The Impact of Decriminalizing Possession and Use of Illegal Drugs in Massachusetts
The United States has battled with illegal drugs for well over 100 years. Yet prohibition of these drugs, especially cocaine and opioids, is implemented in an inequitable way in this country, with criminalization of substances used strategically to target
people of color. Of importance, more White people use drugs than Black people according to data, yet Black and Brown people are arrested in much larger numbers. Incarcerating those who use drugs destroys community, family life, children’s lives, mental
health, housing security, and food security. There is well-established scientific evidence that substance use disorder is a chronic relapsing disease, not a legal or moral issue, and addiction is best treated in health systems where all evidence-based
approaches to treatment are available and where relapse signals the need for more help. The Massachusetts Medical Society “supports legislative and policy efforts that reduce conviction and incarceration solely for personal possession and illicit
use of drugs and supports increased access to harm reduction services and all forms of treatment.” Commitment to resources for harm reduction and treatment, as opposed to incarceration, is crucial. Physicians and other health care professionals, law
enforcement, and legislators need consider decriminalization further, but we must first educate ourselves. This webinar (recorded on October 6, 2022) explores the positive and negative impacts of decriminalizing possession and personal use of illegal
drugs through brief presentations, discussion among the presenters and moderator, and participant questions posed to the speakers.
Faculty
Theodore A. Calianos, II, MD, FACS
President, Massachusetts Medical Society
Dr. Calianos is a practicing plastic surgeon in Mashpee. He was in private practice for several years prior to joining Medical Affiliates of Cape Cod (MACC), the multispecialty group
practice of Cape Cod Healthcare (CCHC), and serves as its medical director. He serves on numerous committees at Cape Cod Healthcare.
Stefan Topolski, MD
Founder and Medical Director, CottageMed
Internist/Hospitalist, Trailside Health, LLC
Consultant, Massachusetts Consultation Service for Treatment of
Addiction
and Pain (MCSTAP)
Stefan Topolski has worked with individuals experiencing behavioral health and substance use disorders for 30 years on the streets, in shelters and soup kitchens, in hospitals and in their homes from Boston to Baltimore
and Pittsburgh to Madrid. He is now a country doctor in active rural practice, a teacher of family medicine, an ethicist, and an avid writer and complex systems science theorist who continues to speak out for care without stigma or prejudice.
Dr. Topolski served veterans suffering mental illness and addiction for 15 years at the VA Leeds psychiatric hospital. He has served on faculty for Tufts, BU, and UMass and as medical director for Commonwealth Care Alliance in their innovative care with
the underserved. He supports the Opioid Task Force of Franklin County and the Franklin Recovery Center while leading Shelburne Falls’ small nonprofit community health center with dedicated mental health and substance dependence treatment in rural
western Massachusetts.
He has presented papers on the experience, meaning and modeling of health and illness before the Society of Teachers of Family Medicine, the Family Medicine Education Consortium, the North American Primary Care Research
Group and World Organization of Family Doctors among others. And for two decades Stefan’s creative programming of CottageMed - the world’s first free, cross-platform, open-source EMR - has opened the door for USAID, the UN, and young doctors worldwide
to begin sharing the benefits of electronic medical records with their patients across many borders.
Today he continues to advocate for what he loves most through home visits, clinical collaborations, teaching and public speaking on the role
of integrative care models in improving access to quality healthcare without judgement for each person.
Catherine Tomko, PhD, MHS
Postdoctoral Fellow, Department of Mental Health
Johns Hopkins University Bloomberg School of Public Health
Catherine Tomko, PhD MHS, is a postdoctoral fellow in the Department of Mental Health
at the Johns Hopkins University Bloomberg School of Public Health. She earned her Master of Health Science and Doctor of Philosophy degrees at the Bloomberg School of Public Health, Department of Health, Behavior and Society at Johns Hopkins University.
Dr. Tomko’s research broadly centers on the social and structural determinants of health (particularly mental health) and healthcare access of people who use drugs and/or sell sex. She is part of a team evaluating the public safety and racial equity
impacts of Baltimore’s drug and sex work decriminalization policy enacted in 2020.
Eowyn Rieke, MD, MPH
Medical Director Outpatient and Residential Services
Fora Health, Portland, Oregon
President, Oregon Chapter, American Society for Addiction Medicine
Former Member, Oregon Measure 110 Oversight and Accountability
Council
Eowyn is passionate about centering community and connection in addictions medicine. Substance use care has been part of her work for over 20 years in primary care. Eowyn received her MD degree from Brown University and MPH from Harvard
School of Public Health. She worked in Massachusetts and Pennsylvania before moving to Portland in 2011. She spent her 1st 4 years in Portland working at Outside In then moved to work at Central City Concern. At CCC she supervised shelter-based services
and other outreach and provided primary care at Old Town Clinic. She joined the team designing and implementing services for the Blackburn Center, which opened in July, 2019. As services director at the Blackburn Center, she worked to develop person-centered,
trauma-informed and integrated substance use, primary care, mental health, housing and employment services. In May, 2021 Eowyn moved to De Paul Treatment Centers, now Fora Health, to serve as the medical director, outpatient and residential services.
In this role she is developing programs to insure patients have uninterrupted access to medications as they transition within Fora Health programs and to community-based prescribers. Eowyn is also interested in policy and served on the state of Oregon's
Measure 110 Council which set policy and rules for $300 million in state funds for substance use care. In Eowyn's non-work life she is delighted to spend time gardening, and with her teenage kid and rescue pup Toad Macaroni.
Jessie Gaeta, MD
Physician, Boston Healthcare For the Homeless
Assistant Professor of Medicine in General Internal Medicine
Boston University School of Medicine
Jessie M. Gaeta, MD has practiced Internal Medicine at Boston Health Care for the Homeless Program (BHCHP) since 2002, and served as Chief Medical Officer from 2015-2022. Dually board certified in Internal Medicine and Addiction Medicine, Dr. Gaeta graduated from the University of Maryland School of Medicine in 1998, trained in Internal Medicine at Boston University Medical Center, and served as Chief Resident in 2002. She completed a Physician Advocacy fellowship at the Institute on Medicine as a Profession at Columbia College of Physicians and Surgeons in 2007.
Dr. Gaeta has dedicated herself to advocacy for and with people living with substance use disorders, particularly when they are disconnected from traditional pathways to care. She is always learning more from people with lived experience about homelessness, opioid use disorder, and harm reduction. Over the past two decades, she has spearheaded numerous innovative initiatives to rethink how we approach care for individuals with substance use disorder and complex health conditions, particularly when these conditions are exacerbated by severe poverty, racism, trauma, and social stigma.
Her tenure as CMO included the first two years of the COVID-19 pandemic, during which she led BHCHP’s response, which included operating the 500-bed COVID field hospital at the Convention Center known as Boston Hope, implementing comprehensive COVID testing across Boston’s shelter system, and vaccination efforts that focused on racial equity.
Abigail (Avi) Davis
Peer
Support Specialist, CADC-R, CRM I
Peer Case Manager (Withdrawal Management)
Ms. Abigail “Avi” Davis has lived experience of stigmatized substance use. She is an opioid agonist therapy patient, a drug user union organizer, drug policy reform advocate, and harm reduction worker. Avi will be graduating this winter with a Bachelor of Science in Family and Human Services. She is a Certified Peer Support Specialist and Certified Alcohol Drug Counselor candidate, with a long background of working in community harm reduction services. She has also been involved in national and regional drug policy work and drug related research over the past years. Avi currently works as a case manager at the intersection of detox / treatment / low barrier medication access.
Intended Audience
This activity is designed for physicians and other healthcare providers and administrators, policy makers, and law enforcement.
Course Objectives
- Describe how stigmatization of illicit substance use contributes to social and health disparities, and fewer treatment options.
- Examine how substance use disorders are chronic and relapsing diseases and not moral failures.
- Assess the role of physicians, health care allies, legislators, and law enforcement in aiding those with a history of illicit substance.
- Develop the skills to provide resource information and/or treatment options to those using illicit substances for personal use.
-
Analyze the role of the criminal justice system regarding illicit substances and personal use.
Course Fees
Massachusetts Medical Society (MMS) Physician Member: $60.00
MMS Resident/Student Member: Free
Non-Member Physician: $135.00
Non-Members Resident/Student: $30.00
Allied Health Professional/Other: $48.00
Format & Estimated Time to Complete
Video,
1.5 hours
Accreditation and Credit Information
Accreditation Statement
The Massachusetts Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education
for physicians.
AMA Credit Designation Statement
The Massachusetts Medical Society designates this internet enduring material for a maximum of 1.50 AMA PRA Category 1
Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets the criteria for the Massachusetts Board of Registration in Medicine for risk management study.
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, This activity has met the requirements as a Lifelong Learning CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
Allergy and Immunology
Anesthesiology
Colon and Rectal Surgery
Family Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry and Neurology
Radiology
Thoracic Surgery
Urology
National Commission on Certification of Physicians Assistant
(NCCPA)
Physician Assistants may claim a maximum of 1.50 Category 1 credits for completing this activity. NCCPA accepts AMA PRA
Category 1 Credits™ from organizations accredited by ACCME or a recognized state medical society.
Exam/Assessment: A score of 70% or higher is required to receive AMA PRA Category 1 Credit™.
Activity Term
Original Release Date: October 17, 2022
Review Date (s): N/A
Termination Date: October 17, 2025
System Requirements
Desktops/Laptops
Windows 10
Mac OSX 10.6 higher
Most modern browsers including:
IE 11+
Firefox 18.0+
Chrome latest version
Safari 12+
Mobile/Tablet
iOS devices beginning with OS version 10 or higher (includes, iPhone, ipad and iTouch devices)
