Inpatient Consults

Inpatient consults occur within UAB hospital and the Birmingham VA Medical Center. While on this rotation, fellows can expect to learn about acute intoxication and withdrawal from various substances of misuse. In addition, fellows will gain extensive experience in starting (or resuming) medications for opioid use disorder in the inpatient setting, including a variety of micro-induction techniques for withdrawal-free induction onto Buprenorphine. Fellows will be expected to master the art of inpatient to outpatient hand-offs and inter-professional communication among a variety of acute care teams.

VA Opioid Reassessment Clinic (ORC)

Given chronic pain is a major contributor to opioid misuse as well as a common comorbidity among patients with substance use disorders, the UAB Addiction Medicine Fellowship leadership believes that learning skills for chronic pain management are critical to a well-rounded addiction education.

The VA ORC is a pain management program certified by the Commission on Accreditation of Rehabilitation facilities. During their rotations in this clinic, fellows will participate in integrated visits with health psychology, addiction medicine and adult psychiatry to continually evaluate the safety and efficacy of long-term opioid therapy in the setting of chronic pain while promoting whole health approaches to chronic pain management. This clinic works in close collaboration with clinical pharmacists, physical and occupational therapists, whole health coaches and interventional anesthesia and psychiatry colleagues. You can anticipate extended visit lengths for complex patients.

Beacon Integrated Care Clinic

Beacon Integrated Healthcare is a UAB affiliated clinic offering basic internal medicine, psychiatry and addiction care to patients whom are under or uninsured and/or justice-involved. Fellows rotating in Beacon clinic will participate in weekly multi-professional team meetings (including providers, case managers, counselors and nursing) to align patient goals and needs with the care team activities. Among other things, fellows will learn to navigate outpatient withdrawal management as well as outpatient management of MOUD and MAUD as well as contingency management for stimulant use disorders. Fellows will be offered the opportunity to perfect their motivational interviewing skills through observation and feedback. 

Research

There are opportunities to collaborate on a variety of research projects with mentors from many different specialties. Topics span infectious diseases, stimulants, smoking cessation, criminal justice and implementation science.

Weekly Half-Day Didactics

Our current schedule allots a half-day per week to didactics.  Topics covered during didactics include but are not limited to:

• Medical and psychiatric comorbidities

• Identification and Treatment of toxidromes and withdrawal syndromes

• History of SUDs and SUD tx including political advances and challenges

• Special populations such as pregnant patients, justice-involved patients, adolescents, etc.

• Emphasis on evidence-base for harm reduction approaches

• Acute and chronic pain management in patients with histories of substance misuse.

• Non-pharmacologic approaches to pain and SUD care.

• Preparation for Addiction Medicine boards.

Want to preview a lecture? Check out this Grand Rounds on the history of opioids and addiction education in medicine: