD, FASAM, FACMT   Dr. Jeanmarie Perrone is a Professor in the Department of Emergency Medicine and the founding Director of the Center for Addiction Medicine and Policy at the University of Pennsylvania. Dr. Perrone leads programs for the treatment of Opioid and Alcohol Use Disorders from the emergency department and via a virtual telehealth bridge clinic (CareConnect). Her work has been funded by city health departments and by NIDA, PCORI, CDC, and SAMHSA. She has advocated at the state and national level and contributed to working groups to enhance low-barrier treatment access for substance use disorders and improving toxicosurveillance. She has been recognized with awards for leadership, education, and mentorship.  📖 Show Segments 00:05 - Season 2 Introduction 01:03 - New Drug Crisis: Medetomidine  02:34 - Pharmacology and Withdrawal Symptoms 05:58 - Clinical Management and Patient Care 08:22 - Public Health and Harm Reduction 11:56 - Regional Impact and Future Concerns 15:21 - Key Takeaways and Action Items 19:26 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Recognize the symptoms: Medetomidine withdrawal presents with refractory vomiting and tremors and is complicated by severe hypertension and tachycardia, within 2 hours of last use.  Treat aggressively with clonidine, an alpha-2 adrenergic agonist, and olanzapine: Use high doses of clonidine (0.2-0.4 mg, as often as every 2 hours) combined with alpha-2 adrenergic agonists for concurrent opioid withdrawal, and olanzapine to help control nausea and vomiting to prevent escalation to the ICU.  Use dexmedetomidine for severe cases: Approximately one-third (or more) of patients require dexmedetomidine infusion in the ED or ICU to manage symptoms. Coordinate early with critical care if symptoms worsen despite initial treatment.  Distinguish from alcohol or benzodiazepine withdrawal: If a patient presents with what looks like alcohol or benzodiazepine withdrawal but doesn't respond to benzodiazepines or barbiturates, consider adding dexmedetomidine. If the patient responds to the dexmedetomidine, medetomidine withdrawal should be considered.  Update naloxone education: Teach patients and bystanders that the goal for naloxone is improved respiratory effort, not wakefulness. Medetomidine may keep the person sedated even after successful opioid reversal.  Provide medetomidine test strips: In areas with lower medetomidine prevalence, test strips can help patients identify and avoid adulterated supplies.   Monitor the local drug supply: Connect with drug-checking programs in your area to learn which adulterants are present and at what prevalence.  Report suspected cases to your local health department: Help track the spread of medetomidine by reporting suspected cases. Public health surveillance is essential.   🔗 Resources Medetomidine: Rising Adulterant in the Illicit Drug Supply - Download HERE ASAM’s 57th Annual Conference - Register HERE  Focus Session: Pharmacologic Innovations in Alpha-2 Agonist Withdrawal Management in EDs and ICUs  Center for Addiction Medicine and Policy by Penn Medicine: Medetomidine -Review current information on Pennsylvania’s medetomidine withdrawal protocol.   Substance Use Philly: Medetomidine - Review current information from the city of Philadelphia on medetomidine, including its effects, treatment, and harm reduction recommendations, and available resources for community members, non-medical organizations, and healthcare providers.  Responding to Overdose and Withdrawal Involving Medetomidine - Philadelphia Department of Public Health. Division of Substance Use Prevention and Harm Reduction. June 10, 2025.   Medetomidine Palm Card - Department of Public Health, City of Philadelphia -  An informational card on medetomidine withdrawal that can be used for patient education and guidance to healthcare providers on managing medetomidine withdrawal.  Emergence of Medetomidine in the Illicit Drug Supply: Implications for Emergency Care and Withdrawal Management - Lynch MJ, Pizon AF, Yealy DM. Ann Emerg Med. Published online January 22, 2026. doi:10.1016/j.annemergmed.2025.12.004 A Powerful New Drug Is Causing a “Withdrawal Crisis” in Philadelphia - The New York Times  📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    21 min

  2. 08/31/2025

    Overdose Awareness: Preventing, Responding, and Intervening

    In recognition of International Overdose Awareness Day, the Season 1 finale of ASAM Practice Pearls explores recent trends in overdoses. Drs. Stephen Taylor and Alexander Walley discuss the increase of fentanyl and other contaminants in the drug supply, the impact of racial and geographic disparities, and the importance of community-specific responses. They highlight the value of compassionate overdose care, data-driven interventions, and strategies to help individuals post-overdose. Together, they discuss the need to lower barriers to treatment and foster future leaders in addiction medicine. ----more---- Looking for this episode's transcript? Download it HERE We want to hear from you! Please take our short, five-minute survey HERE or email us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board-certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states.  Expert Alexander Y. Walley, MD, MSc, DFASAM  Dr. Alexander Y. Walley is Professor of Medicine at Boston University Chobanian & Avedisian School of Medicine, primary care physician and addiction specialist at Boston Medical Center focused on the medical complications of substance use, specifically HIV and overdose. He leads research studies on overdose prevention and the integration of addiction specialty care and general medical care. He is a founder of Boston Medical Center’s inpatient addiction consult service and walk-in substance use care bridge clinic. Dr. Walley was a founding director of the Grayken Addiction Medicine Fellowship and is the president of the American College of Academic Addiction Medicine. He serves as the medical director for the Massachusetts Department of Public Health’s Bureau of Substance Addiction Services, the Overdose Prevention Program, and the SafeSpot Overdose Prevention Hotline.  📖 Show Segments 00:05 - Introduction  00:17 - Epidemiology and Geographical Areas of Concern  07:15 - Racial, Geographic, and Socioeconomic Disparities 08:58 - Contaminants in the Drug Supply Affect Overdose Response 13:03 - Engaging Patients with Post-Overdose Care 18:18 - Approaching Conversations About Overdose Risk 23:42 - Tools for Overdose Prevention 26:19 - Policy, Protocols, and Treatment Innovationsr 30:41 - Training the Next Generation 33:23 - Final Thoughts on the Overdose Crisis 34:05 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Understand the Evolving Nature of the Opioid Epidemic: The overdose crisis has progressed through distinct waves, from prescription opioids, to heroin, to fentanyl, and now to increasingly complex combinations with stimulants and synthetic substances.  Address Racial, Ethnic, and Geographic Disparities: Marginalized populations and rural communities often face greater risk and reduced access to prevention, harm reduction, and treatment resources, requiring intentional, equity-focused interventions.  Respond to Emerging Drug Supply Contaminants: The presence of non-opioid substances like xylazine complicates overdose response, as naloxone may not reverse all effects, requiring expanded training and protocols for responders.  Promote Compassionate Overdose Response: In the event of an overdose, the priority is to restore breathing quickly and safely. Use only the amount of naloxone necessary and offer supportive, nonjudgmental care throughout the recovery process.  Encourage Practical Overdose Prevention Strategies: Most fatal overdoses occur when people use alone. Help patients develop practical safety plans, such as not using alone, developing safety plans, using drug checking tools, and maintaining access to naloxone to reduce overdose risk.   Leverage Real-Time Data for Community Action: Tools like OD Map and CDC dashboards provide real-time insights that can help inform timely, targeted community responses to emerging overdose patterns.  Lower Barriers to Evidence-Based Treatment: Expanding access to care through same-day treatment, low-barrier programs, and integrated support services, such as housing, education, and employment, helps improve outcomes and reduce overdose deaths.  Remove Barriers to Treatment and Support Systems: Expanding access to care, integrating social supports, and investing in workforce development, including training future addiction medicine leaders, are important for sustainable progress.  🔗 Resources The ASAM Principles of Addiction Medicine (Seventh Edition):  The Harm Reduction Approach to Caring for People Who Use Substances: Miller S, Rosenthal RN, Levy S, Saxon AJ, Tetrault JM, Wakeman SE. (Eds), The ASAM Principles of Addiction Medicine (Seventh Edition). American Society of Addiction Medicine, Inc.; 2024:1509-1529.  A Call for Compassionate Opioid Overdose Response: Russell E, Hawk M, Neale J, Bennett AS, Davis C, Hill LG, Winograd R, Kestner L, Lieberman A, Bell A, Santamour T, Murray S, Schneider KE, Walley AY, Jones TS.  Int J Drug Policy. 2024 Nov;133:104587. doi: 10.1016/j.drugpo.2024.104587. Epub 2024 Sep 18. PMID: 39299143.    Understanding and Addressing Widening Racial Inequalities in Drug Overdose: Friedman JR, Nguemeni Tiako MJ, Hansen H.  Am J Psychiatry. 2024 May 1;181(5):381-390. doi: 10.1176/appi.ajp.20230917. PMID: 38706336; PMCID: PMC11076008.  National Syndromic Surveillance Program (NSSP): Provides expertise and technical assistance to support public health professionals.  Safe Spot (1-800-972-0590): A toll-free, 24/7 confidential service that provides overdose safety planning and response to people using drugs alone.  State Unintentional Drug Overdose Reporting System (SUDORS): Provides detailed information on the characteristics and circumstances of overdose deaths to inform drug overdose prevention and response efforts.  📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    35 min

  3. 08/18/2025

    Perinatal Substance Use Care: Listening, Trust, and Treatment

    In this episode of ASAM Practice Pearls, Dr. Stephen Taylor and Dr. Cara Poland explore the unique challenges of perinatal substance use care. They discuss the impact of stigma, the importance of compassionate care, and the use of medications for addiction treatment in pregnancy. Additionally, they address polysubstance use, physiological changes during pregnancy, and the critical postpartum period, sharing insights from their clinical experience and emphasizing a patient-centered, non-judgmental approach to improve treatment outcomes for mothers. ----more---- Looking for this episode's transcript? Download it HERE We want to hear from you! Please take our short, five-minute survey HERE or email us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board-certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states.  Expert Cara Poland, MD, MEd, FACP, DFASAM  Dr. Cara Poland is ASAM’s Vice President, is board-certified in Addiction Medicine, and is a faculty member at Michigan State University. In 2018, Dr. Poland identified the need to strengthen our country’s Addiction Medicine workforce. Dr. Poland leads MI CARES, which trains physician-level addiction specialists in Michigan and across the country. The program also teaches physicians-in-training, resident physicians, social work students, social work practitioners, APRNs, and PAs. Her didactic program involves purposeful education to train healthcare providers to treat persons with SUDs in a kind, compassionate, destigmatized way. Dr. Poland has a special interest in treating pregnant people and their families living with a substance use disorder.  📖 Show Segments 00:05 - Introduction  00:15 - New York Times Excerpt  03:07 - Substance Use and Overdose Risk During Pregnancy 04:07 - Addressing Stigma in Addiction Treatment 19:18 - Effective Support Systems for Pregnant People with Addiction 13:56 - Medication for Opioid Use Disorder During Pregnancy 18:00 - Postpartum Care and Overdose Risk 27:06 - Polysubstance Use and Alcohol Use Disorder 33:38 - Key Takeaways 35:10 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Recognize Pregnancy as a Motivator for Change: Pregnancy can inspire individuals to seek help and begin recovery. Leveraging this motivation through empowering, respectful care can improve outcomes for both parent and baby.  Understand Vulnerability in Substance Use: Addressing underlying vulnerabilities that often contribute to substance use, such as trauma, mental health conditions, and social factors, through compassionate care is essential to supporting recovery.   Foster Trust by Reducing Stigma: Creating nonjudgmental healthcare environments, along with respectful, supportive patient-provider relationships, encourages engagement and improves treatment outcomes.  Promote Evidence-Based Treatment During Pregnancy: Medications for opioid and alcohol use disorders are safe and effective during pregnancy. Addressing misinformation and normalizing these treatments can help improve access and reduce harm.  Normalize Return to Use as Part of Recovery: Recovery is rarely linear. Approaching return to use with empathy, as a step in the process, encourages long-term engagement and helps reduce shame.  Deliver Empathic, Individualized Care: Active listening, empathy, and individualized care planning help build trust, deepen understanding, and guide effective, patient-centered interventions.  Implement Team-Based Support: Pregnant individuals with substance use disorders often face complex medical, social, and behavioral health challenges. Coordinated, interdisciplinary care is essential for addressing these needs holistically.  🔗 Resources ASAM’s Clinical Tips Microlearning Video Series: Women and Addiction Engaging Families and Care Providers in Women’s SUD Treatment Substance Use Among Aging Women Pregnancy and Substance Use Disorders Dressing Motivated Behaviors in Women with SUD ASAM’s Women and Addiction Education and Resources: Explore HERE Patient-Centered Care for Women with Substance Use Disorders – Online Course Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants: Substance Abuse and Mental Health Services Administration. HHS Publication No. (SMA) 18-5054. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018.  Your Words Matter – Language Showing Compassion and Care for Women, Infants, Families, and Communities Impacted by Substance Use Disorder: Offers tips on how to use person-first language and which terms to avoid using to reduce stigma and negative bias when discussing addiction or substance use disorder with pregnant women and mothers. The ASAM Principles of Addiction Medicine (Seventh Edition): Substance Use During Pregnancy: Weaver MF, Jones HE, Wunsch MJ. Substance Use During Pregnancy. In Miller S, Rosenthal RN, Levy S, Saxon AJ, Tetrault JM, Wakeman SE. (Eds), The ASAM Principles of Addiction Medicine (Seventh Edition). American Society of Addiction Medicine, Inc.; 2024:1509-1529. 📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    37 min

  4. 08/04/2025

    Listening First: The Future of Women's Addiction Treatment

    In this episode of ASAM Practice Pearls, Dr. Peter Selby and Dr. Hendree Jones discuss the importance of implementing gender-responsive and trauma-informed care in addiction treatment. They offer insights on recognizing trauma in patients, creating safer treatment environments, addressing gender-specific treatment gaps, and emphasizing the importance of language and empathy in clinical practice. Together, they highlight the positive impact that a compassionate and inclusive approach can have on patient care and treatment outcomes. ----more---- Looking for this episode's transcript? Download it HERE We want to hear from you! Please take our short, five-minute survey HERE or email us at education@asam.org. Host Peter Selby, MBBS, CCFP(AM), FCFP, FASAM  Dr. Peter Selby is a Senior Scientist and Senior Medical Consultant at the Centre for Addiction and Mental Health (CAMH) and Vice-Chair, Research, and Giblon Professor in Family Medicine at the University of Toronto. His research focuses on innovative methods to understand and treat addictive behaviors and their comorbidities. He utilizes technology to scale and test health interventions, with his cohort of over 400,000 treated smokers in Ontario serving as an example. Dr. Selby has received over $100 million in grant funding from CIHR, NIH, and the Ministry of Health and has published more than 200 peer-reviewed articles. His most recent research program utilizes a Learning Health Systems approach to investigate how technology-equitable, collaborative care can enhance the delivery of evidence-based interventions to the patient while providing a more satisfying care experience for patients and providers across systems. Expert Hendree Jones, PhD Dr. Hendree Jones is a licensed psychologist and an internationally recognized expert in the development and examination of both behavioral and pharmacologic treatments for pregnant women and their children in risky life situations. She was the Division Director of UNC Horizons for a decade and, in May of 2023, stepped into a Senior Advisor role for Horizons to take on several national policy and international policy projects. Expertscape ranks Dr. Jones as a top world expert in neonatal abstinence syndrome and opioid-related disorders. She has received continuous National Institutes of Health funding since 1994 and has written more than 350 publications. Dr. Jones has also authored two books, one on treating patients for substance use disorders and the other on comprehensive care for women who are pregnant and have substance use disorders. She has also written multiple textbook chapters on the topic of pregnancy and addiction, as well as 17 courses for adult learners on topics of substance use disorder treatment (WISE, CHILD, PEERS, ALLIES, etc.). Dr. Jones has co-authored multiple national and international guidelines on the topic of caring for pregnant and post-pregnant patients with substance use disorders and their children, including those published by the WHO, SAMHSA, and ASAM. She also co-authored both the women’s and children’s section of the UN International Standards for the Treatment of Drug Use Disorders and the UN guidelines on prevention and treatment for girls and women. In 2020, Dr. Jones won the ASAM R. Brinkley Smithers and Distinguished Scientist Award. In 2024, she won the MED Brady-Schuster Division 28 American Psychological Association award for lifetime achievement for contribution to addiction science. She consults for the UN and the WHO and is a member of the NIH’s HEAL multidisciplinary working group and the Advisory Committee on Research on Women's Health. Dr. Jones has been involved in over 43 projects around the world focused on improving the lives of children, women, and families. 📖 Show Segments 00:05 - Introduction  01:09 - Patient Story: The Impact of Trauma on Women with Addictions 03:34 - Principles of Gender Responsive and Trauma-Informed Care 05:41 - Language and Communication in Addiction Treatment 08:06 - Challenges and Solutions in Implementing Trauma-Informed Care 17:17 - Biological and Gender Differences in Addiction 17:30 - Addressing Treatment Gaps for Women in Addiction Care 23:56 - Practical Steps for Trauma-Informed Care in Clinical Practice 27:08 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Implement Trauma-Informed Care: Trauma plays a significant role in women's addiction, requiring a trauma-informed approach to care that considers not just the events but also the lasting effects and individual experiences of trauma. Create Safe, Supportive Environment: Fostering a safe, transparent, and non-punitive environment is crucial for effective trauma-informed care. This includes considering physical surroundings, psychological safety, and the overall treatment environment to create a more welcoming and less anxiety-inducing environment. Use Respectful, Non-Stigmatizing Language: The language used by providers can significantly impact the comfort and dignity of patients. Avoiding stigmatizing terms and promoting respectful communication are essential to building trust between healthcare providers and patients. Implement a Gender-Responsive Approach: There are biological and social differences in how women experience addiction and substance use. Healthcare providers need to address these unique needs, such as offering targeted support and addressing gender-specific triggers. Address Systemic Issues and Barriers: Barriers to implementing trauma-informed care can be both systemic and cultural. Securing buy-in from all stakeholders, addressing staff concerns and fears, and ensuring consistent and positive reinforcement of new practices are important steps in overcoming organizational and cultural barriers. Foster Collaborative Care: Engaging patients as partners in their own treatment plans through shared decision-making and understanding their individual needs and triggers can enhance engagement and outcomes. This collaborative approach also applies to interactions with team members and creating a supportive work environment. Engage with Compassion and Curiosity: Maintaining empathy, validating patients' experiences, being genuinely curious about their needs and stories, and using mindfulness techniques can build stronger, more supportive patient-provider relationships, ultimately improving recovery. 🔗 Resources ASAM’s Women and Addiction Education and Resources: Explore HERE Trauma-Responsive Care for Women with Substance Use Disorders – Factsheet Patient-Centered Care for Women with Substance Use Disorders – Online Course ASAM’s Clinical Tips Microlearning Video Series: Women and Addiction Engaging Families and Care Providers in Women’s SUD Treatment Substance Use Among Aging Women Pregnancy and Substance Use Disorders Dressing Motivated Behaviors in Women with SUD NIDA Substance Use in Women Research Report: Provides an overview of how women not only use and respond to substances differently than men but also face unique biological, psychological, and social barriers in developing, experiencing, and treating substance use disorders. Your Words Matter – Language Showing Compassion and Care for Women, Infants, Families, and Communities Impacted by Substance Use Disorder: Offers tips on how to use person-first language and which terms to avoid using to reduce stigma and negative bias when discussing addiction or substance use disorder with pregnant women and mothers. Opioid-Use Disorders in Pregnancy: Management Guidelines for Improving Outcomes: Intimate Partner Violence, Pregnancy, and Substance Use Disorder: Soper R, Jones H. Intimate Partner Violence, Pregnancy and Substance Use Disorder. In: Wright (Ed.), Opioid-Use Disorders in Pregnancy: Management Guidelines for Improving Outcomes. Cambridge University Press; 2018:41-48. Treatment Approaches in Women with Substance Use Disorders Who Become Pregnant: Jones H. Treatment Approaches in Women with Substance Use Disorders Who Become Pregnant. In: Wright T (Ed.), Opioid-Use Disorders in Pregnancy: Management Guidelines for Improving Outcomes. Cambridge University Press; 2018:72-83. The ASAM Principles of Addiction Medicine (Seventh Edition): Substance Use During Pregnancy: Weaver MF, Jones HE, Wunsch MJ. Substance Use During Pregnancy. In Miller S, Rosenthal RN, Levy S, Saxon AJ, Tetrault JM, Wakeman SE. (Eds), The ASAM Principles of Addiction Medicine (Seventh Edition). American Society of Addiction Medicine, Inc.; 2024:1509-1529. 📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    29 min

  5. 07/21/2025

    Neurologic-Informed Care: Integrating Brain Injury Awareness into Addiction Medicine

    In this episode of ASAM Practice Pearls, Dr. Peter Selby and Dr. John Corrigan explore the intersection of brain injury and addiction treatment. They introduce the concept of neurologic-informed care and discuss how cognitive impairments from brain injuries impact addiction recovery. The episode explores practical strategies for screening, treatment, and creating supportive environments to enhance outcomes for individuals with co-occurring brain injury and substance use disorder. ----more---- Looking for this episode's transcript? Download it HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Peter Selby, MBBS, CCFP(AM), FCFP, FASAM  Dr. Peter Selby is a Senior Scientist and Senior Medical Consultant at the Centre for Addiction and Mental Health (CAMH) and Vice-Chair, Research, and Giblon Professor in Family Medicine at the University of Toronto. His research focuses on innovative methods to understand and treat addictive behaviors and their comorbidities. He utilizes technology to scale and test health interventions, with his cohort of over 400,000 treated smokers in Ontario serving as an example. Dr. Selby has received over $100 million in grant funding from CIHR, NIH, and the Ministry of Health and has published more than 200 peer-reviewed articles. His most recent research program utilizes a Learning Health Systems approach to investigate how technology-equitable, collaborative care can enhance the delivery of evidence-based interventions to the patient while providing a more satisfying care experience for patients and providers across systems. Expert John Corrigan, PhD, ABPP Dr. John Corrigan is a professor in the Department of Physical Medicine and Rehabilitation at Ohio State University and Director of the Ohio Valley Center for Brain Injury Prevention and Rehabilitation. His research interests include a focus on education and treatment for individuals with co-occurring brain injury and substance use, a critical area in both clinical practice and public health. Dr. Corrigan is Editor-in-Chief of the Journal of Head Trauma Rehabilitation. He has been the PI and co-PI of the Ohio Regional Traumatic Brain Injury Model System since 1997 and chaired the Executive Committee of the TBI Model Systems Project Directors from 2007-2017. Dr. Corrigan is the National Research Director for the Brain Injury Association of America. Since 2013 he has served as the Director of the Ohio Brain Injury Program, which is the designated lead agency in the state of Ohio for policy and planning related to living with brain injury. He has more than 200 peer reviewed publications and has received many awards for his service and research in brain injury rehabilitation, including the Brain Injury Association of America’s William Fields Caveness Award, the 2007 Robert L. Moody Prize, the Gold Key Award from the American Congress of Rehabilitation Medicine, and the Lifetime Achievement Award from the International Brain Injury Association. 📖 Show Segments 00:05 - Introduction  02:20 - Understanding Neurologic-Informed Care 05:53 - The Hidden Epidemic in Addiction Medicine 08:03 - Anoxic and Hypoxic Brain Injuries 15:19 - Practical Screening and Treatment Modifications 22:05 - Accommodations and Environmental Factors 24:48 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Recognize and Screen for Brain Injuries: Brain injuries, including traumatic brain injuries (TBI) and anoxic/hypoxic injuries, are common but often overlooked in mental health and addiction treatment. Standardized screening at intake, using detailed patient histories and cognitive assessments, is crucial for accurate identification and effective care planning.  Implement Neurologic-Informed Care: Similar to trauma-informed Care, this approach integrates an understanding of neurologic impairments into all aspects of treatment. It highlights the importance of understanding cognitive limits, modifying care approaches, and fostering an environment that supports recovery for those with neurological impairments. Understand Cognitive Impacts on Recovery: Brain injuries often impair attention, memory, processing speed, and executive function—issues that can impact treatment adherence and be mistaken for a lack of motivation. These impairments can also increase the risk of substance misuse and make recovery more challenging. Adapt Treatment Environments and Methods: Creating supportive environments, such as reducing noise, adjusting lighting, and allowing for restlessness, along with practical strategies like visual aids, repetition, and hands-on tools, can help individuals with cognitive impairments better engage in treatment, retain information and make the behavior changes needed for successful recovery. Address Sleep Disorders: Sleep disturbances are common in both brain injury and substance use populations. Identifying and treating sleep disorders can improve cognitive functioning and support overall treatment success.  Individualized Care to Reduce Substance Use Risks: Individuals with brain injuries face an increased risk of substance misuse and relapse. Individualized, neurologically informed accommodations can reduce these risks and support more sustainable recovery outcomes.  🔗 Resources Accommodating the Symptoms of Traumatic Brain Injury: This booklet from the Ohio Valley Center for Brain Injury Prevention and Rehabilitation provides clear guidance on understanding the effects of TBIs and offers practical, individualized accommodation strategies to support full participation in work, school, and community life.  INROADS Issue Brief: Opioid Use Among Persons with Traumatic Brain Injury: In this brief, we will discuss the relationship between TBI, opioid use disorder, and targeted policy solutions to improve short- and long-term outcomes.  Modifying Clinical Interventions for TBI: This brief from the ACL's Traumatic Brain Injury (TBI) Technical Assistance and Resource Center (TARC) highlights considerations and best practices for diagnosing and treating behavioral health disorders in people with TBI.  SAMHSA Advisory: Treating Patients with TBI: This Advisory summarizes key elements of TBI and describes its relevance to behavioral health, including recommendations for behavioral health professionals. Traumatic Brain Injury and SUD Series: The Mid-America and Mountain Plains Addiction Technology Transfer Centers (ATTCs), in partnership with the National Association of State Head Injury Administrators (NASHIA), offer recorded webinars and a toolkit on the intersection between brain injury and substance use disorders. The ASAM Criteria: The most widely used and comprehensive set of standards for placement, continued service, and transfer of patients with addiction and co-occurring conditions. Chapter 19 of the 4th Edition Adult version addresses cognitive impairment and neurologic-informed care.  ASAM Criteria Curriculum: Explore the different trainings ASAM offers on both the 3rd and 4th Edition ASAM Criteria.   📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    26 min

  6. 07/07/2025

    When Behavior Becomes Addiction: What Clinicians Need to Know

    In this episode of ASAM Practice Pearls, Dr. Peter Selby and Dr. Emily Brunner explore behavioral addictions—including gaming, gambling, sex, and social media. They discuss how these behaviors impact the brain, how they present clinically, and how to recognize and treat them using evidence-based approaches. The episode emphasizes the importance of validating these conditions and offering appropriate care.  ----more---- Looking for this episode's transcript? Download it HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Peter Selby, MBBS, CCFP(AM), FCFP, FASAM  Dr. Peter Selby is a Senior Scientist and Senior Medical Consultant at the Centre for Addiction and Mental Health (CAMH) and Vice-Chair, Research, and Giblon Professor in Family Medicine at the University of Toronto. His research focuses on innovative methods to understand and treat addictive behaviors and their comorbidities. He utilizes technology to scale and test health interventions, with his cohort of over 400,000 treated smokers in Ontario serving as an example. Dr. Selby has received over $100 million in grant funding from CIHR, NIH, and the Ministry of Health and has published more than 200 peer-reviewed articles. His most recent research program utilizes a Learning Health Systems approach to investigate how technology-equitable, collaborative care can enhance the delivery of evidence-based interventions to the patient while providing a more satisfying care experience for patients and providers across systems. Expert Emily Brunner, MD, DFASAM  Dr. Emily Brunner is board-certified in family medicine and a distinguished fellow in addiction medicine. She has experience treating addiction in both inpatient and outpatient settings. She specializes in trauma-informed clinical treatment of substance use disorders with a comprehensive and compassionate approach. Dr. Brunner has been involved in leadership of the Minnesota Society of Addiction Medicine and is now on the national board of the American Society of Addiction. She is a passionate advocate for improving the care of patients with substance use disorder across the healthcare system, specifically in advocating for increased utilization of medications for opioid use disorder across all levels of care. Minnesota Magazine recognized her as a Top Doctor for Addiction Medicine in 2020 and 2021. She is the medical director of Gateway Recovery and Recovering Hope and does training on behalf of the Hazelden Betty Ford Foundation.  📖 Show Segments 00:05 - Introduction  02:03 -  How Behavioral Addictions Compare to Substance Use Disorders 04:18 - Clinical Presentation and Initial Screening 06:19 - Emerging Neuroscience and Research 09:15 - Diagnostic and Screening Tools 12:56 - Patient Experience in the Healthcare System 14:13 - Evidence-based Interventions 19:11 - Co-occurring Conditions and Risk Factors 21:14 - Advice to Clinicians 23:40 - Regulation and Future Directions 25:53 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways Behavioral Addictions are Real Diseases: Behavioral addictions such as gaming, gambling, and social media are increasingly recognized as legitimate disorders. They share similar brain mechanisms and clinical presentations with substance use disorders, including loss of control, impaired functioning, and continued use despite harm.  Emerging Neuroscience: Studies using fMRI have shown changes in brain structures in gaming and gambling disorders similar to those in substance addiction.  Screening and Diagnosis: Various validated screening tools exist for different behavioral addictions; it is crucial to familiarize oneself with and integrate them into clinical practice.  Treatment Approaches: Evidence-based treatments include cognitive-behavioral therapy (CBT), motivational interviewing, and contingency management. Additionally, certain medications, such as naltrexone and bupropion, have also shown some evidence of effectiveness. GLP-1 agonists may be another option in the future.   Co-Occurring Conditions: Individuals with behavioral addictions often have co-occurring mental health issues such as anxiety, depression, and other substance use disorders.  Regulatory Needs: There is a need for better regulation to protect young people from addictive technologies and predatory behaviors.  The Importance of Listening: Patients often feel dismissed when discussing behavioral addictions. Take patients' reports seriously and consider treatment options when appropriate.  🔗 Resources ASAM’s 56th Annual Conference Session - Games, Sex, and Social Media: Current Perspectives Register HERE  Bergen Social Media Addiction Scale: A screening instrument to measure dependence on social media.  Hypersexual Behavior Inventory: A screening instrument to help measure compulsive sexual behavior.  Lie-Bet Questionnaire: A screening instrument used to screen for gambling addiction.  The IGDT-10: A screening instrument to assess internet gaming disorder.  The South Oaks Gambling Screen: A 20-question screening instrument for gambling addiction.  Yale Food Addiction Scale: A screening instrument designed specifically to assess signs of addictive-like eating behavior.  Careless People: A Cautionary Tale of Power, Greed, and Lost Idealism by Sarah Winn-Williams  The ASAM Criteria: Call for Applications for Behavioral Addiction Volume Editors - ASAM is seeking experts in behavioral addictions (e.g., problem gambling, internet/social media addiction, problem gaming, compulsive sex, pornography addiction, and food addiction) to serve as Editors for the Fourth Edition of The ASAM Criteria, Behavioral Addictions Volume. This volume will propose principles for managing behavioral addiction and organizing the addiction treatment system.  📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    27 min

  7. 06/19/2025

    Sickle Cell Disease: Intersection of Pain and Addiction

    In recognition of Sickle Cell Awareness Day (June 19), this episode of ASAM Practice Pearls features host Dr. Peter Selby and expert Dr. Andrew Smith as they explore the complex intersection of sickle cell disease (SCD), pain, and addiction. They discuss the challenges individuals with SCD face in accessing effective pain management, often compounded by stigma and opioid-related concerns. The episode provides insights into evidence-based treatments, the balance between pain relief and opioid dependence risks, and strategies for compassionate, patient-centered care. ----more---- Looking for this episode's transcript? Download it HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Peter Selby, MBBS, CCFP(AM), FCFP, FASAM  Dr. Peter Selby is a Senior Scientist and Senior Medical Consultant at the Centre for Addiction and Mental Health (CAMH) and Vice-Chair, Research, and Giblon Professor in Family Medicine at the University of Toronto. His research focuses on innovative methods to understand and treat addictive behaviors and their comorbidities. He utilizes technology to scale and test health interventions, with his cohort of over 400,000 treated smokers in Ontario serving as an example. Dr. Selby has received over $100 million in grant funding from CIHR, NIH, and the Ministry of Health and has published more than 200 peer-reviewed articles. His most recent research program utilizes a Learning Health Systems approach to investigate how technology-equitable, collaborative care can enhance the delivery of evidence-based interventions to the patient while providing a more satisfying care experience for patients and providers across systems. Expert Andrew J. Smith, MDCM  Dr. Andrew J. Smith is a Staff Physician, Pain and Addiction Medicine and Medical Lead of the Interprofessional Pain and Addiction Recovery Clinic at the Centre for Addiction and Mental Health in Toronto. He comes from McGill Medicine, University of Washington Neurology, and UCLA Medical Genetics, initially focusing on neurodevelopmental medicine. Frustrated by how many of his young patients with learning disabilities would fall into substance use problems despite early successes, he retooled in the field of addiction medicine. He became the first in Canada to do a combined clinical fellowship in pain and addictions at CAMH and Mount Sinai Hospital. He now leads an Interprofessional team dedicated to helping people with substance use disorders, severe mental health conditions, and chronic pain improve their pain, function, and quality of life. Dr. Smith is passionate about improving access to better care for patients with chronic pain and addiction, educating patients, families, and clinicians about pain and addiction, and reducing stigma. He is an executive and hub member of ECHO Ontario Chronic Pain — a telementoring resource for primary care clinicians to enhance their skills and confidence in managing more of their own patients who have complex pain and opioid issues. 📖 Show Segments 00:05 - Introduction  00:26 - Dr. Selby’s Journey into Pain Management and Addiction Medicine 02:32 - Understanding Pain in SCD 04:40 - A Holistic Approach to Pain Management 06:15 - Reducing Stigma and Taking a Non-Judgmental Approach 09:16 - Discussing Opioid Use with Patients 12:36 - Assessing Patients with SCD 13:11 - Diagnosing Use Disorders in Patients with SCD 15:33 - Preparing for Emergency Room Visits 17:10 - The Importance of Patient Autonomy 18:31 - A Patient Success Story 21:41 - Conclusion and Additional Learning Opportunities 📋 Key Takeaways “Pain is Pain is Pain”: There are different kinds of pain in SCD. People with SCD experience acute pain from vaso-occlusive crises, chronic pain, sensitization-related pain, and acute flare-ups that may not necessarily be vaso-occlusive. Dual Diagnosis Complexity: Individuals with SCD may have co-occurring pain and addiction. Effective treatment plans need to address both components without invalidating the patient's experience of pain. Build Rapport and Use a Holistic Approach: Establishing a trusting and safe environment is crucial. Practitioners should take a trauma-informed and motivational approach to reduce stigma and defensiveness, addressing not only the physical aspects of pain but also the psychological, social, and contextual factors. Patient Autonomy and Collaboration: Empower patients by involving them in the decision-making process and providing them with information and options to improve treatment adherence and outcomes. Use of Buprenorphine: Buprenorphine has been effective in treating chronic pain in patients with SCD and can be used in divided doses or as a single dose, providing a safer alternative to traditional opioids. Universal Precautions Approach: Screening for risk factors and potential opioid misuse should be part of the assessment process. Practitioners should normalize discussions about substance use and develop a non-judgmental dialogue. Emergency Department Challenges: Educate both patients and emergency department staff about managing pain in patients with opioid use disorder. Care passports can help guide treatment during episodes of pain crisis. 🔗 Resources ASAM’s Pain and Addiction Curriculum: Explore the different courses and resources ASAM offers for treating patients with pain and addiction. ASAM’s Motivational Interviewing Courses: Explore the different courses and resources ASAM offers to develop techniques and practice skills in motivational interviewing. Sickle Cell Disease Association of America (SCDAA): A national organization dedicated to advocating for individuals affected by SCD. I Believe in Therapy Toolkit by SCDAA: A resource that addresses the stigma surrounding mental health in the Black community and encourages seeking therapy and support. June 19th is World Sickle Cell Awareness Day - check for local events on the Sickle Cell Disease Association of America 📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    22 min

  8. 06/09/2025

    Engaging and Retaining Young People in OUD Treatment: Making the Wish Come True

    In this episode of ASAM Practice Pearls, Dr. Stephen Taylor welcomes Dr. Marc Fishman for an insightful conversation on improving engagement and retention of youth in medication treatment for opioid use disorder (MOUD). They examine the unique challenges young people face and present developmentally informed strategies—including prevention, family involvement, and assertive outreach. The discussion highlights the importance of a medication-first approach and building partnerships with schools and communities to foster long-term recovery. ----more---- Looking for this episode's transcript? Download it HERE Have an idea for a future episode? Share it with us at education@asam.org. Host Stephen M. Taylor, MD, MPH, DFAPA, DFASAM Dr. Stephen M. Taylor is ASAM's President and is board-certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states.  Expert Marc Fishman, MD Dr. Marc Fishman is a specialist in addiction psychiatry and addiction medicine. He is a member of the faculty of the Department of Psychiatry at the Johns Hopkins University School of Medicine. He leads Maryland Treatment Centers, which offers programs for residential and outpatient treatment of SUD and co-occurring disorders in adolescents, young adults, and adults. He has been a principal investigator on numerous research studies in addiction and has published extensively in the field. His academic focus has been on medication treatment for OUD and other SUDs, treatment of opioid use disorder in youth, models of care, and treatment engagement strategies. Dr. Fishman served as a co-editor for past editions of ASAM’s Patient Placement Criteria, leading the adolescent section, and served as the chief editor for the ASAM PPC Supplement on Pharmacotherapies for Alcohol Use Disorders. He was a member of the Guideline Committee that developed the ASAM National Practice Guideline for the Treatment of OUD in 2015 and its update in 2020. He is the chair of the Adolescent SIG for ASAM. He is a Past President of the Maryland Society of Addiction Medicine and a current member of its Board. 📖 Show Segments 00:05 – Introduction 00:17 – Introductory Vignette: Pediatric Onset of Addiction  02:26 – Current Statistics and Challenges in Youth OUD  03:58 – Early Intervention  05:38 – Three Types of Prevention  06:17 – Barriers and Challenges to Effective Treatment for Youth  10:36 – The Role of Family in Treatment   15:47 – Unique Strengths of Youth  17:44 – Extended-Release Medications for OUD 21:21 – Motivating Youth in Treatment  24:49 – Engaging Schools in Care 26:56 – Assertive Approaches to Youth OUD Treatment 29:32 – Final Thoughts 31:47 – Conclusion and Additional Learning Opportunities 📋 Key Takeaways Initiate Early Intervention: Addiction is a developmental disorder of pediatric onset. Early intervention is necessary to prevent the disorder from progressing to its advanced stages.  Encourage Family Involvement: Incorporate family or a designated concerned significant other in the treatment process to support the young patient and improve adherence.  Implement Youth-Specific Treatment Approaches: Understand the unique developmental and psychological challenges youths face, and tailor engagement methods to include humor, their interests, therapeutic alliances, and empathy.  Promote Collaboration with Other Youth-Friendly Settings: Collaborate with schools, pediatricians, and other primary care practitioners to identify and support youth with substance use to promote treatment and facilitate their reintegration into educational environments.  Adopt an Assertive Approach: Utilize assertive outreach methods, such as frequent texting and continuous communication, to maintain young patients' engagement in their treatment plans.  Employ a Medication Forward Approach: Advocate for the use of medications for opioid use disorder (MOUD) early in the treatment process as a foundational step towards recovery.  Integrate Holistic Treatment Plans: Develop multi-component treatment plans that address not only the substance use but also the overall well-being and functional aspects of the young person’s life.  Utilize Extended-Release Medications: Extended-release medications, such as buprenorphine and naltrexone, are safe and effective options that can improve adherence and retention in treatment among young people. Promote Location-Based Interventions: Make treatments accessible by integrating them into environments where youths already are, such as schools, family practices, specialized addiction treatment settings, or juvenile justice settings.  Set Realistic Expectations: Medication doesn’t have to be a lifelong commitment. Focus on the present moment, setting realistic, short-term treatment goals to establish initial stabilization and momentum for recovery.  🔗 Resources ASAM’s 56th Annual Conference Session: Improving Outcomes for Youth OUD Treatment Register HERE Joint Meeting on Youth Prevention, Treatment, and Recovery: A conference focused on supporting youth in recovery from substance use. Youth Opioid Recovery Support (YORS) Intervention Study: A clinical trial designed to improve medication adherence in young adults 18–28 with opioid use disorder (OUD) through home delivery of extended-release medications, family involvement, digital communication outreach, and contingency management to increase treatment engagement and reduce return to use rates.  A Pilot Randomized Controlled Trial of Assertive Treatment Including Family Involvement and Home Delivery of Medication for Young Adults With Opioid Use Disorder: Fishman M, Wenzel K, Vo H, Wildberger J, Burgower R. Addiction. 2021;116(3):548-557. doi:10.1111/add.15181 An Assertive Community Intervention to Engage Youth with Opioid Use Disorder and Their Families: Wenzel K, Mallik-Kane K, Anderson K, Fishman M. Child Adolesc Psychiatr Clin N Am. 2024;33(4):709-728. doi:10.1016/j.chc.2024.02.007 Choice of Extended Release Medication for OUD in Young Adults (Buprenorphine or Naltrexone): A Pilot Enhancement of the Youth Opioid Recovery Support (YORS) Intervention: Wenzel K, Selby V, Wildberger J, Lavorato L, Thomas J, Fishman M. J Subst Abuse Treat. 2021;125:108306. doi:10.1016/j.jsat.2021.108306 Engagement, Initiation, and Retention in Medication Treatment for Opioid Use Disorder Among Young Adults: A Narrative Review of Challenges and Opportunities: Fishman M, Wenzel K, Gauthier P, et al. J Subst Use Addict Treat. 2024;166:209352. doi:10.1016/j.josat.2024.209352 The Use of Extended-Release Buprenorphine in the Treatment of Adolescent Opioid Use Disorder: A Case Series: Neptune A, Kaliamurthy S. J Addict Med. Published online February 3, 2025. doi:10.1097/ADM.0000000000001447 📢 Join the Discussion Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

    33 min
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Ratings & Reviews

4.9
out of 5
18 Ratings

About

Season 1 | Season 2 Join ASAM Practice Pearls for in-depth discussions on addiction prevention, treatment, and recovery. Geared toward healthcare professionals and individuals seeking knowledge, this series explores the latest evidence-based approaches to addiction medicine. Listen to interviews with leading experts as they delve into critical topics and share practical tools you can use to improve patient care and promote public health.

Information

  • Creator
    ASAM Education
  • Years Active
    2025 - 2026
  • Episodes
    23
  • Rating
    Clean
  • Copyright
    © Copyright 2025 All rights reserved.
  • Show Website
    ASAM Practice Pearls

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