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EtohBottleSmall120pxALCOHOL ABUSE ACADEMY:
Current Perspectives on Impairment, Dependence and Withdrawal

March 14, 2013, 8am-5pm, Grand Ballroom
San Juan Marriott Resort & Stellaris Casino
San Juan, Puerto Rico 

Alcohol use disorders can be seen in over 20% of the general population with acute intoxication, withdrawal and dependence approaching 50% of certain hospitalized patient populations.  Understanding the pathophysiology and methods of treating impairment, withdrawal, and dependence are critical in caring for these patients. Alcohol effects nearly every organ in the body, highlighting the importance of this drug in both clinical and forensic science.

This course is designed to augment the knowledge base and skill set of providers who frequently encounter patients with alcohol-related health consequences including impairment or acute intoxication, dependence and addiction or withdrawal. 

In this one-day course, expert clinicians from medical toxicology, emergency medicine, psychiatry, and addiction medicine will provide evidence- and experience-based perspectives on the understanding and treatment of a wide array of alcohol-related health consequences. Among the topics included will be impairment, dependence, and withdrawal as well as review the current thinking on the underlying processes result in these complex clinical syndromes.  

This course is appropriate for physicians, nurses, mid-level providers, and pharmacists who practice in primary care, emergency department, addiction medicine (including counselors and other treatment providers), urgent care, or hospital settings.


COURSE OBJECTIVES

  • Provide an evidence-based review of current and emerging management strategies for the treatment of alcohol withdrawal and dependence.           
  • Understand the role of alcohol in deliberate self poisoning and suicide and review the pathophysiology of alcohol abuse, dependence and addiction.                                  
  • Obtain a practical understanding of ethanol metabolism including the use of markers such as ethyl glucuronide and other metabolites in monitoring and forensic cases.
  • Describe differences in intoxication and metabolism in special populations including pediatric patients.

AGENDA

7:00-8:00am
Registration and Continental Breakfast
8:00-8:05am
Introduction to the Course
8:05-8:35am
Through the Glass Darkly: The History of Treating the Alcoholic and Withdrawal
8:35-9:10am
One Step at a Time: A Case Based Discussion of Treating Alcohol Dependence
9:10-9:50am
The "80-Hour Alcohol Test" and More: Novel Markers of Alcohol Exposure
9:50-10:10am
Break
10:10-10:45am
Arrested and Angry: Treatment of the Agitated Intoxicated Patient
10:45-11:25am
Breakout Session:
Beyond the BAL: Legal Concerns in Clinical Assessment
11:30am-12:50pm
Lunch - on your own
12:50-1:25pm
Liquid Courage or Potent Poison: Alcohol and Suicidality
1:30-2:10pm
Hair of the Dog: The Pathophysiology of Alcohol Withdrawal & Foundations of Treatment
2:10-2:25pm
Break
2:25-2:55pm
Stopping the Shakes: Advanced Concepts in Alcohol Withdrawal Management  
2:55-3:15pm
Treatment Associated Delirium: Use of Flumazenil to Reverse Benzodiazepine Associated Delirium
 
3:15-4:00pm
Breakout Session:
Here Come the Pink Elephants: Complicated Withdrawal Cases
4:00-4:50pm
 
 

Faculty

 
Conner125w Dr. Conner is Acting Director of the VA VISN 2 Center of Excellence for Suicide Prevention, and Associate Professor of Psychiatry and Co-Director of the Center for the Study and Prevention of Suicide at the University of Rochester Medical Center.  He conducts clinical- and epidemiological research on suicidal behavior with a focus on the role of drinking and alcohol use disorders.  He has methodological expertise in postmortem research, record abstraction, the study of stressful life events and meta-analysis.  He was Chair of the SAMHSA Center for Substance Abuse Treatment panel that developed Treatment Improvement Protocol number 50 (TIP 50) entitled “Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment.”  He received the Edwin Shneidman Award from the American Association of Suicidology for his research.
Gunja125w

Dr. Gunja is Medical Director & Toxicologist at the NSW Poisons Centre in Sydney, Australia. Following on from his fellowship in Emergency Medicine, he trained in medical toxicology at Westmead Hospital. He works as a Medical Toxicologist at two admitting Toxicology units in Sydney (Westmead and Blacktown Hospitals) and as a Paediatric Toxicologist at the Children’s Hospital. Dr. Gunja’s interests include forensic toxicology, snake bite, heavy metal poisoning and clinical informatics in toxicology. Being the media spokesperson for the Poisons Centre, Dr. Gunja is acutely involved with the public health and image of toxicology. He is a graduate of the University of Sydney and currently Senior Lecturer at the Sydney Medical School teaching in Clinical Pharmacology and Toxicology.

Holland125w Dr. Holland is a Consulting Medical Toxicologist at the Upstate NY Poison Center & Associate Professor at SUNY Upstate Medical University. He is Director of Occupational Medicine at Glens Falls Hospital Center for Occupational Health, where he has directed the drug and alcohol testing program for over twenty years. He serves on the Board of Directors of ACOEM, and Chair of the ACOEM Toxicology Committee and Co-Chair of the ACOEM Council of Scientific Advisors. He is also on the Board of Directors of the Medical Review Officer Certification Council (MROCC), and served on the Schedule II Medications Expert Panel for the DOT FMCSA in 2006. He serves on the Editorial Board of Clinical Toxicology, and is a peer-reviewer for the Journal of Medical Toxicology. He is board-certified in Medical Toxicology, Occupational Medicine, Emergency Medicine, and Undersea and Hyperbaric Medicine. His special research interests include forensic toxicology and post-mortem redistribution.
Hodgman125w

Dr. Hodgman is Medical Toxicology Fellowship Director at Upstate Medical University in Syracuse, NY. He completed his training in medical toxicology at the University of Pittsburgh in 1995 and is board certified in Internal Medicine and Medical Toxicology. He has been a medical toxicologist for the Upstate New York Poison Center since 2001 and has also been a member of the editorial board of the Journal Medical Toxicology since 2011. In addition to his activities in Syracuse he practices in the Department of Emergency and Trauma Services at Bassett Medical Center in Cooperstown, NY. Areas of interest include acute poisoning management, drugs of abuse and medical education.

Levine125w

Dr. Levine, a Southern California native, completed his medical school in Chicago, and residency in emergency medicine at the Brigham and Women’s/Massachusetts General Hospital in Boston, MA.  Following residency, he completed his medical toxicology fellowship at the Banner Good Samaritan Medical Center in Phoenix, AZ.  Currently, he is an assistant professor of emergency medicine at the University of Southern California, and also continues to attend part time on the in-patient toxicology service at Good Samaritan in Phoenix.

Menke125w

Dr. Menke is a second year medical toxicology fellow at the University of Pittsburgh Medical Center. Dr. Menke received his medical degree at the Ohio State University in 2002; he completed his Emergency Medicine Residency at the Medical College of Virginia in 2005.  Dr. Menke completed his Ph.D. in Biochemistry and Molecular Biology from Virginia Commonwealth University in 2010.  Dr. Menke is board-certified in Emergency Medicine.

Maldonado125w

Dr. Maldonado is an Associate Professor of Psychiatry, and by courtesy of Medicine, Surgery, Emergency Medicine and Law at Stanford University; where he also serves as Medical Director of the Psychosomatic Medicine Service. Dr. Maldonado has received numerous national and internationals awards for teaching, research and scholarly work, particularly in the areas of delirium prevention and treatment, organ transplantation and the neurobiology of delirium and alcohol withdrawal. Dr. Maldonado’s research interest include: the neurobiology and management of delirium; psychosocial aspects of solid organ, bone marrow and composite tissue transplantation, including psychosocial predictors of transplant success; novel methods for the prophylaxis and treatment of alcohol withdrawal syndromes; neurobiology of conversion disorder; neuropsychiatric aspects of infectious agents (e.g., Lyme disease and Chronic Fatigue Syndrome); and application of hypnosis in psychiatry and medicine.  Dr. Maldonado has over 110 publications to his name and has delivered over 120 peer reviewed and over 200 invited presentations and courses at national and international meetings.

Lewis Nelson, MD

Dr. Nelson received his medical degree from SUNY Health Science Center in Brooklyn, NY. He completed a residency in emergency medicine at Mount Sinai School of Medicine followed by a fellowship in Medical Toxicology at New York City Poison Control Center/New York University School of Medicine. Dr. Nelson is Professor in the Department of Emergency Medicine at New York University School of Medicine and also the Director of Education for his department. He is the Director of the Fellowship in Medical Toxicology program at NYUSOM and NYCPCC. He is an attending physician in the Department of Emergency Medicine at Bellevue Hospital Center and New York University Langone Medical Center. At NYULMC, he is Chair of both the Pharmacy and Therapeutics and Medication Safety committees. Dr. Nelson has served as Chair of the Medical Toxicology Subboard, the board certifying organization for medical toxicologists. He has also been of the Food and Drug Administration's Drug Safety and Risk Management (DSaRM) Advisory Committee. In addition to editing Goldfrank's Toxicologic Emergencies, now in its 9th edition, Dr. Nelson’s educational and research interests focus on opioid toxicology, medication safety, and chemical terrorism.

Rasimas125w

Dr. Rasimas attended the University of Scranton and graduated summa cum laude with degrees in biochemistry, mathematics, and philosophy. He completed the Medical Scientist Training Program at Penn State University, earning a Ph.D. in Chemical Biology (2002) and M.D. (2003). Upon graduation from the Penn State College of Medicine, Dr. Rasimas was honored for excellence in both psychiatry and medical toxicology. He matriculated to psychiatry residency training at the Mayo Clinic in Rochester, Minnesota. Dr. Rasimas received the National Institute of Mental Health (NIMH) Outstanding Resident Award in 2005 and was recognized by the American College of Psychiatrists with the Laughlin Fellowship in 2007. He is a member of a number of academic honor societies as well as the Association for the Advancement of Philosophy and Psychiatry. He has studied psychotherapy at the Minnesota Psychoanalytic Society and Institute and the Washington School of Psychiatry. Dr. Rasimas was a clinical fellow at the NIMH, training in consultation-liaison psychiatry, bioethics, and clinical research. He has served as a staff psychiatrist for Hershey Medical Center and remains an Associate Professor of Psychiatry and Emergency Medicine for the Penn State College of Medicine, there. He completed a medical toxicology fellowship, obtained board certification in Addiction Medicine, and then returned to NIMH to join the Intramural Research Program. Dr. Rasimas is pursuing an academic medical career at the interface of psychosomatic medicine, medical toxicology, and psychodynamic psychotherapy. His primary areas of clinical interest are pharmacotherapeutics, neuropsychiatric toxicity, psychoanalysis, and the phenomenology of suicide.

Rivers125W

Dr. Rivers received her medical degree from New York University School of Medicine. She completed her residency at the Beth Israel Deaconess Medical Center Harvard Affiliated Emergency Medicine Residency in Boston, Massachusetts where she also served as Chief Resident and received the Clinical Excellence Award. She then completed her fellowship in Medical Toxicology at the New York City Poison Control Center/ New York University School of Medicine. Dr. Rivers is currently an Assistant Professor of Emergency Medicine at New Jersey Medical School of UMDNJ and an attending physician at University Hospital in Newark, New Jersey. She is board certified in Emergency Medicine and Medical Toxicology. Her current educational and research interests focus on alcohol withdrawal and opioid toxicology.

Wiegand125w

Dr. Wiegand is an Associate Clinical Professor in the Department of Emergency Medicine at the University of Rochester Medical Center and is Director of the bedside Toxicology Consult Service at Strong Memorial Hospital and Highland Hospital and of the outpatient Toxicology Consultation Clinic at Strong Memorial Hospital in Rochester, New York. Dr. Wiegand is Board Certified in both Internal Medicine as well as Medical Toxicology and completed additional fellowship training in Clinical Pharmacology at the University of California, San Francisco. Dr. Wiegand’s practice revolves mostly around the delivery of consultation toxicology, pharmacology and addiction services although has also been involved in poisoning prevention serving as either consultant or Assistant/Associate Medical Director Positions for several different Poison Control Centers including the San Francisco Division of the California Poison Control System and the Northern New England Poison and Drug Information Center before moving to Rochester and becoming the Director of the Ruth Lawrence Poison & Drug Information Center.  He is currently a consultant toxicologist for the SUNY Upstate Poison Center and active in their toxicology fellowship program. One of Dr. Wiegand’s particular interests is the intersection of addiction medicine and medical toxicology. He Chairs the Addiction Medicine Section for the American College of Medical Toxicology. Dr.Wiegand has an addiction medicine pharmacotherapy clinic at Huther-Doyle Chemical Dependency Treatment program, a 500-600 person capacity comprehensive drug and alcohol dependence treatment program in Rochester, New York and he became the Medical Director of Huther-Doyle in September, 2012.