Rotation Descriptions

Central City Concern Hooper Detoxification and Stabilization Center

Through the inpatient chemical dependency rotation at Hooper Detox (Central City Concern) the addiction medicine fellow will acquire and demonstrate competence in the medical care of alcohol, opioid, and benzodiazepine dependent patients treated with medically-managed withdrawal. The fellow shall be able to render patient care that is compassionate, appropriate, and effective for the prevention and treatment of problems related to substance use disorders.

Visit Hooper's website here.

IMPACT Consult Service

Fellows will assess a diverse group of hospitalized patients to confirm substance use disorder diagnoses and development and communicate treatment recommendations to the referring service. They will work with an interdisciplinary team including nurses, social workers, counselors, peer recovery specialists, the patient, and their family members to tailor treatment recommendations and link patients to appropriate community-based services in accordance with appropriate ASAM criteria. They will participate in case conferences with addiction medicine faculty.

Harm Reduction and Bridges to Care (HRBR)

HRBR partners with the OHSU emergency department and Multnomah County corrections to provide low-barrier buprenorphine, Peer support, and connection to care to at-risk individuals on a walk-in basis. HRBR is an evening clinic. General fellow shifts are from 12-5pm with potential to extend further into the evening.

Kaiser

This rotation is designed for fellows to obtain experience in both the residential and outpatient levels of care for substance use disorders. Time is spent in both residential/inpatient and outpatient settings with emphasis on diagnosis and management of withdrawal, management of co-existing medical and psychiatric conditions in these patients as well as observing individual and group counseling therapy when available.

Recovery Works NW

Fellows will have a patient panel comprised of opioid dependent, alcohol dependent, polysubstance dependent patients, and patients with substance use disorders and co-occurring mental health and medical issues.  Fellows will get an opportunity to use Medication Assisted Treatment (MAT) with buprenorphine or Extended-Release Naltrexone in the setting of 12 step facilitation as a treatment modality for appropriate opioid dependent patients. The fellows may sit in or participate in a variety groups offered by both primary addiction counselors, all master’s level trained, and psychologists. Fellows may also spend part of a week participating in Family Week where family members of patients come in to learn about addiction, support one another, learn about self-care and learn how to not enable their family members to continue to use.

Visit their website here.

VA

Fellows will perform comprehensive psychiatric assessments on patients in the Portland VA Medical Center’s Substance Abuse Treatment Program (SATP) & Opioid Treatment Program (OTP) in Vancouver, WA.  Trainees formulate bio-psycho-social treatment plans in collaboration with colleagues in these clinics. This may include psychotropic medication management, pharmacotherapy for substance use disorders, ambulatory withdrawal management, and delivery of evidence-based psychotherapy for substance use & psychiatric disorders. Fellows will also work with SATP’s health psychology team to conduct comprehensive psychiatric/psychological assessments & make treatment recommendations for persons being evaluated for liver transplant.

Additionally, fellows will perform psychiatric consultation within the Center for Integrative Pain Care (CIPC) on the Portland VA campus.  Duties include chart review, diagnostic interview, discussion, and collaboration with multidisciplinary team, and treatment planning.  Consultation for patients on high dose opioids and planning taper and/or medication-assisted treatment with Buprenorphine will be included when indicated.  Fellows will learn about the Whole Health approach to chronic pain and about biopsychosocial approach to managing chronic pain, including interventional pain procedures, pain management skills, educational and psychological interventions, e.g., mindfulness-based educational group for chronic pain, acceptance commitment therapy (ACT) for pain.

Read more about the VA here.

Allied Health Centers of Portland

This rotation is designed for fellows to further their skills in diagnosis and management of opioid use disorders in the OTP setting.  Emphasis is placed on managing methadone, buprenorphine, and naltrexone medications. Particular care and attention is devoted to prioritizing medication treatment for pregnant women with opioid use disorders. Fellows gain experience managing co-occurring substance use disorders, especially involving stimulants, alcohol, and sedative-hypnotics. 

Visit their website here.

Rural Electives

Jackson County Mental Health (Medford, OR)

Fellows will work with Dr. John Mahan, Psychiatric Medical Director. Dr. Mahan’s practice includes dual diagnosis treatment including assertive community treatment (with a multidisciplinary team including therapists, CADC, employment specialist, housing specialist, case managers, and skills trainers), outpatient psychiatry, and low-threshold buprenorphine for utilizers of syringe exchange in Southern Oregon. Dr. Mahan also facilitates the Southern Oregon Addiction Medicine Journal Club, which fellows would attend. Learn more about Jackson County Mental Health.

The Oasis Center of the Rogue Valley (Medford, OR)

The Oasis Center provides integrative health care and social support services, including childcare and parenting classes for pregnant women, adolescents, and families in recovery and experiencing difficult life challenges. Medical director Kerri Hecox is ABPM Addiction Medicine boarded and an active member of the OHSU ECHO telehealth clinics. Fellows with work directly with Dr. Hecox to provide interdisciplinary care for pregnant women with substance use disorder, their children, and families. Learn more about The Oasis Center.
 

Urban Electives

Boston Children's Hospital (BCH)

This rotation addresses the current curriculum gap of limited options for training in pediatric or adolescent addiction medicine. BCH is the nation’s premier pediatric and adolescent addiction training program and serves a predominantly low-income, inner city population. Fellows work alongside pediatric addiction medicine fellows for a 1-week intensive training experience under the supervision of BHC program director, Dr. Sharon Levy and her faculty. Learn more about the BCH program.