: In September 2016, the American Academic of Pediatrics released a policy statement that adolescents with opioid use disorder should be offered pharmacotherapy with buprenorphine/naloxone, methadone, or naltrexone. In our clinical practice, however, we have encountered the perception among patients, families, and clinicians alike that medications should be used as a last resort. That we should wait until things get worse is a discarded approach. As addiction specialists, it is imperative that we prevent and identify risky use and use disorders, then intervene early and offer timely, evidence-based treatment. We suggest that adolescents deserve special attention and that specific efforts should be made to reduce the stigma associated with treating adolescents with opioid use disorder with medications to optimize those efforts.

Background Internal medicine residents care for a sizable number of patients with chronic pain. Programs need educational strategies to promote safe opioid prescribing.

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Co-training generalist chief residents with a faculty mentor appeared to facilitate functional mentoring-driven Teaching Project implementation but did not further increase already high levels of other addiction medicine teaching. Faculty mentors with more years of teaching experience were more effective in facilitating Teaching Project implementation.

SummaryThe Massachusetts Screening, Brief Intervention and Referral to Treatment (MASBIRT) Program, a substance use screening program in general medical settings, created a web-based, point-of-care (POC), application -the MASBIRT Portal ( the "Portal") to meet program goals. Objectives: We report on development and implementation of the Portal. Methods: Five year program process outcomes recorded by an independent evaluator and an anonymous survey of Health Educator's (HEs) adoption, perceptions and Portal use with a modified version of the Technology Readiness Index are described.[8] Specific management team members, selected based on their roles in program leadership, development and implementation of the Portal and supervision of HEs, participated in semi-structured, qualitative interviews. Results: At the conclusion of the program 73% (24/33) of the HEs completed a survey on their experience using the Portal. HEs reported that the Portal made recording screening information easy (96%); improved planning their workday (83%); facilitated POC data collection (84%); decreased time dedicated to data entry (100%); and improved job satisfaction (59%). The top two barriers to use were "no or limited wireless connectivity" (46%) and "the tablet was too heavy/bulky to carry" (29%). Qualitative management team interviews identified strategies for successful HIT implementation: importance of engaging HEs in outlining specifications and workflow needs, collaborative testing prior to implementation and clear agreement on data collection purpose, quality requirements and staff roles. Discussion: Overall, HEs perceived the Portal favorably with regard to time saving ability and improved workflow. Lessons learned included identifying core requirements early during system development and need for managers to institute and enforce consistent behavioral work norms. Conclusion: Barriers and HEs' views of technology impacted the utilization of the MASBIRT Portal. Further research is needed to determine best approaches for HIT system implementation in general medical settings. Research Article C. Shanahan et al.: Evaluation of Integrated Information System for Substance Use Screening in General Medical SettingsFor personal or educational use only. No other uses without permission. All rights reserved. The spectrum of unhealthy substance use, from risky use to substance use disorders (SUD), is a major cause of preventable morbidity and death [12, 13]. In the US, from 2012, the prevalence of unhealthy substance use in the adult population is 29.2% for alcohol and 7.0% (adults aged 26 years or older) and 21.3% (young adults aged 18 to 25) for illicit drugs. For SUD, prevalence rates are 8.5% for alcohol and 2% for illicit drugs [14][15][16].To address this public health problem, the Substance Abuse and Mental Health Services Administration (SAMHSA) funded through a cooperative agreement for Screening, Brief Intervention and Referral to Treatment (SBIRT) programs to implement universal SBIRT to address unhealthy substance use in gener...

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Strategies to expand point-of-care testing for flu T hough pharmacists play an important part in flu prevention by administering influenza vaccinations, the pharmacist's role is not limited to prevention alone. According to CDC estimates, there were nearly 31 million flu-related illnesses in the 2016-17 flu season. 1 Pointof-care testing (POCT) for influenza provides pharmacists an opportunity to reduce flu-related medical visits and transmission through early identification of influenza.