This session will review the opioid findings, trends, and future insights based on analysis performed at the DC Office of the Chief Medical Examiner (DC OCME). The Toxicology Division of the DC OCME performs postmortem and human performance toxicology. A summary of the last few years’ findings will be combined with interpretive and impactful analysis of those findings, as well as some insight into possible future compounds of interest based on regional and national trends.
Stephen Raso, MD, PhD, Deputy Chief Toxicologist, Office of the Chief Medical Examiner
Dr. Stephen Raso is a board-certified Forensic Toxicologist with a Ph.D. in Analytical Chemistry, a Masters degree in Forensic Science, and Bachelors degrees in Chemistry and Forensic & Investigative Science. Dr. Raso received a research Fellowship from the National Institute of Justice (NIJ) to perform his doctoral research on the pyrolysis of synthetic cannabinoids. Dr. Raso has worked at the DC Office of the Chief Medical Examiner for four years as the Deputy Chief Toxicologist, and prior to that, worked as a Research Scientist at Quest Diagnostics. Dr. Raso is an active member in multiple organizations including the American Academy of Forensic Sciences and the Society of Forensic Toxicologists, where he is the current Chair of the Publication Committee.
J. Hunter Fleming, M.S.F.S, Forensic Toxicologist, Office of the Chief Medical Examiner
Hunter Fleming holds a BS in Chemistry and a MS in Forensic Science. During his Master’s research, he studied commercially available kratom products, which resulted in two publications in the Journal of Forensic Chemistry. Hunter has been a Forensic Toxicologist at the Washington, DC Office of the Chief Medical Examiner for the past two years. In this role, he tests postmortem samples for the presence of drugs and alcohol. Hunter is an associate member of the American Academy of Forensic Sciences and the Society of Forensic Toxicologists. He has actively served on committees in both organizations and presented numerous times at annual meetings.
The District of Columbia Department of Forensic Sciences will provide a programmatic update and data presentation on the analysis of drug residue in used needle-exchange syringes. The innovative surveillance program provides near real-time monitoring of drug trends and detection of novel and emerging psychoactive substances to inform decision-making for public health and safety agencies. The program is part of a broader initiative to comprehensively understand the District’s illicit drug supply and intravenous consumption trends.
Lucy Nguyen, Technical Lead, Forensic Chemistry Unit
Sne Parikh, Program Analyst, Forensic Chemistry Unit, DC Department of Forensic Sciences
A discussion of opioid trends, testing, and composition in the District. The speakers will estimate the scope of the District’s opioid epidemic evidenced by data on overdoses, hospital transports, naloxone administration, and deaths; recognize key demographics of individuals who have overdosed on opioids; describe trends in opioid composition, including fentanyl levels; and outline methods the District uses for overdose and opioid surveillance.
Kenan Zamore, MPH, Senior Research Epidemiologist, DC Health
Kenan Zamore, MPH, is a Senior Research Epidemiologist with the District of Columbia Department of Health. Working out of the Center for Policy, Planning and Evaluation, he is tasked with applying public health surveillance techniques to non-traditional public health problems, most notably violence prevention, suicides, and substance misuse disorders. Mr. Zamore primarily works to facilitate the effective dissemination of timely and reliable surveillance data to inform public policy and intervention efforts, and to attack barriers to the routine exchange of vital data. He holds degrees from Stanford University and Tulane University School of Public Health and has over a decade of public health experience as an epidemiologist.
The most updated clinical guidance published by SAMHSA regarding the care of pregnant and postpartum patients with substance use disorders and their children will be addressed. Topics include behavioral and medication treatment with an emphasis on dosing of methadone and buprenorphine. Creating safe clinical spaces for healing, pain management, breastfeeding, treating withdrawal during the neonatal period and approaches to dyadic care to promote healthy families will be discussed. A summary of the latest guidance for upholding patient confidentiality and rights will be shared with resources to contact when specific issues arise. Lastly, the audience will practice several simple and effective ways to provide compassionate care that can help promote healthy outcomes for mother/birthing person and child.
Hendrée E. Jones, PhD, LP Professor, Department of Obstetrics and Gynecology, Adjunct Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University Chair; Women & Substance Use Disorders Special Interest Group, School of Medicine, The University of North Carolina at Chapel Hill
Dr. Jones is a licensed psychologist and Professor in the Department of Obstetrics and Gynecology in the School of Medicine at The University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, North Carolina and a SAMHSA R3 Special Expert. Dr. Jones is also a top world expert in neonatal abstinence syndrome and opioid-related disorders. She has written more than 250 peer-reviewed publications, and 17 courses for adult learners on topics of substance use disorder treatment (WISE, CHILD, PEERS, ALLIES etc.). She has also co-authored multiple national and international guidelines on the topic of caring for women as well as children with substance use problems including those published by SAMHSA, the United Nations and the World Health Organization.
This session will focus on the treatment of fentanyl driven opioid use disorder in adolescents. The speaker will use case-based examples to highlight barriers to treatment entry, challenges in engagement, lack of options for treatment and interim solutions we have created to meet the needs of this growing population.
Dr. Sivabalaji Kaliamurthy, MD, is a distinguished Child and Adolescent Addiction Psychiatrist serving as the Director of the Addiction Clinic at Children’s National Hospital. He holds positions as Assistant Professor of Psychiatry and Behavioral Sciences at The George Washington University School of Medicine and Health Sciences, and as Assistant Professor of Psychiatry at Howard University. Dr. Kaliamurthy also serves as a Clinical Instructor in Psychiatry at Yale University. His expertise and research focus on addiction psychiatry in youth have earned him recognition as a leading voice in the field.
Death and disability resulting from the use of prescription and street opioids has skyrocketed in the past 20 years, and hospital-based clinicians have seen a sharp escalation in visits related to opioid use disorder, opioid overdose, and chronic pain. This presentation will describe the fundamental principles around the prevention, identification, and treatment of patients with OUD, with an emphasis on the first-line therapy buprenorphine, which protects OUD patients from withdrawal, cravings, and overdose, and is effectively initiated from the emergency department, inpatient, and outpatient clinic-based settings.
Reuben J. Strayer, MD, Associate Medical Director of Addiction Medicine, Department of Emergency Medicine, Maimonides Medical Center
Reuben Strayer, author of emupdates.com, is an emergency physician based in New York City. His clinical areas of interest include airway management, analgesia, opioid misuse, procedural sedation, agitation, decision-making and error. His extra-clinical areas of interest include sweeping generalizations and jalapeño peppers. He lures himself out of bed with chocolate dipped in peanut butter before heading to Maimonides Medical Center, in Brooklyn, where he is happily employed.
This activity is sponsored by the State Opioid Response Grant through the District of Columbia Department of Behavioral Health.
