PEH SUD Trainings

PEH SUD Presentation Topics

Learn more about the Educational Objectives for the series and its sessions.

Presbyterian Espanola Hospital (PEH) Substance Use Disorder (SUD) Education Series is designed to improve patient outcomes by addressing gaps between current and best practices for the treatment of SUDs. These trainings are designed to help improve the recognition, appreciation of, and management of substance use disorders, including withdrawal management, overdose recognition and management, withdrawal management, long-term medication initiation, patient engagement, and ability to overcome common obstacles.

Providers (and other staff) participating in this activity will gain a deeper, updated knowledge of multiple substance used disorders (SUDs), particularly opioid use disorder, stimulant use disorder, and commonly co-occurring alcohol use disorder, as well as emerging illicit substances. Provider will better understand how to identify, test for, and determine the key role various substances play in overdose and withdrawal presentations. Providers will be able to appreciate the mixed picture of polysubstance withdrawal and avoid undertreating withdrawal symptoms. Providers will improve their communication with patients with SUDs to obtain a more complete history, and improve outcomes for patients, even when those patients opt to leave the hospital against medical advice (AMA).

The presentations will focus on meeting the educational gaps of providers at Presbyterian Espanola Hospital (PEH), who generally have more experience in treating SUDs and complications of SUDs than providers at most other hospitals. Thus, this education series seeks to meet PEH providers at their educational and experience level. Topics were chosen based on frequent requests from the medical staff, as well as informal surveys with individual providers and physician leaders – to address the knowledge and practice gaps discussed above. Per the request of the providers surveyed at PEH, we will incorporate case-based learning into the presentations.

“Alcohol Use Disorder: Management of Withdrawal and Treatment” by Jessica Gregg, MD, PhD (1hr)

Learning Objectives:

• Review the epidemiology of alcohol use disorder
• Discuss pharmacotherapy for alcohol use disorder
• Describe approaches to management of alcohol withdrawal

“Emerging Illicit Drug” by Jessica Gregg, MD, PhD (1hr)

Learning Objectives:

• Discuss the clinical presentation, screening, and management of:
  • Medetomedine
  • Xylaxine
  • kratom
  • “Designer” benzodiazepines

“Healing Without Judgement: Tackling Stigma in Substance Use Disorder Care” by Cindy Ketcham, EdD, RN (1hr)

Learning Objectives:

• Review the epidemiology of alcohol use disorder
• Discuss pharmacotherapy for alcohol use disorder
• Describe approaches to management of alcohol withdrawal

“Improving the Management of Opioid Use Disorder & Opioid Withdrawal in the Hospital: Recurring Obstacles, Challenges, and Misperceptions” by Eric Ketcham, MD (1hr)

Learning Objectives:

• Understand the symptoms of stimulant withdrawal and how this alters the presentation of opioid withdrawal.
• Demonstrate management of precipitated withdrawal (from buprenorphine, naloxone, and/or naltrexone).
• Describe overdoses and toxicities often mistakenly treated as opioid overdoses (including alcohol, benzodiazepines, designer benzodiazepines, etc.) – to not miss the real threat.
• Identify when patients are likely using their own supply of opioids, and how to manage.
• Understand why patients with SUDs often need to leave the hospital AMA – how to mitigate, and improve outcomes even when patients choose to leave.

“Initiating Buprenorphine for Opioid Use Disorder in the Era of Fentanyl by Eric Ketcham, MD” (1hr)

Learning Objectives:

• Describe the epidemiology of the opioid use disorder in the fentanyl era
• Understand the unique pharmacology of street fentanyl, and challenges to buprenorphine initiation.
• Describe the pharmacology of buprenorphine
• Demonstrate the advantages/disadvantages and applicability of different approaches to buprenorphine initiation, including:• •“Standard” or “Macro-dose” initiation
• “Low Dose Initiation
• “Quick Start” (naloxone precipitated withdrawal/buprenorphine rescue) initiation
• Initiation with depot sustained release subcutaneous administration

“Stimulant Use Disorders: A Review and Update” by Jessica Gregg, MD, PhD (1hr)

Learning Objectives:

• Describe the differences between implicit and explicit bias.
• Explain why Harm Reduction Strategies are important in the treatment of addiction
• Appreciate Addiction as a Disease supported by Neuroscience

PEH SUD Training Team

Get free online education from SUD experts!

Presbyterian Espanola Hospital (PEH) Substance Use Disorder (SUD) Education Series is led by SUD experts Dr. Cindy Ketcham, Dr. Eric Ketcham, and Dr. Jessica Gregg. Dr. Eric Ketcham and Dr. Jessica Gregg are physicians at Presbyterian Espanola Hospital. Dr. Eric Ketcham and Dr. Cindy Ketcham are Directors of Education for the NM Bridge Program. Together, the training team has substantial experience providing health care for people who struggle with SUDs.

Cindy Ketcham, EdD, RN

• Cindy M. Ketcham, RN, EdD, MSHE, BSN, NEA-BC, LNCC, HACP, CARN, is a registered nurse with 30 years’ experience in healthcare. Her experience includes cardiac surgery, emergency nursing, behavioral health, intensive care, general surgery, hospital compliance and accreditation, and correctional health nursing. Dr. Ketcham has held several certifications in correctional medicine including mental health specialist nurse and corrections nurse management. She had been an independent contractor for healthcare since 2015 specializing in training and education. Dr. Ketcham has worked with hospitals in NM educating leadership and staff about stigma in addiction. During her time in correctional medicine, Dr. Ketcham worked extensively with inmates suffering from substance use disorders and helped to implement Medication Assisted Treated (MAT) using buprenorphine for opioid use disorder (OUD) at the San Juan County Detention Center in Farmington, NM. Dr. Ketcham holds the Certified Addictions Registered Nurse (CARN) distinction. She was an invited presenter at the national Rx Drug Abuse and Heroin Summit in 2020.

Eric Ketcham, MD, MBA

• Eric Ketcham MD, MBA, FACEP, FASAM, FACHE, FAAEM is board certified in both addiction medicine (ABPM) and emergency medicine (ABEM). He works as an EM physician for the Presbyterian Healthcare system (PHS), primarily in Espanola, NM. He is the medical director for the addiction medicine/substance use disorder service line at Espanola Hospital, where he works clinically as an addiction specialist, seeing patients in the “Renewal Clinic,” (the SUD clinic), and as an inpatient addiction medicine consultant (in the ICU, PCU, ED, L&D, etc.). He is currently directing a broad expansion of this service line and serves as a clinical expert for several SUD treatment projects for PHS for the treatment of alcohol use disorder (AUD) and opioid use disorder (OUD). Dr. Ketcham also serves as the medical director for the medical “detox” and residential treatment centers, Cenikor Foundation, Farmington, NM, and Serenity Mesa Youth Recovery, Albuquerque, NM. He has served as the medical director of a methadone clinic (OTP) for nearly 9 years. Dr. Ketcham works with New Mexico Behavioral Health Services Division (NM BHSD) as the Director of Clinical Implementation for the NM Bridge Program, assisting hospitals in the development of OUD treatment programs, and as an on-call addiction expert for the New Mexico Poison Control Center Addiction Helpline. He is the co-founder and a past chair of the Pain Management and Addiction Medicine Section of the American College of Emergency Physicians (ACEP). He is active in both state and federal advocacy. He has testified before the NM Legislature, and he has been called twice to speak as an expert at United States Congressional briefings (2019) and to testify as an expert in addiction and emergency medicine before the US Congress, House Judiciary Committee (2016).

Jessica Gregg, MD, PhD

• Coming soon!

Continuing Education

CME Credits

 Presbyterian Espanola Hospital (PEH) Substance Use Disorder (SUD) Education Series is approved by the American Medical Association (AMA) and the American Association of Continuing Medical Education ® (AACME). Each training session provides AMA PRA Category 1 credit tm CMEs. Many boards and agencies accept these credits as an equivalent. To obtain CNE contact hours and non-physician credit, refer to the guidelines provided by your board to understand specific requirements.

DEA MATE Act

The PEH SUD Education Series fulfills required hours for the Drug Enforcement Agency Medication Access and Training Access (MATE) Act. Attend each training topic in the series to fulfill six of the eight required education hours.

NM Medical Board Pain Management

The PEH SUD Education Series features two trainings that fulfill required hours for the New Mexico Medical Board Management of Pain and Other Conditions with Controlled Substances. These two trainings are titled, “Initiating Buprenorphine in the Era of Fentanyl” and “Improving Management of Opioid Withdrawal and Opioid Use Disorder in the Hospital.” Attend these two trainings to fulfill two of the five required education hours.

Statement of Accreditation & Financial Disclosure:

This activity has been planned and implemented in accordance with the Essential Areas and policies of the New Mexico Medical Society (NMMS) through the joint sponsorship of Comagine Health and University of New Mexico. Comagine Health is accredited by the NMMS to provide Continuing Medical Education for physicians. In compliance with the ACCME Standards for Commercial Support of CME, the Presbyterian Espanola Hospital Substance Use Disorder Education Series speakers have no relevant financial relationships to disclose.

***Some training sessions are currently pending CME Board approval but are fully expected to be approved. This web page will be updated to confirm approval by time of the time of the training. Contact NM Opioid Hub to learn more.***

This education program is here to support you!

Presbyterian Espanola Hospital Education Series is funded by the State Opioid Response (SOR) grant and supported by NM Opioid Hub. NM Opioid Hub is a Health Care Authority (HCA) Behavioral Health Services Division (BHSD) initiative intended to expand and improve access to statewide treatment for Opioid Use Disorder (OUD), Stimulant Use Disorder, and co-occurring disorders. HCA offers many free and statewide resources and programs for Substance Use Disorder (SUD) treatment, prevention, and harm reduction. Please take a moment to learn about the many resources available to you so you can get the most out of what this education series has to offer attendees.

New Mexico Substance Use Disorder Resources:

• Click here to access a document that goes over the basic guidelines providers need to start treating their patients for OUD.
• Click here to find OUD treatment centers in New Mexico filtered by treatment type, county, city, and tele-health options.
• Click here to contact the New Mexico Poison Control Center’s 24/7/365 call-line for real-time OUD treatment consultations.