UK Health Physician Helps SAMHSA to Develop New Guidelines on Opioid Maintenance Therapies | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

UK Health Physician Helps SAMHSA to Develop New Guidelines on Opioid Maintenance Therapies

March 19, 2018
by Mark Hagland
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A psychiatrist at UK Health has been involved in helping to develop new guidelines on the use of opioid maintenance therapies

In an announcement on March 7, the University of Kentucky announced that “Dr. Michelle Lofwall, associate professor in the University of Kentucky College of Medicine, was among the experts who assisted the Substance Abuse and Mental Health Services Administration (SAMHSA) in developing and publishing a new set of guidelines regarding the use of opioid maintenance therapies in the treatment of opioid use disorders (OUD).”

The SAMSHA announcement was released on Feb. 15. It read, in part, “The Substance Abuse and Mental Health Services Administration (SAMHSA) is publishing guidance today to help broaden healthcare professionals’ understanding of medications that can be used to treat Americans with opioid use disorder (OUD).” And it quoted Elinore F. McCance-Katz, M.D., Ph.D., Assistant Secretary for Mental Health and Substance Use, who said in a statement contained in the Feb. 15 press release that “We know that people can and do recover from opioid use disorders when they receive appropriate treatment, and medication-assisted treatment’s success in treating opioid use disorders is well documented. TIP 63 emphasizes that increasing access to medications to treat opioid use disorder will help more people recover, enabling them to improve their health, living full and productive lives,” Dr. McCance-Katz said.

As the SAMSHA announcement noted, “The Treatment Improvement Protocol (TIP) 63, ‘Medications for Opioid Use Disorder,” reviews the use of the three Food and Drug Administration-approved medications to treat opioid use disorders: methadone, naltrexone, and buprenorphine. Mandated by Section 303 of the Comprehensive Addiction and Recovery Act (P.L. 114-198), this TIP provides guidance for healthcare professionals and addiction treatment providers on appropriate prescribing practices for these medications and effective strategies for supporting the patients utilizing medication for the treatment of OUD. TIP 63 also educates patients, families, and the general public about how OUD medications work and the benefits they offer. As part of SAMHSA’s response to the opioid crisis, TIP 63 is a resource for health professionals throughout the country to employ in addressing crucial facets of the epidemic. Expanding access to OUD medications is an important public health strategy,” the announcement noted. “The gap between the number of people who need opioid addiction treatment and the capacity to treat them with OUD medication is substantial. Improving access to treatment with OUD medications is crucial to closing the wide gap between treatment need and treatment availability – especially considering the strong evidence of effectiveness for such treatments. Data indicate that medications for OUD are both cost-effective and cost-beneficial.”

Assisting with the development of these guidelines was something Lofwall was proud to be a part of, she said. "I was excited to be asked to help develop this new Treatment Improvement Protocol (TIP) focused on how to use FDA-approved medications for opioid use disorder,” she said in the UK Health announcement. “There is a lot of stigma around addiction, and medications used to treat it, so it was critical to have a federal document that clearly explained indications for medicine, provided clinical guidance and dispelled several myths about OUD and its treatment."

As UK Health noted, “The opioid epidemic has significantly impacted the state of Kentucky and Lofwall has worked with other researchers and clinicians at UK to improve available treatment options and increase access for those diagnosed with an OUD. Along with Dr. Sharon Walsh, director of the UK Center on Drug and Alcohol Research, Lofwall has been involved with conducting clinical trials for new formulations of buprenorphine including an implant and an injectable formulation. The inclusion of experts from states hardest hit by the epidemic is something Lofwall believes will allow those communities to better serve their patients.” Lowfall said in the UK Health announcement, "Experts in states hard hit are part of the solution – we often have to get creative and develop pathways to treatment that didn’t previously exist. This (improving access) is in large part what this TIP is about."

As her biography on the website of the American Society of Addiction Medicine (ASAM) notes, “Michelle Lofwall, M.D. is board-certified in Psychiatry and Addiction Medicine. She completed residency and fellowship training at Johns Hopkins University. For the last ten years, she has been a faculty member at the University of Kentucky (UK) College of Medicine and is now an Associate Professor of Psychiatry and Behavioral Science in the Center on Drug and Alcohol Research. At UK, she has clinical service/leadership, research and teaching roles. She is the medical director of the outpatient Straus Clinic, which treats adults with substance use disorders and other comorbidities. In addition, she is an addiction consultant to UK’s high­-risk opioid dependence in pregnancy treatment clinic. Her research is focused primarily on improving recognition and treatment of substance use disorders and better understanding factors influencing medication diversion. She teaches medical students, residents, physicians and other health professionals about addictive disorders and their treatment both within her university, nationally and internationally.”

What’s more, her ASAM biography notes, “Dr. Lofwall also has been active within her state and community addressing addiction-related issues (e.g., appointed member to the Kentucky Governor’s KASPER Advisory Council, served as her state ASAM chapter President and Vice-­President). She has provided consultation to ASAM leadership on topics of medication diversion and is a participating member of ASAM’s annual scientific program meeting.”



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