Medical-Assisted Opioid Cessation in the Limelight at ACEP

Ingrid Hein

October 01, 2018

SAN DIEGO — The opioid crisis and highly anticipated results from a double-blind placebo-controlled trial of lofexidine, a new therapy to ease the symptoms of opioid withdrawal, will be in the spotlight at the upcoming American College of Emergency Physicians (ACEP) 2018 Scientific Assembly.

"Studies are suggesting that medical-assisted therapy is the only way to go," said Joe Piktel, MD, from MetroHealth Medical Center in Cleveland, who is cochair of the ACEP research forum subcommittee. "But not everyone is allowed to prescribe or feels comfortable prescribing."

Research exploring the attitudes of emergency providers toward opioid use disorder and buprenorphine treatment will also be presented, as will findings from a study of opioid prescription in a children's hospital in California.

A featured talk on the opioid crisis will examine research initiatives from the National Institutes of Health (NIH) and opportunities for emergency practitioners.

That talk, from members of the National Institute on Drug Abuse, will be "a good opportunity to review the current research" and look at what is needed, Piktel told Medscape Medical News.

Violence and Psychiatric Patients in the Emergency Department

A study on the "boarding of psychiatric patients in emergency" and the impact of long wait times for care, which can translate to violence or assault in the emergency department, is highly anticipated by many emergency physicians.

This is a controversial topic, Piktel pointed out. "We do not want to focus just on decreasing violence, but also on treating the patient's condition. You want someone suffering a heart attack to get care in the right setting."

In addition, results from a prospective study on the reporting of patients with violent tendencies and mental health issues by emergency physicians will be presented. The findings could play a determining role in whether or not emergency physicians will take a role in gun-control legislated interventions.

"This is also highly controversial," said Piktel.

The featured science at the conference is not only important to emergency physicians, it is also relevant to the medical community as a whole, he added.

Piktel himself will be hosting a discussion on the impact of social media on medical research. New ways of sharing information — in quick bits on social media — will be under scrutiny during a panel that includes Esther Choo, MD, from Oregon Health and Science University in Portland, whose recent tweet about the racism she experiences as a practicing Asian-American emergency physician went viral.

Choo will be joined by Megan Ranney, MD, from the Emergency Digital Health Innovation program at Brown University in Providence, Rhode Island, and Seth Trueger, MD, from the Northwestern University Feinberg School of Medicine in Chicago, who is the digital media editor at JAMA.

"How we report data is of increasing concern," said Piktel.

Researchers, particularly young researchers, are seeking to disperse information— such as interesting EKG findings on a disease process — quickly, "but this information is not peer-reviewed and could well be misinformation," he explained.

"Telemedicine is becoming a big deal," Piktel told Medscape Medical News.

A discussion on what telemedicine will look like in 30 years will be led by Judd Hollander, MD, from Jefferson University in Philadelphia, and several researchers will present data on the effectiveness of telemedicine and the impact it has on patients, nurses, and outcomes in the emergency department.

College Celebrates 50 Years

The conference is celebrating its fiftieth anniversary this year, "but we still feel relatively young in the house of medicine," said Robert Heard, who is associate executive director for membership and education at ACEP.

The anniversary will be commemorated with a "history museum" that will consist of large panels that tell the story of the last half-century in emergency medicine, a series of Titan Talks from the association founders, including the first woman president, and a coffee-table book with photography by the renowned photojournalist Eugene Richards.

"We will also have a display of emergency military medicine, where emergency has its roots," said Heard.

"We are growing; emergency care is becoming better recognized," said Piktel. He noted the recent opening of an emergency care research office at the NIH. "Our research is becoming more impactful to the medical community as a whole."

"There is so much happening this year. I'm really looking forward to the discussion and connecting with colleagues," he added. "This is an exciting time in emergency medicine."

Piktel and Heard have disclosed no relevant financial relationships.

Follow Medscape on Twitter @Medscape and Ingrid Hein @ingridhein

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