Publications by authors named "Cara Poland"

Objectives: Emergency Medical Services (EMS) agencies are beginning to provide low-barrier access to treatment for opioid use disorder (OUD) through the development of EMS buprenorphine (EMS-Bupe) programs. However, evidence-based practices for these programs are lacking. Our aim was to review the current literature on EMS and emergency department (ED) based buprenorphine treatment programs to provide consensus recommendations on the EMS-Bupe program development.

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Objective: Pregnant people receiving treatment for opioid use disorders (OUD) are at significant risk of return to use during the postpartum period. Recently, practice groups and other national organizations have called for the co-location of addiction medicine and obstetric care to reduce the burden on pregnant and postpartum people with OUD associated with engaging in treatment. This paper examines the effectiveness of co-locating services in retaining pregnant people with OUD in care following childbirth.

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A virtual addiction medicine elective was developed using interactive multimedia modules, active learning strategies, and patient-based cases. Student had opportunities for professional networking and interacting with physicians and patients. The elective was successful in boosting Year-1 medical students' confidence to screen, manage, and treat patients with substance abuse disorder.

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Importance: Buprenorphine is an underused treatment for opioid use disorder (OUD) that can be prescribed in general medical settings. Founded in 2017, the Michigan Opioid Collaborative (MOC) is an outreach and educational program that aims to address clinician and community barriers to buprenorphine access; however, the association between the MOC and buprenorphine treatment is unknown.

Objective: To evaluate the association between MOC service use and county-level temporal trends of density of buprenorphine prescribers and patients receiving buprenorphine.

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Nitrous oxide is a highly lipid-soluble molecule, which can produce euphoria and calming effects through noncompetitive antagonism of the N-methyl-D-aspartate (NMDA) glutamate receptor and agonism of the y-aminobutyric acid (GABA) A receptor. It can also produce toxicities likely through inactivation of methylcobalamin (vitamin B12) with subsequent neurological, psychiatric, and other sequelae that may be mistaken for other clinical entities. We present a classic presentation of nitrous oxide toxicity, which was missed and urgently referred to infectious diseases with concerns for an infectious neuromyelitis.

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Problem: There is a shortage of addiction medicine (AM) physicians and a 9-year period (2017-2025) in which to build the workforce via a practice pathway enabling physicians to combine experiential hours with passing a board exam to become board-certified AM physicians. Afterward, AM specialists will need to complete the traditional fellowship pathway, requiring additional training.

Approach: The Michigan Collaborative Addiction Resources and Education System (MI CARES) was developed from February to June 2019 to support physicians in obtaining AM certification via the practice pathway.

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Personality-linked psychological factors including distress tolerance and delay discounting have been shown to underlie both Alcohol Use and Major Depressive Disorders. Although these disorders commonly co-occur, especially among individuals seeking in-patient treatment, no study has examined the association between distress tolerance, delay discounting and dual diagnoses. This project evaluated these relations in a sample of 79 low-income adults receiving in-patient substance use treatment.

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Purpose: This article describes the implementation of a clinical nurse specialist-led emergency department overdose education and naloxone distribution program. The program's purpose is to increase naloxone availability to reduce opiate overdose mortality rates within the local community.

Description Of Program: The program distributes naloxone kits to patients in the emergency department after an opioid overdose.

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