Methadone-Associated Mortality:
Report of a National Assessment

Appendix 2. Agenda

Thursday, May 8, 2003

Introductions:
Alan Trachtenberg, MD, MPH; Medical Officer, DPT/CSAT/SAMHSA

Opening Remarks: The CSAT Perspective:
H. Westley Clark, MD, JD, MPH, CAS, FASAM; Director, CSAT

The Opioid Treatment Program (OTP) Perspective:
Mark W. Parrino, MPA, President, AATOD (OTP Co-Chair)

Clinical Importance of Methadone in Opioid Agonist Therapy (OAT)
and Pain Management:
Seddon R. Savage, MD, FASAM (Pain Co-Chair)

Challenges to the Forensic Community:
Bruce Goldberger, PhD (Toxicology Co-Chair)

Drug Abuse Warning Network (DAWN) and other SAMHSA Office of Applied
Studies (OAS) Data:
Elizabeth Crane, PhD, MPH

Opioid Utilization (Denominator) Data:
ARCOS: June Howard, DEA, & Alan Trachtenberg, CSAT
NCHS Outpatient Utilization Data: Catharine Burt, EdD, NCHS
IMS: Laura Governale, PharmD, FDA

Methadone Mortality Data from MedWatch (Passive National Surveillance):
Martin L. Pollock, PharmD, FDA

Surveillance of Medication-Related Mortality and Morbidity (Current efforts of the National Center for Injury Prevention and Control):
Dan Budnitz, MD, MPH

Cardiac Questions (QT prolongation, TdP):
Background: Mori Krantz, MD
New Population-based Data: Bridget Martell, MD
Discussion: Barry Stimmel, MD

Trends in Fatal Opioid Poisoning - National Numerator and Death Certificate Data:
Lois Fingerhut, MA, NCHSR

State-Level Data:
Florida: Bruce Goldberger, PhD
North Carolina: Kay Sanford, MSPH
Maine: Marcella Sorg, RN, PhD
Washington & Virginia: Ann Marie Gordon, BA, MS
Texas: Jane Maxwell

Discussion Breakout Meetings (3 Interdisciplinary Groups):
Questions for resolution:
- What are the problems?
- Which drugs and persons are involved?
- What further data are needed? Why?
- Where should data come from?
- How should the data be organized?
- How can the data help in developing action plans?

Group Reports & Discussion

Friday, May 9, 2003

Overview:

H. Westley Clark, MD, JD, MPH, CAS, FASAM; Director, CSAT

The Challenge for the Morning:
Seddon R. Savage, MD, FASAM

Relevant New Efforts at Data Collection:
National Violent Death Reporting System (NVDRS): Randy Hanzlick, MD
NAME Pediatric Toxicology Registry: John Howard, MD
Consumer Product Safety Commission: Tom Schroeder, MS
Electronic Prescription Monitoring Systems: Danna Droz

Developing Relationships Between Medical Examiner & Medical Practitioner - A report from Canada:
Doug Gourlay, MD

Action Planning Breakout Sessions (3 Intra-disciplinary Groups): Forensics (Pathology & Toxicology), Addiction Treatment, Pain Treatment:
General questions for resolution:
- Are there actions that could/should be taken immediately?
- What are longer-range goals?
- How can each "community"/ disciplinary group contribute?
- What resources, programs, or services (RPS) already exist?
- What new RPSs can/should be developed? Why?
- Who are the target audiences?
- How should outcomes be monitored?

Group Reports from Breakout Sessions

Brief Statements from Organization representatives (NAME, AAFS, SOFT, ASAM, AAAP, AAPM, etc.):
Open invitation for voluntary additions to the record (proceedings)
from the national organizations represented at the meeting.

Closing: Where do we go from here?
Mark W. Parrino, MPA