Mar 25, 2026

Hello OPEN,

In 2025, OPEN made important strides in Michigan. We launched the OPEN Warmline service and have helped over 180 patients get buprenorphine. Painless: The Opioid Musical visited and performed in the Upper Peninsula for the first time ever. Over 14,000 naloxone kits were distributed to Michigan residents to help reverse an opioid overdose.

As we look ahead into the rest of 2026, we are honored to provide medication-first care to our community. At OPEN, we see that there is an ongoing need for these services, and we look forward to continuing to find ways to make these programs more accessible to all.

With spring just around the corner, now is a great time to explore the upcoming OPEN webinars that are available for CME, MCBAP, and SW credit. Do you have a question about pain management for one of your patients living with SUD/OUD? Make sure to explore our Clinician-to-Clinician Consultation Service and get your questions answered by one of our on-call physicians.

Best wishes!

Eliza Hutchinson, MD

On-Call Provider

KEEP UP WITH PAINLESS

Painless: The Opioid Musical has an Instagram! Stay up to date on all things Painless by following us and be among the first to see behind the scenes photos, casting announcements, and exciting new ventures Painless goes on!

Follow Painless on Instagram

CLINICIAN TO CLINICIAN CONSULT SERVICES

Have a question about managing patients with substance use disorder or complex pain? Request a virtual consultation with one of OPEN’s addiction medicine providers. Available Monday through Friday, 9AM to 5PM.

Submit a Consultation

OPEN WARMLINE SERVICE

The OPEN Warmline offers same-day telehealth prescribing for buprenorphine for people in the State of Michigan who use opioids. Telehealth visits can be done by a video visit or phone.

Explore the Warmline

UPCOMING EVENTS

For prescribers, all webinar credits qualify for the DEA required SUD training. FREE CME, MCBAP and Social Work CE credits.

Alcohol Use Disorder & Liver Disease: Improving Diagnosis, Treatment, and Outcomes

April 14, 2026

@ 12:00 pm – 1:00 pm

1.0 CE Credit

CME, MCBAP, SW

Presenter:

Ponni Perumalswami, MD, MSCR

Alcohol use disorder (AUD) is common, underdiagnosed, and a major contributor to rising liver-related morbidity and mortality. This session reviews evidence-based strategies for screening, diagnosing, and treating AUD, including behavioral and medication options appropriate for patients with liver disease. Participants will gain practical tools to improve identification and management of AUD in routine clinical care.

From Cell to Community: Supporting Individuals Reintegrating After Incarceration

May 6, 2026

@ 12:00 pm – 1:00 pm

1.0 CE Credit

CME, MCBAP, SW

Presenter:

Eliza Hutchinson, MD, FASM

Adam Grant

This session will explore the health risks associated with incarceration, with a focus on the transition from carceral to community settings among individuals with a history of opioid use disorder. We examine common barriers to care faced after release and highlight strategies to strengthen clinical engagement. Participants will gain practical skills to support more effective, compassionate, and equitable care for individuals with current or past incarceration exposure.

Benzodiazepines 101: Facts, Myths, and Safety

May 21, 2026

@ 12:00 pm – 1:00 pm

1.0 CE Credit

CME, MCBAP, SW

Presenter:

Elizabeth Hoffman, MD

This session is designed to clarify the role of benzodiazepines in modern clinical practice. Participants will review core pharmacology and appropriate indications, examine common misconceptions, and assess key risks such as tolerance, dependence, withdrawal, and drug–drug interactions. The session will also emphasize safety-focused strategies for prescribing, monitoring, and tapering benzodiazepines to support informed, responsible, and patient-centered care.

The Relative Benefits and Risks of Kratom Derived Products

June 9, 2026

@ 12:00 pm – 1:00 pm

1.0 CE Credit

MCBAP, SW

1.0 CE Credit pending

CME

Presenter:

Dr. C. Michael White, Pharm.D., FCP, FCCP, FASHP

Join us for an informative webinar examining the relative benefits and risks of kratom-derived products. This session will provide an overview of natural leaf kratom, mitragynine extracts, and isolated synthetic compounds (7-OH, mitragynine pseudoindoxyl, MGM-15/16), compare their pharmacologic profiles with traditional opioids, review available clinical and anecdotal data on potential risks and benefits, and discuss regulatory strategies aimed at reducing public health harms while preserving access to natural leaf kratom.

Introduction to Treating Patients with Buprenorphine for Primary Care Providers

October 12, 2026

@ 9:00am – 1:00pm

4.0 CME Credits pending

Presenters:

Chris Frank, MD, Ph.D.

Eliza Hutchinson, MD, FASM

Primary Care Providers (Physicians and Advanced Practice Professionals) who attend this MOUD training are eligible to receive a $250 incentive.

PUBLICATIONS THIS QUARTER

Access literature with OPEN’s publication portfolio. We use evidence to inform public health policy and practice recommendations.

Precision Approaches for Scalable Digital and Clinic-based Interventions in Mental Health

• Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 1/19/2026
• Common mental health conditions affect 20.6% of U.S. adults annually, yet first-line treatments (SSRIs, SNRIs, CBT) achieve only ~30–40% response rates, often after weeks to months of trial, contributing to long wait times and repeated treatment cycling.
• Meta-analyses of digital mental health interventions report small-to-moderate effect sizes (Hedges g ≈ 0.2–0.4) for depression and anxiety, but real-world usage is extremely limited, with only ~4% of users continuing app use beyond two weeks, restricting clinical impact at scale.
• Emerging precision tools show proof-of-concept benefits: EHR-based AI decision support has improved depression outcomes compared with active controls, while genetic approaches explain only limited variance (e.g., polygenic risk scores accounting for ~4.5% of remission likelihood in lithium augmentation), underscoring the need for multimodal, data-integrated precision strategies combining EHR, mobile sensing, and advanced analytics .

Sociodemographic and Clinical Predictors of Digital Mental Health Intervention Engagement Among Treatment-seeking Psychiatric Outpatients

• Journal of Affective Disorders, 1/27/2026
• To assess digital mental health interventions (DMHIs), 1,223 adults with scheduled intake appointments for outpatient psychiatric services were randomized to either a mindfulness-based app (Headspace) or a CBT-based app (SilverCloud).
• 88.2% participants used teir assigned DMHI at least once during the study, with more than twice as many days of engagement with Headspace, and grater engagement predicted among female sex, white race, college degree, and older age up to 60.
• Further, depression severity was associated with engagement in a non-linear manner for those assigned to Headspace, with less engagement at minimal/mild and severe symptoms compared to moderate and moderately-severe symptoms.

Association of Patient-reported Substance Use and Postoperative Pain

• Regional Anesthesia & Pain Medicine, 2/4/2026
• Study design and exposure definition involved a prospective cohort of 4,410 adults undergoing elective surgery across multiple institutions from 2018 to 2023 who completed the Tobacco, Alcohol, Prescription medication, and other Substance use questionnaire (TAPS) preoperatively, with worst and average postoperative pain measured at baseline, 2 weeks, and 1 month and analyzed using adjusted repeated-measures mixed linear models.
• Prevalence of risky substance use, and baseline differences showed that 42.2% of patients screened positive on TAPS in the year before surgery and that these patients had higher baseline worst pain scores than TAPS-negative patients after adjustment (3.51 vs 3.15, p<0.001).
• Postoperative pain trajectories and effect size demonstrated that TAPS-positive patients reported slightly higher worst pain at 1 month postoperatively than TAPS-negative patients (2.66 vs 2.41, p=0.036), with no significant difference at 2 weeks and effect sizes below the minimal clinically important difference.

Governance Framework for Safe and Ethical Implementation of Artificial Intelligence in Surgery: A Modified-Delphi Consensus

• JACS, 2/5/2026
• To establish a clear governance framework for adopting AI-enabled clinical decision support systems into surgical practice, a systematic literature review was conducted of PubMed, Cochrane Library, Medline, and Embase databases until 2024 to identify key governance themes.
• Thematic analysis of 80 full-text articles meeting inclusion criteria identified four overarching themes for AI governance: (1) Technical Prerequisites and Model Design, (2) Clinical Implementation and Human Factors, (3) Ethics, Safety, and Trustworthiness, and (4) Bias, Fairness, and Equity.
• The consensus-driven framework presented herein provides foundational guidance essential for navigating the complexities of implementing AI-enabled CDSS safely and ethically in surgery.

Association Between Tailored Prescriber Training and Buprenorphine Treatment for Opioid Use Disorder Among Emergency Medicine Clinicians

• American Journal of Emergency Medicine, 2/9/2026
• Buprenorphine prescription fills increased by 2.1 fills/clinician (95% CI 0.9–3.3), rising from 531 to 963 total fills (2.6 → 4.7 fills/clinician) after the tailored training.
• Unique patients treated increased by 1.5 patients/clinician (95% CI 1.1–1.9), growing from 162 to 457 patients post‑training.
• New patient initiations increased by 0.8 per clinician (95% CI 0.6–1.0), rising from 53 to 222 total initiations after training, while non‑participants saw almost no change (2.2 → 2.4 fills/clinician).

Identifying the “Gray Zone:” Developing Scalable Methods to Detect Opioid Misuse in Veterans on Long-term Opioid Therapy for Pain

• Drug and Alcohol Dependence, 2/12/2026
• Manual review identified 541 of 741 Veterans (73%) as meeting gray zone criteria for high‑risk opioid misuse without OUD diagnosis.
• The elastic net regression model achieved a positive predictive value (PPV) of 84%, which is 11 percentage points higher than relying on structured EHR data alone (73%).
• Using the model, researchers identified 4,047 additional gray‑zone patients in the larger unreviewed cohort, greatly expanding the size of the identified high‑risk population.

Randomized Controlled Trial of Medical Assistant-coached Behavioral Intervention for Chronic Pain

• Regional Anesthesia & Pain Medicine, 3/6/2026
• PRISM‑CBT showed no advantage over usual care at 8 weeks but achieved a 7.4‑point greater improvement in FIQR global impact by 12 months, and it produced a 4.8‑point greater improvement than standard CBT at 8 weeks.
• PRISM‑CBT produced consistently lower pain interference than both usual care and CBT, improving by 0.88 points at 8 weeks, 0.88 at 6 months, and 1.42 at 12 months versus usual care, and by 0.98, 0.63, and 1.92 points at the same intervals versus CBT.
• PRISM‑CBT showed modest but meaningful reductions in pain severity, performing 0.56 points better than usual care at 6 months and 0.86 points better than CBT at 12 months.