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  • March 20, 2019 5:40 PM | Sally Winkelman (Administrator)

    March 20, Wisconsin Health News

    National experts broke down the health and legal aspects of marijuana at a Tuesday panel in Madison.

    There's some evidence that marijuana can reduce nausea in patients undergoing chemotherapy as well as reduce pain in adults with chronic pain, according to Dr. Ron Wallace, a professor of epidemiology and internal medicine at the University of Iowa College of Public Health and Medicine. Wallace worked on a national report summarizing marijuana’s health effects.

    Those with multiple sclerosis who use marijuana also report fewer muscle spasms. But Wallace said that the effects of cannabinoids were “modest."

    “Cannabis can help a little bit,” he said at an Evidence-based Health Policy Project briefing. “But it’s not clear whether it’s better than the other options that are out there.”

    There’s some evidence that long-term cannabis smoking can worsen respiratory problems and exacerbate some mental conditions, he said. Cannabis can also impair learning, memory and attention.

    But it’s unclear how cannabis relates to heart attack, stroke and diabetes. And it’s not known how using marijuana during pregnancy affects pregnancy and childhood outcomes.

    Determining marijuana's health effects can be difficult due to a host of issues, including a lack of standardization among the drug, federal restrictions and little funding for research, Wallace said.

    Karmen Hanson, program director of behavioral health at the National Conference of State Legislatures, said 34 states have legalized medical marijuana.

    Most states require or allow dispensaries and patient registries. They also have a list of specific conditions that patients can use medical marijuana.

    But each state’s program is unique and legislators have to design programs that work best for their state, Hanson said.

    “No two programs are going to be alike,” she said. “You can’t take what has worked in Colorado and drop it into Wisconsin.”

    Gov. Tony Evers’ budgetwould legalize medical marijuana, but parts of it face opposition from Republican leaders.  

    Read more. 
  • March 20, 2019 5:38 PM | Sally Winkelman (Administrator)

    March 20, Wisconsin Health News

    Attorney General Josh Kaul called Tuesday for increasing access to treatment, taking action to prevent people from becoming addicted to opioids and holding drug traffickers and others accountable for their role in the opioid epidemic.

    Speaking at an opioid forum in Green Bay, Kaul said the state should ensure more Wisconsinites have access to treatment and expand local programs that are working well.

    He also called for taking federal money to expand Medicaid to get more people access to healthcare.

    Wisconsin has done well on raising awareness, but it needs to take more action to prevent people from being addicted, Kaul said. That includes continuing work on reducing overprescription of opioids and its drug take back days.

    He also suggested looking at the legalization of marijuana in other states and seeing whether it was effective as an alternative to opioids.

    “My view is that I would have a doctor prescribing that patient medical marijuana than an opioid in almost every case,” he said.

    Kaul also said large-scale drug traffickers need to be held accountable as well as those who created the epidemic.

    Those who “reaped massive profits off the creation of the epidemic owe money back,” he said.

    “It’s critical that we learn what caused this epidemic so that we don’t repeat the mistakes that were made as this epidemic was created,” he said

  • March 05, 2019 11:29 AM | Sally Winkelman (Administrator)

    Summer is only a few months away, and the Wisconsin Medical Society has teamed up with the Medical College of Wisconsin (MCW) and the University of Wisconsin School of Medicine and Public Health (UWSMPH) to make sure your health care team is prepared.

    From Asthma to Zika: A Physician's Guide to Summer is being held April 5-6 in Madison. Focusing on emerging health trends in infectious disease, environmental health and trauma, the new two-day education conference features a full lineup of speakers from MCW and UWSMPH, plus the opportunity to fulfill opioid education required by the Medical Examining Board and plenty of time to network with colleagues from across the state. s teamed up with the Medical College of Wisconsin (MCW) and the University of Wisconsin School of Medicine and Public Health (UWSMPH) to make sure your health care team is prepared. 

    Click here for details including session descriptions, speaker bios and registration information. The conference has been approved for AMA PRA Category 1 Credit™. Application for CME credit with the American Academy of Family Physicians is pending.

  • February 22, 2019 5:24 PM | Sally Winkelman (Administrator)

    This quarterly recurring conference, taking place on May 22, 2019; September 11, 2019 and November 20, 2019, creates an educational forum in which primary care providers present cases of patients with complex pain to a multidisciplinary medical team.

    The team consists of specialists in:

    • Addiction Medicine
    • Pain Medicine
    • Pharmacy
    • Physical Therapy  Physical and Rehabilitation Medicine
    • Primary Care
    • Psychiatry

    The team will offer patient-specific recommendations for 

    • Opioid and non-opioid medication management
    • Psychiatric and/or behavioral-health factors and treatment pathways, including addiction treatment
    • Physical therapy and other movement therapies
    • The use of interventional and non-interventional pain-blocking therapies

    Patient identifiers will be removed so that other providers can attend the case presentations and learn the team’s recommendations for controlling pain and improving function.

    This conference is designed to support providers’ efforts to develop multi-modal, pain management plans for their complex, chronic pain patients.

    Providers on the May 22nd team include:

    • Alaa Abd-Elsayed, MD, MPH, Medical Director, UW Health Pain Services; Medical Director, UW Pain Clinic
    • Ellen Braatz, DPT – Physical Therapy, UnityPoint Health-Meriter
    • John Ewing, MD – Addiction Medicine, NewStart – UnityPoint Health-Meriter
    • Jennifer George, PharmD – Pharmacy, UnityPoint Health-Meriter
    • Jared Greenberg, MD - Interventional Spine and Rehabilitation, UnityPoint Health-Meriter
    • Jim Shropshire, MD, Primary Care – Conference Moderator, UnityPoint Health-Meriter, Chair of the Ambulatory Chronic Pain Committee
    • Ketty Thertus, MD – Psychiatry, Assistant Professor, Department of Psychiatry, UW School of Medicine and Public Health,

    The conference will recur quarterly and team members may vary. If you would like to present a case at a future conference, please email

    This conference is generously funded by the UnityPoint Health-Meriter Foundation.

    STATEMENT OF ACCREDITATION UnityPoint Health - Meriter is accredited by the Wisconsin Medical Society to provide continuing medical education for physicians.

    AMA CREDIT DESIGNATION STATEMENT UnityPoint Health - Meriter designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity

  • February 15, 2019 11:22 AM | Sally Winkelman (Administrator)

    The Wisconsin Medical Society and the Wisconsin Society of Addiction Medicine (WISAM) have raised concerns that a recent letter sent by the U.S. Department of Justice (DOJ) could have negative unintended consequences for patients trying to receive medically necessary treatment.

    The letters were sent February 4 to more than 180 Wisconsin physicians, physician assistants and nurse practitioners who are “prescribing opioids at relatively high levels compared to other prescribers,” but did not specify if those comparisons reflected different types of patient populations that exist—a critical variable considering that some clinicians spend the bulk of their practices treating patients who experience pain or who are being weaned off addictive drugs, including opioids.

    “We’re very concerned that these letters will alarm prescribers to the point that they may get out of the pain treatment arena altogether,” said Society President Molli Rolli, MD, in a press release distributed statewide today. “For years, Wisconsin’s physicians, elected officials and law enforcement leaders have collaborated to find the best ways to combat the opioids crisis; these letters seem to pivot into an area where physicians are threatened with criminal sanctions even if the treatment provided is medically appropriate.”

    The DOJ letter admits that those receiving the letter haven’t been accused of any criminal wrongdoing: “Your prescriptions may be medically appropriate, and we have made no determination that you are violating the law.”

    However, WISAM President Matthew Felgus, MD, said, “You have to get pretty deep into the letter to see that disclaimer. So essentially the letter is saying ‘you’re not doing anything illegal, but we’re watching you’—that’s a very new law enforcement attitude compared to what we’ve seen over the last several years, so it’s quite troubling.”

    A recent report from the state’s Prescription Drug Monitoring Program (PDMP) shows that the total number of opioids and other monitored prescription drugs dispensed in Wisconsin has decreased 29 percent between 2015 and 2018—a drop of almost 1.5 million prescriptions.

    “We’re making progress in reducing the amount of opioids being prescribed; at the same time, it’s important to remember that it’s already very difficult for some patients in Wisconsin to get quick access to legitimately needed care,” said Dr. Felgus. “Prescribers receiving this letter may think twice about continuing to see patients who have pain treatment needs—and those patients risk turning to street drugs when they can’t see a physician who is trying to wean them off opioids altogether.”

    Both Dr. Felgus and Dr. Rolli emphasized that physicians are grateful for law enforcement efforts to help combat the opioid epidemic and suggested that the state’s Medical Examining Board—made up of 10 physicians and three public members—is best-suited to determine if a physician should face sanctions for providing inappropriate care.

    “We hope to continue to collaborate with law enforcement on efforts like Wisconsin’s Dose of Reality initiative and drug take-back days, which have resulted in literally tons of unused prescription drugs being turned in to law enforcement offices for destruction, and that what appears to be a more punitive stance in the DOJ letter is an anomaly rather than a new standard,” said Dr. Rolli.

  • February 01, 2019 11:28 AM | Sally Winkelman (Administrator)

    Heading to The ASAM 50th Annual Conference April 4-7? While in Orlando, make plans to participate in a Wisconsin Chapter meeting on Saturday, April 6th, 5:30-6:30 pm EST. We look forward to seeing you there!

  • January 30, 2019 3:16 PM | Sally Winkelman (Administrator)

    January 30, Wisconsin Health News

    Opioid-related overdose deaths appear to be leveling off in Milwaukee County, according to a recent report.

    If trends continue, the projected likely number of fatal opioid-related overdoses last year will be 9 percent lower than in 2017, according to the Milwaukee Community Opioid Prevention Effort.

    The report estimated that for every overdose death, five additional people received an anti-overdose drug and survived.

    The report also called for efforts focused on reducing drug use, working with providers to prevent those taking pain medications from developing opioid use disorder and connecting people with treatment.

    "While much effort has been put into addressing the opioid crisis, and projected fatal and non-fatal overdoses appear to be decreasing, more is needed," the report noted.

    The Milwaukee Community Opioid Prevention Effort is sponsored by the city of Milwaukee, The Medical College of Wisconsin's Department of Emergency Medicine and the Zilber Family Foundation.

  • December 21, 2018 1:06 PM | Sally Winkelman (Administrator)

    December 20, WMS Medigram

    The Wisconsin Medical Society has urged the state’s Medical Examining Board (MEB) to be flexible when approving courses related to opioid prescribing so that more physicians can receive useful education befitting their particular specialties. The input was given at a public hearing before the MEB on a new administrative rule related to an extension of the opioid prescribing continuing medical education (CME) course requirement until November 2021.

    Current rules require physicians holding a U.S. Drug Enforcement Administration number to complete two of the 30 required hours of CME per biennium in an MEB-approved course related to the state’s opioid prescribing guidelines. The current requirement expires in November 2019. The MEB is extending the requirement for another CME reporting biennium while broadening the subject matter scope to “an educational course or program related to opioid prescribing.”

    The Society was the only organization to testify before the MEB on the rule proposal.

    Flexibility in the types of courses that can gain MEB approval would make the requirement more relevant to certain physicians who, while not being active opioid prescribers, often take care of patients dealing with the aftermath of opioid addiction or abuse. The Society also suggested that the Board could incentivize physicians taking coursework in Medication Assisted Treatment (MAT) by making those courses eligible to satisfy the requirement should they be submitted for CME approval. The MEB welcomed the comments and indicated that such flexibility would be useful as Wisconsin continues to grapple with this issue.

    The MEB unanimously approved the rule proposal, which now moves on to standard Governor’s office and legislative review.

    Each of the webinars available in the Society’s opioid prescribing series has been approved by the MEB for fulfilling the 2018-2019 CME requirement, including two 2-hour webinars presented by Michael McNett, MD. The other programs vary in length and may be combined to satisfy the mandate. Click here to learn more.

  • December 20, 2018 2:22 PM | Sally Winkelman (Administrator)

    December 19, Wisconsin Health News

    A state commission has designed a care delivery model to increase access to treatment for substance use disorder. But critical parts of the model, like how it'll be paid for, still need work. 

    The report from the Commission on Substance Abuse Treatment Delivery was released at the final meeting of the Governor’s Task Force on Opioid Abuse in Friendship last week.

    The commission, created by Gov. Scott Walker in January, met with Medicaid officials, provider associations and others as it developed the model.

    The report describes a system of regional “hubs,” with staff specialized in addiction providing high-intensity, medication-assisted treatment, and “spokes” that offer less intensive treatment in the community.

    Vermont first developed the hub-and-spoke model, and other states have adopted similar models.

    “The model can be viewed as a draft, and a goal to move towards, as it will benefit from further input from additional stakeholders and from individuals with lived experience of addiction,” the report notes.

    The report recommends that the treatment initiation process begin within 24 hours of a person seeking care to minimize withdrawal. That capacity isn’t available in the current system, the report notes, describing it as a “long-term goal.”

    But a starting point could be emergency departments, where doctors could provide patients with a one- to three-day prescription for buprenorphine, a drug used to treat opioid addiction.

    Care teams that provide support throughout treatment and recovery and address the social determinants of health are another critical part of the model. The makeup of the teams could vary, and the report doesn’t specify how they’d be paid for and what requirements they'd need to meet.

    Hubs will have to be able to quickly accept transfer patients that spoke clinics can't support. Spokes will also need access to specialized resources to support patients, which could be provided by either the team or the hub. “All services should be available locally across the state,” the report notes.

    The report's roadmap toward implementation includes coordinating funding and a call on healthcare payers to change how they pay for care to ensure providers participate in the model. That could include increases in reimbursement rates and incentives for care coordination and delivery.

    It’ll also require a “comprehensive monitoring and program evaluation plan" to track performance.

    Health information technology and telehealth will play a large role as will regulatory changes aimed at breaking down barriers to accessing medication-assisted treatment, according to the report.

    “How services are integrated and provided can look very different in different regions and counties, and it indeed should look different,” the report notes. “The current expectation is not a finished model, but to align the direction and goals that all partners are moving towards.” 
  • December 18, 2018 2:10 PM | Sally Winkelman (Administrator)

    Matt Felgus, MD
    WISAM President

    The impact of substance use disorders is in the news every day -- there is no escaping the effects this has on patient care whether you are a physician, nurse, pharmacist or therapist. However, not all of our colleagues are comfortable with this unavoidable reality, which is why it is so important for all of us to stay informed and to serve as points of contact along the way.

    I've heard some of you, especially newer WISAM members, say that you don't feel you know enough about addiction to be able to serve as a point of contact for your colleagues. But the fact that you've joined WISAM and are reading this now makes a huge difference in moving our respective fields forward in this critical subject. Keep connected and keep learning! 

    As one who started in the field as a drug counselor and finished addiction psychiatry training in the late 90s at the crest of the 'patients can't get addicted to opioids if they are using them only for pain' era, I can say from experience that your involvement matters more than you think. And for this I thank you and honor your willingness to join with us.

    And for those of you who have been on the front lines of addiction treatment for years, deep gratitude to you as well. WISAM is an amazing organization with tireless, committed officers, committee chairs, administrative staff and members. It's been an honor to represent and work alongside of you all. Let's keep moving things forward!

    Have a wonderful holiday season. And Best Wishes for 2019!

    Matt Felgus, President

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