Clinical Grand Rounds

Synopsis & Objectives:

The Analog Antidote explores what we lost, what we gained, and what we must protect as addictive technology reshapes human connection, attention, and wellbeing. Drawing on decades inside the tech industry and years researching its social costs, John Murphy offers mental health professionals a clear-eyed framework for understanding digital harm — and practical strategies for helping clients stay grounded in an increasingly ungrounded world.

Objectives: Participants will be able to (1) identify the psychological mechanisms behind addictive technology design; (2) articulate the documented costs of chronic digital immersion on attention, relationships, and identity; and (3) apply at least two analog-grounded strategies when working with clients navigating technology-related stress or disconnection.

Synopsis & Objectives:

 The current administration has presented challenges for health care policy, and SUD has not escaped unscathed. While funding for SUD research and treatment has not been impacted (yet,) the message is clear: science and data have taken a back seat to a focus on interdiction and law enforcement, threatening the progress of the last two decades. Overall, overdose deaths continue to come down, but a closer look at current policies illustrates that we will be facing great challenges in the future when it comes to workforce, innovation, and community outreach.

Synopsis and Objectives:

This session will explore the context as a determinant of behavior in addiction and recovery. Research suggests that the context, such as the social environment and availability of robust alternative reinforcers, impacts the etiology, maintenance, and recovery from addictive behaviors, yet such factors are often underemphasized in treatment and prevention models. This session will outline contextual models of addiction and recovery, review empirical evidence supporting the role of context, and outline potential benefits of a contextual model at the level of the individual and society in the areas of science, clinical practice, and policy.

Synopsis & Objectives:

We will discuss the latest updates to Contingency Management Interventions in the treatment of substance use disorders, including policy developments, implementation fidelity, and technology adaptations.

Synopsis & Objectives:

Attendees will be able to: Review medications 1) approved for treating alcohol use disorder, 2) used off-label for that purpose, and 3) in active development for that indication.

Synopsis & Objectives: 

This talk will describe evidence supporting use of a real-time amygdala targeted fMRI neurofeedback protocol focused on positive memory recall for the treatment of mood disorders and suicide risk, both as a standalone treatment and supplement to CBT/DBT therapy.  By the end of the presentation, participants will be able to provide a basic description of real-time fMRI neurofeedback and explain why targeting 1) the amygdala and 2) positive memory recall may help to reduce symptoms of depression and suicide risk.

Synopsis & Objectives:

Synopsis:

This presentation explores the growing impact of substance use disorders, particularly illicit drug use and xylazine exposure, on lower extremity pathology leading to severe tissue destruction, infection, limb-threatening complications, and amputation. Through a review of current literature and clinical cases, attendees will gain insight into the unique challenges of diagnosing and managing drug-related foot and ankle pathology.

Objectives:

Identify the clinical manifestations and pathophysiology of drug and xylazine-induced lower extremity wounds and infections.

Discuss multidisciplinary treatment strategies aimed at limb salvage, wound management, and prevention of amputation in this high-risk patient population.

Recognize the social, medical, and surgical challenges associated with caring for patients affected by substance use disorders and limb-threatening pathology.

Synopsis & Objective:  

This presentation covers key risk factors of psychotic disorders in young adults and how these patients may look at initial presentation.  The role of coordinated specialty care is highlighted and practical advice is provided for when such care is not an option.  Important sticking points in treatment of first episode psychosis are also covered.

Synopsis and objectives:

Synopsis

Cannabis is the most commonly used secondary substance among patients in opioid treatment programs, and staff frequently encounter patients who believe cannabis is harmless, even helpful, for their recovery. This presentation examines what the evidence actually shows about cannabis use among patients receiving methadone for opioid use disorder: its effects on treatment retention and opioid use outcomes, the risk of cannabis use disorder in this population, methadone-cannabis interactions, and practical strategies OTP staff can use to screen for, counsel on, and address cannabis use without jeopardizing the therapeutic relationship or treatment engagement.

Learning Objectives

Upon completion of this presentation, participants will be able to:

1. Evaluate the current evidence on how concurrent cannabis use affects methadone treatment outcomes including treatment retention, opioid use, and overdose risk.

2. Recognize cannabis use disorder in OTP patients and understand why ASAM guidelines recommend against requiring cannabis abstinence as a condition of continued methadone treatment.

3. Apply screening, brief intervention, and harm reduction strategies for cannabis use that are appropriate for the OTP setting and consistent with a patient-centered, nonpunitive approach.

Synopsis and Objectives:

 Measurement-based care is a clinical framework where providers routinely and systematically collect and review patient data to track progress and guide treatment decisions. This presentation will describe how measurement-based care can be used in substance use disorder treatment and describe challenges and opportunities in implementing it into routine care.

Synopsis and Objectives:

Coming soon!

Synopsis & Objectives:

This presentation will cover differences between normal cognitive aging and MCI/dementia, briefly review the primary diseases leading to dementia, and discuss dementia caregiver burden and how to support caregivers