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Module 9: Advanced Topics in Addiction Medicine - — Urine Diagnostic Testing, Chronic Pain, Infectious Disease, Pregnancy, Cultural Responsiveness, Comprehensive Assessment, and Criminal Justice Care addresses critical competency gaps in the management of complex, high-risk clinical scenarios commonly encountered in modern addiction practice, including urine diagnostic testing interpretation, multimodal chronic pain management, infectious disease integration, pregnancy-related care, culturally responsive practice, comprehensive assessment, and justice-involved populations. This activity equips clinicians with structured, evidence-based, and non-punitive frameworks to enhance diagnostic accuracy, improve interdisciplinary coordination, integrate harm-reduction principles, and deliver trauma-informed, longitudinal care that reduces preventable morbidity and mortality across medically and socially vulnerable populations.
Addiction medicine clinicians increasingly manage complex, high-risk clinical scenarios that extend beyond core substance use treatment, including interpretation of urine diagnostic testing (UDT), chronic pain in patients with substance use disorders (SUD), infectious disease integration, pregnancy-related care, culturally responsive practice, and justice-involved populations. Despite the frequency of these presentations, many clinicians report limited formal training in applying structured, non-punitive toxicology interpretation, multimodal pain management, trauma-informed assessment, and cross-system coordination within addiction settings.
Urine toxicology is widely used but inconsistently interpreted. Clinicians often report uncertainty in distinguishing presumptive immunoassay screening from confirmatory testing (gas chromatography–mass spectrometry [GC-MS], liquid chromatography–tandem mass spectrometry [LC-MS/MS]), understanding metabolic pathways and detection windows, and using results therapeutically rather than punitively. Similarly, chronic pain management in patients with SUD presents diagnostic and safety challenges, including differentiating nociceptive, neuropathic, nociplastic pain, opioid-induced hyperalgesia (OIH), and withdrawal-associated injury site pain (WISP), while prioritizing function-based, non-opioid strategies.
Additional gaps exist in integrating Hepatitis C virus (HCV) and HIV prevention and treatment into addiction care, managing medications for opioid use disorder (MOUD) during pregnancy and justice involvement, addressing social determinants of health (SDOH), and applying culturally responsive, trauma-informed frameworks. Fragmented care across medical, behavioral, correctional, and community systems contributes to preventable morbidity and mortality.
This activity addresses identified gaps in knowledge, competence, and performance by equipping clinicians with evidence-based strategies for toxicology interpretation, multimodal pain management, infectious disease integration, trauma-informed assessment, culturally responsive care, and coordinated longitudinal treatment across high-risk populations in addiction medicine settings.
By the conclusion of this activity, learners will be able to:
Interpret urine diagnostic testing (UDT) results in addiction medicine by distinguishing presumptive immunoassay screening from confirmatory testing using gas chromatography–mass spectrometry (GC-MS) and liquid chromatography–tandem mass spectrometry (LC-MS/MS), and by integrating metabolic pathways, detection windows, cross-reactivity, and causes of false positives/negatives across opioids, benzodiazepines, stimulants, alcohol biomarkers, nicotine, tetrahydrocannabinol (THC), and emerging substances, while correlating results with clinical history and medication lists.
Apply a structured, ethical, non-punitive framework for the clinical use of toxicology by documenting informed consent, therapeutic intent, and harm-reduction rationale, and by using UDT findings to enhance safety, engagement, and treatment planning rather than to enforce punitive or exclusionary actions, including in patients with chronic pain, pregnancy, and justice involvement.
Differentiate pain mechanisms—including nociceptive pain, neuropathic pain, nociplastic pain, opioid-induced hyperalgesia (OIH), and withdrawal-associated injury site pain (WISP)—and design a multimodal, patient-centered pain management plan for individuals with substance use disorder (SUD) that prioritizes non-pharmacologic and non-opioid strategies, incorporates function-based goals, and specifies monitoring elements such as follow-up cadence and nonjudgmental UDT use when opioids are considered.
Select, administer, and interpret validated screening and assessment tools to guide diagnosis, risk stratification, and level-of-care decisions, including Alcohol Use Disorders Identification Test (AUDIT), Drug Abuse Screening Test (DAST), Screening, Brief Intervention, and Referral to Treatment (SBIRT)–aligned tools, PEG Pain Scale, Central Sensitization Inventory (CSI), Pain Catastrophizing Scale (PCS), World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), Adverse Childhood Experiences (ACE) screening, and structured psychiatric screeners, and determine when interdisciplinary or specialty co-management is indicated.
Implement evidence-based infectious disease prevention and treatment within addiction medicine settings by selecting and interpreting appropriate Hepatitis C virus (HCV) screening and diagnostic tests (antibody, RNA, reflex testing), initiating or coordinating direct-acting antiviral (DAA) therapy alongside medications for opioid use disorder (MOUD), addressing adherence and drug–drug interactions, and prescribing and monitoring HIV pre-exposure prophylaxis (PrEP) using guideline-concordant patient selection, laboratory screening, follow-up intervals, and counseling.
Chief Medical Education Officer
Porch Light Health
Provider
Porch Light Health
Provider
Porch Light Health
Medical Lead, Infectious Disease Lead, Safety Lead
Porch Light Health
Director of Medical Services
Porch Light health
cpack@plhealth.com
Chief Clinical Officer
Porch Light Health
Provider
Porch light Health
Counselor
Porch Light Health
Director of Community Engagement and Development
Porch Light Health
Medical Director, AMSWS Lead, Lead Liaison, MA Lead
Porch Light Health
Bernie Birnbaum, MD
UCHealth
Chief of Addiction Medicine
Summit Stone Health
Provider
Porch light Health
In support of improving patient care, this activity has been planned and implemented by Porch Light Health and CME Outfitters, LLC. CME Outfitters LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
CME Outfitters, LLC, designates this enduring material for a maximum of 5.75 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity is designated for 5.75 contact hours.
This knowledge-based activity is approved for 5.75 contact hours (0.25 CEUs) of continuing pharmacy credit (UAN UAN JA0007185-9999-26-074-H01-P).
CME Outfitters, LLC, has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 5.75 AAPA Category 1 CME credits. Approval is valid until March 19, 2028. PAs should only claim credit commensurate with the extent of their participation.
As a Jointly Accredited Organization, CME Outfitters, LLC is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 5.75 general continuing education credits.
CME Outfitters, LLC is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.
CME Outfitters, LLC designates this activity for 5.75 continuing education credits.
Concerns or complaints about a CE provider may be directed to the provider, or to the Commission for Continuing Education Provider Recognition at ADA.org/CERP.
This activity was planned by and for the healthcare team, and learners will receive 5.75 Interprofessional Continuing Education Credit for learning and change.
| First Name | Last Name | Disclosures |
|---|---|---|
| Ken | Davis, PA | Discloses Stock Shareholder (directly purchased): Own shares of Lilly |
| Jeremy | Dubin, DO | Nothing to disclose |
| Joshua | Blum, MD | Nothing to disclose |
| Jarratt | Pytell, MD | Nothing to disclose |
| Karlie | Straight, PA | Nothing to disclose |
| Jeanie | Folan, MD | Nothing to disclose |
| Kaylin | Klie, MD | Nothing to disclose |
| Kimberly | Nordstrom, MD | Nothing to disclose |
| Tracey | Walls, PA-C | Nothing to disclose |
| Dayna | DeHerra-Smith, MPH | Nothing to disclose |
| Katie | Fiske, MSW | Nothing to disclose |
| Jacob | Bellendir, PA | Nothing to disclose |
| First Name | Last Name | Disclosures |
|---|---|---|
| Ken | Davis, PA | Discloses Stock Shareholder (directly purchased): Own shares of Lilly |
| Jeremy | Dubin, DO | Nothing to disclose |
| Joshua | Blum, MD | Nothing to disclose |
| Jarratt | Pytell, MD | Nothing to disclose |
| Karlie | Straight, PA | Nothing to disclose |
| Jeanie | Folan, MD | Nothing to disclose |
| Kaylin | Klie, MD | Nothing to disclose |
| Kimberly | Nordstrom, MD | Nothing to disclose |
| Tracey | Walls, PA-C | Nothing to disclose |
| Dayna | DeHerra-Smith, MPH | Nothing to disclose |
| Katie | Fiske, MSW | Nothing to disclose |
| Jacob | Bellendir, PA | Nothing to disclose |
At the end of the module, you will be provided with the activity post-test and evaluation link, then print your certificate/statement of credit.
Credit request forms, and activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately. This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit https://www.cmeoutfitters.com/privacy-and-confidentiality-policy
Please contact: plhu@plhealth.com
