2018 Opioid Summit: Treating Opioid Misuse and Opioid Use Disorder

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Aim for Excellence Conference

Start Time:12:00 AM
End Time:12:00 AM
Contact Information
Additional Information

This educational activity is jointly provided by AXIS Medical Education and MHA Health Institute.
AxisLogo_4ColorProcess MHA Health Institute Logo

Date & Location

Friday, March 2, 2018

Marriott St. Louis West
660 Maryville Centre Dr.
St. Louis, Mo.

Program registration is now full due to an overwhelming registration response.

The majority of conference expenses are covered by Missouri's State Targeted Response to the Opioid Crisis Grant and our sponsors. The reduced registration fee covers portions of the provided meal and other amenities that are not allowed to be covered by the grant.

Funds from the Missouri State Targeted Response for Opioid Crisis Grant and received through the Department of Mental Health and the University of St. Louis, Missouri Institute of Mental Health have been used for authorized expenses, such as speaker fees, to provide this educational offering at a reduced registration fee.


This is not another opioid summit telling you what you already know! Missouri is in the midst of a crisis! This Opioid Summit is for providers that need evidence-based guidance for treatment of pain, opioid use disorder, community-based services and policy solutions. Learn from national and state leaders who have data that demonstrate successful interventions.

Thank you to our sponsors!

Platinum Sponsors:
MAOPS logo
MHI logo

Gold Sponsors:
MoAHQ logo
MSMA logo

Silver Sponsors:
Missouri Academy of Family Physicians
Missouri College of Emergency Physicians

Co-sponsored by: Missouri Board of Healing Arts and the Missouri Board of Pharmacy


Chief medical officers, chief nursing executives, directors of case management, directors of emergency services, directors of infection control, directors of nursing, pharmacists, directors of outpatient services, directors of patient safety, directors of quality, directors of rehabilitation, and directors of social workers and health clinic coordinators

Learning Objectives

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

  • Review key factors driving the current opioid epidemic and their impact on health care utilization and delivery.
  • Assess the impact of the statewide levels of care efforts in standardizing care and on overdose-related outcomes.
  • Describe how illicitly-made fentanyl drugs are sold and consumed in the U.S.
  • Identify public health interventions in the U.S. that are working to address these health outcomes.
  • Describe the evidence base that supports agonist therapy for Opioid Use Disorder, especially in preventing death.
  • Outline the systematic barriers to evidence-based medical treatment of Opioid Use Disorder.
  • Describe promising practices and opportunities for integrating agonist therapy throughout the health care system for Opioid Use Disorder.
  • Describe the successes and challenges of medication-assisted maintenance treatment for Opioid Use Disorder.
  • Compare buprenorphine, methadone and naltrexone in the treatment of Opioid Use Disorder and the importance of a long-term clinic model in addiction treatment.
  • Analyze evidence-based practices of managing chronic pain and addiction and treatment initiation in the ER.
  • Review current Missouri initiatives focused on increased access to naloxone within community health centers and community pharmacies.
  • Discuss health care collaboration efforts that have the potential to reduce opioid overdose deaths.
  • Illustrate the impact of the opioid/heroin epidemic on different systems.


7:30 a.m. — Registration/Continental Breakfast

8:30 a.m. — Welcome and Opening Remarks
Leslie L. Porth, Ph.D., MPH, R.N.
Senior Vice President of Strategic Quality Initiatives
Missouri Hospital Association
Jefferson City

Mark Stringer, M.A., LPC, NCC
Missouri Department of Mental Health
Jefferson City

8:45 a.m. — Developing a Statewide, Hospital-based Program
Traci C. Green, Ph.D., MSC

Deputy Director, Boston Medical Center Injury Prevention Center
Associate Professor, Boston University School of Medicine and
The Warren Alpert School of Medicine of Brown University
Providence, R.I.

This session will review the drivers of the current opioid epidemic, how the emerging trends are impacting hospitals and emergency departments, and present one state's approach to standardizing the care of Opioid Use Disorder and overdose in emergency departments and hospitals. The overall goal is to encourage and inspire improvements in the way we currently care for overdose injuries and patients with Opioid Use Disorder.

10 a.m. — Break

10:15 a.m. — America’s Fentanyl Crisis: A National Perspective with Notes for the Field
Jon E. Zibbell, Ph.D.
Senior Health Scientist
RTI International
Atlanta, Ga.

Dr. Zibbell will discuss the factors involved in the sharp increase in morbidity and mortality associated with the increase in illicitly-made fentanyl in the U.S.. He will describe the types of illicitly-made fentanyl and fentanyl analogs being sold and consumed via illicit drug markets and how these illicit versions are different from prescribed fentanyl. Learn about fentanyl’s pharmacokinetics and why it is such a dangerous drug when manufactured and sold alongside heroin in street drug markets, including its public health risks. Finally, programmatic interventions that have shown success in reducing negative health outcomes associated with the fentanyl crisis will be discussed.

11:30 a.m. — Lunch (provided)

12:45 p.m. — A “Medication First” Model of OUD Treatment and the Opioid STR Grant
Ned Presnall, MSW, LCSW
Executive Director of Clayton Behavioral
Adjunct Professor and research collaborator at Washington University in St. Louis
Consultant for Missouri's State Targeted Response to the Opioid Epidemic
St. Louis

In traditional treatment programs for addiction, the majority of patients are not offered ongoing medical treatment. The minority who do receive medical care typically face intensive psychosocial service requirements that make access to medical treatment both burdensome and costly. Others face arbitrary limitations on medical treatment that are associated with greatly increased risk for morbidity and mortality. Medication First programs get persons with opioid use disorder maintenance medical treatment as quickly as possible and provide voluntary supportive services as needed. A patient's access to medical treatment is not dependent upon psychosocial treatment compliance or unrealistic expectations about the course of treatment and recovery. The Medication First approach is supported by decades of research. It prioritizes client choice in both service selection and service participation. There is a strong consensus in the scientific community that expanding the Medication First or "low-threshold" medical approach to Opioid Use Disorder will be essential to reversing the epidemic of opioid-related deaths.

2 p.m. — Break

2:15 p.m. — Missouri Practice Panel - Effective Treatments for Opioid Use Disorders

Treatment of Opioid Use Disorder continues to change as we understand more about the neurobiology of chemical dependence. The use of Medication-Assisted Treatment requires education at many levels as it is often thought of as simply drug substitution. Medications used in addition to therapy can assist in sustaining recovery in some people with Opioid Use Disorder. As with all medications, the right medication for the right patient is so important and often difficult in those who have substance use disorders. The goal of MAT is to improve patient survival, increase retention in treatment and assist patients in recovery so they have the ability to live a self-directed life.

Facilitator: Shawn Billings
Project Manager
Behavioral Health Network of Greater St. Louis
St. Louis

Treatment Initiation in the Emergency Department
Evan Schwarz, M.D.
Assistant Professor of Emergency Medicine; Medical Toxicology Section Chief
Washington University School of Medicine
St. Louis

Methadone and Maintenance Treatment at the VA
Naazia Azhar, M.D., MBA
Staff Psychiatrist, Opiate Addiction Treatment Program
St Louis Veterans Affairs Hospital
St. Louis

Managing Both Chronic Pain and Addiction
Thomas Peter Pirotte, M.D.
Chronic Pain Management/Substance Abuse Staff Physician
Jordon Valley Community Health Center
Springfield, Mo.

Reducing Opioid Overdose Deaths: Best Practices from a Pharmacist’s Perspective
Kelly N. Gable, Pharm.D., BCPP
Associate Professor
SIUE School of Pharmacy
Edwardsville, Ill.

3:45 p.m. — The Face of Recovery
Tessalean Woods
Engagement/Community Support Specialist
Queen of Peace Center
St. Louis

Through sharing her story with peers and clinicians, her hope is to increase awareness of how the disease of addiction impacted her life, her family and the community.

4:15 p.m. — Closing Remarks
Leslie L. Porth, Ph.D., MPH, R.N.

4:30 p.m. — Adjournment


Naazia Azhar obtained her MBA in Health Care Administration from Union Graduate College in Schenectady, N.Y. and obtained her M.D. from Albany Medical College in Albany, N.Y. She completed her residency in Adult Psychiatry from Washington University School of Medicine in St. Louis, Mo. She currently works full time at the VA Hospital in St Louis and manages the Opiate Addiction Treatment Program. Dr. Azhar also works part time on the inpatient psychiatry unit at Washington University. She is involved in various community projects, including volunteering at the Saturday Night Health Clinic and mentoring medical students and residents, and she has initiated a program for veterans in recovery with the scope of teaching high school students about Opioid Use Disorder by sharing their personal stories.

Shawn Billings currently serves as a Projects Manager for Behavioral Health Network of Greater St. Louis. Previously, he worked as a Treatment Court Administrator for the 31st and 39th Judicial Circuits, based out of Springfield, Mo. For the past ten years he has been responsible for managing local, state and federally-funded programs to enhance and expand substance abuse and mental health treatment services for high-risk and high-need populations. He has managed and coordinated various community collaborations delivering behavioral health services for youth and adults in both urban and rural settings. He has a Masters in Criminology and Criminal Justice from Drury University and holds a certification in Court Management from the National Center for State Courts.

Kelly Gable is an associate professor in the department of pharmacy practice and coordinator of global partnerships at SIUE School of Pharmacy in Edwardsville, Ill. Dr. Gable is a graduate of the University of Mississippi School of Pharmacy and subsequently completed a specialty residency in psychiatric pharmacy practice at the University of Southern California. Her clinical areas of interest include the treatment of personality and substance use disorders, the integration of motivational interviewing into clinical practice, and Assertive Community Treatment. Dr. Gable’s clinical appointment is with Family Care Health Center in St. Louis, where she works collaboratively as part of a behavioral health team focused on the integration of primary and behavioral health care.

Traci Green is an epidemiologist whose research focuses on drug use, addiction and injury. She earned a Master of Science in Epidemiology and Biostatistics from McGill University and a Ph.D. in Epidemiology from Yale University. Dr. Green helped design the ASI-MV®, a real-time illicit and prescription drug abuse surveillance system developed by Inflexxion, Inc. Currently, she is Deputy Director of the Boston Medical Center Injury Prevention Center, Associate Professor of Emergency Medicine and Community Health Sciences at the Boston University School of Medicine and Adjunct Associate Professor at the Warren Alpert School of Medicine at Brown University. Dr. Green helped co-found www.prescribetoprevent.org and www.prevent-protect.org, serves as an advisor to the Rhode Island Governor on addiction and overdose, and consults for the Centers for Disease Control and Prevention and the High Intensity Drug Trafficking Areas on public health and public safety opportunities. She serves on the Board of Scientific Counselors for the CDC’s National Center for Injury Prevention and Control and the National Academy of Sciences, Engineering, and Medicine’s Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse. Her research is supported by the CDC, the National Institute on Drug Abuse, the Agency for Healthcare Research and Quality, the Patient Centered Outcomes Research Institute, and the Department of Justice.

Thomas Peter Pirotte is a family physician in Springfield, Mo., who, after a long and highly varied career, became interested in addiction medicine. After working with addiction patients for a period of time, he received an opportunity to work in chronic pain management at Jordon Valley Community Health Center. Although each service involves overlap with the other and the clinical challenges are substantial, he hopes his knowledge benefits his patients and his colleagues.

Ned Presnall is executive director of Clayton Behavioral, an Adjunct Professor and research collaborator at Washington University in St. Louis, and a consultant for Missouri's State Targeted Response to the Opioid Epidemic. Presnall has widely presented on the science and practice of medical treatment for addiction. He has conducted trainings; developed online curricula; and written papers for the Addiction Technology Transfer Center, the Missouri Department of Mental Health, the Missouri Chapter of the National Association of Social Work, the St. Louis Alliance for Re-entry, and St. Louis Probation and Parole. He is passionate about reducing stigma against persons with addiction and increasing access to life-saving medications for addiction.

Evan Schwarz completed his residency in emergency medicine at Washington University School of Medicine in St. Louis and his medical toxicology fellowship at the University of Texas Southwestern School of Medicine. Since then he has become board certified in addiction medicine. He is currently an assistant professor of emergency medicine and is the Medical Toxicology Section Chief at Washington University School of Medicine. Additionally, he is the director of the emergency medicine addiction program and the outpatient Medical Toxicology and Addiction Medicine Clinic at Barnes Jewish Hospital.

Tessalean Woods currently serves as an Engagement/Community Support Specialist for Queen of Peace Center of Greater St. Louis. She is a Recovery Coach for the Engaging Patients in Care Coordination Project that is funded through Behavioral Health Network. Previously, she worked as a residential technician at Bridgeway Behavioral Health treatment facility in the Detox Center. Seventeen years ago she made a commitment to a life of recovery. This commitment has been the influence that undergirds her dedication to empower others who seek recovery. She received her bachelor’s in social work from University of Missouri St. Louis, and she holds certifications in Addiction Studies, Missouri Associate Addiction Counselor from Missouri Credentialing Board and Certified Missouri Peer Specialist through Department of Mental Health.

Jon Zibbell is a senior public health scientist in the Behavioral Health Program at RTI International where he conducts behavioral and community-based epidemiological research on risk factors and health outcomes associated with the opioid epidemic and injection drug use. He is a medical anthropologist with two decades of field experience in the areas of injection drug use, opioid use disorder, drug overdose and injection-related infectious disease. Previously, Dr. Zibbell worked as a CDC health scientist in the Divisions of Viral Hepatitis and Unintentional Injury Prevention, conducting epidemiological and surveillance research on viral hepatitis and drug overdose while assisting states during outbreak investigations to respond to injuries and infections caused by drug use behaviors. Dr. Zibbell’s work has appeared in both academic and professional journals, and he holds a joint adjunct appointment in the Center for the Study of Human Health and the Department of Anthropology at Emory University.

Continuing Education

Participants must attend the program in its entirety to receive a certificate of completion and continuing education contact hours.

Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by AXIS Medical Education the MHA Health Institute. AXIS Medical Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation for Physicians
AXIS Medical Education designates this live activity for a maximum of 5.75 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Credit Designation for Pharmacists
This knowledge-based activity is approved for 5.75 contact hours of continuing pharmacy education credit (UAN 0592-9999-17-050-L01-P)

Credit Designation for Nursing
AXIS Medical Education designates this continuing nursing education activity for 5.75 contact hours.
Learners are advised that accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with an activity.

Quality Professionals
This program has been approved by the National Association for Healthcare Quality for 5.75 CPHQ continuing education hours.

Social Workers
This program is Approved by the National Association of Social Workers (Approval # 886749394-3359) for 5.5 continuing education contact hours.

AXIS Contact Information
For information about the accreditation of this program please contact AXIS at 954/281-7524 or info@axismeded.org.

Disclosure of Conflicts of Interest
AXIS Medical Education requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by AXIS for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity:

Name of Faculty or Presenter Reported Financial Relationship
Traci C. Green, Ph.D., MSC
Nothing to disclose
Jon E. Zibbell, Ph.D. Nothing to disclose
Ned Presnall, MSW, LCSW
5% or greater equity interest in CB Programs, LLC
Shawn Billings Nothing to disclose
Evan Schwarz, M.D.
Nothing to disclose
Naazia Azhar, M.D., MBA Nothing to disclose
Peter Pirotte, M.D.
Nothing to disclose
Kelly N. Gable, Pharm.D., BCPP Nothing to disclose
Tessalean Woods Nothing to disclose

The planners and managers reported the following financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity:

Name of Planner/Manager Reported Financial Relationship
Rita F. Kay Nothing to disclose
Holly M. Hampe, D.Sc., RN, MHA, MRM Nothing to disclose
Dee Morgillo, M.Ed., CHCP Nothing to disclose
Ronald Viggiani, M.D. Nothing to disclose

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Americans with Disabilities Act
In compliance with the Americans with Disabilities Act, we will make every reasonable effort to accommodate your request. For any special requests, please contact the MHA Health Institute at 573/893-3700 before the meeting dates.

Requirements for Credit:

  • Attend/participate in the educational activity and review all course materials.
  • Complete the CE Declaration form online by 11:59 p.m. ET Friday, March 16, 2018. Instructions will be provided. If you do not enter the online portal by the above date, you will not be able to retrieve your statement of participation.
  • Upon successful completion of the online form, your statement of completion will be presented to you to print. Pharmacists: Your record will be automatically uploaded to CPE Monitor.