Course Description
Join the Conversation: Real Cases, Real Challenges, Real Learning
Step into a dynamic 30 minutes of facilitated discussion where substance use disorder (SUD) cases take center stage—especially the ones where evidence is limited, cannot be uniformly applied, or may not exist. Collaborate with your peers to unpack complex scenarios, debate treatment paths, and problem-solve solutions.
AAPP members can register once for this complimentary series and attend as many of the webinars as you like! Once registered, you will have access to each session’s case presentation—posted one week prior to the webinar—and the session recordings, which will be available afterward. All materials can be found in the Course Materials section below. Registered attendees will receive an email reminder on the morning of the session, which begins at 11 AM Central. ACPE credit is not available for SUD Scoop.
Upcoming Presentations - All at 11 AM Central
February 4, 2026
Naltrexone for Management of ‘Kratom Use Disorder’ in a Patient with Concurrent Alcohol Use Disorder
Case Overview: A patient with alcohol use disorder, polysubstance use, and multiple psychiatric comorbidities presented to a residential treatment program where heavy daily kratom use (10–15 bottles per day) was incidentally discovered. Given his concurrent alcohol use disorder, seizure history, and complex psychiatric background, oral naltrexone 50 mg daily was selected to target both kratom and alcohol cravings while minimizing risks of sedation or dependence that may be present with alternatives. The patient subsequently transitioned to long-acting injectable naltrexone with good tolerability, maintained abstinence from both alcohol and kratom, and reported resolution of cravings, highlighting naltrexone as a promising yet off-label option for kratom use disorder in the context of co-occurring alcohol use disorder.
Moderator: Eileen Mintz, PharmD, BCPP
Case Presenters:
| Ronnie McCarty, PharmD | PGY1 Pharmacy Resident South Texas Veterans Health Care System San Antonio, TX Dr. McCarty received her PharmD degree from Texas Tech University Health Sciences Center in Dallas, Texas. During pharmacy school, she engaged in research focused on the cardiovascular risk of stimulants in ADHD, enhancing student empathy with educational initiatives, and was recognized with the graduation award for Outstanding Patient Advocate. She is currently completing her PGY1 Pharmacy Residency at the South Texas Veterans Health Care System (STVHCS), where she has worked closely on rotation with Dr. Williams at the Domiciliary Residential Rehabilitation Treatment Program. Her experiences there inspired ongoing research into emerging substance use concerns among veterans. Dr. McCarty will continue her training as a PGY2 Psychiatric Pharmacy Resident at STVHCS beginning in summer 2026. |
 | Raeschell Williams, PharmD, MPH, BCPS, BCPP Clinical Pharmacist Practitioner, Mental Health and Substance Use Disorders South Texas Veterans Health Care System San Antonio, TX Dr. Williams is a graduate of the University of Virginia where she earned her BA in Psychology. She then relocated to Kentucky where she earned her PharmD and MPH degrees from the University of Kentucky Colleges of Pharmacy and Public Health, respectively. She then moved to San Antonio, TX, where she completed her PGY1 Pharmacy Practice and PGY2 Psychiatric Pharmacy residencies at the South Texas Veterans Health Care System. She currently works as a clinical pharmacist practitioner (CPP) at the South Texas Veterans Health Care System at the Domiciliary Residential Rehabilitation Treatment Program (DRRTP), focusing on medication management for substance use disorders and mental health conditions. She is Board Certified in Pharmacotherapy and Psychiatric Pharmacy and has experience in substances of misuse through her work in the Clinical Pharmacy Practice Office (CPPO) Substance Use Disorder Subject Matter Expert Workgroup along with her current practice role. |
March 4, 2026
When the ‘Hat Man’ Appears: Understanding Delirium from Diphenhydramine Withdrawal
Case Overview: Misuse of diphenhydramine has become a growing concern due to its easy accessibility, low cost, and potential for psychoactive effects driven by its anticholinergic activity. While commonly used over-the-counter for allergies, insomnia, and motion sickness, recreational use continues to trend in adolescents and young adults. In patients with psychiatric conditions, symptoms of delirium and potential for drug-induced psychosis may complicate the clinical picture. This session will discuss a case of a patient presenting with acute psychosis and anticholinergic withdrawal effects after use of high dose diphenhydramine, complicated by underlying schizoaffective disorder. A better understanding of diphenhydramine misuse is needed to ensure appropriate clinical management in affected individuals.
Moderator: Raeschell Williams, PharmD, MPH, BCPS, BCPP
Case Presenters:
 | Amber R. Tran, PharmD | PGY2 Psychiatric Pharmacy Resident Dr. Amber R. Tran is a PGY2 Psychiatric Pharmacy Resident at the Laureate Psychiatric Clinic and Hospital in Tulsa, Oklahoma. Amber completed her Bachelors of Science in Psychology and Doctor of Pharmacy degrees at the University of Texas at Austin prior to completing her PGY1 at Saint Francis Hospital in Tulsa, Oklahoma. Her academic and professional interests focus on substance use disorder treatment and the advancement of care for treatment-resistant mental health conditions. Her dedication to pharmacy service and innovation is rooted in patient advocacy and a harm reduction approach, shaped by her clinical experiences across traditional healthcare and emerging behavioral health settings where the pharmacist can play a role in patient-centered care. |
 | Emily N. Gray, PharmD, BCPP Dr. Emily Gray is a Clinical Pharmacy Specialist at Laureate Psychiatric Clinic and Hospital in Tulsa, Oklahoma. She earned her Doctor of Pharmacy degree from the University of Oklahoma College of Pharmacy in 2011 and completed her Psychiatric Pharmacy Residency at the Captain James A. Lovell Federal Health Care Center in North Chicago in 2013. Dr. Gray has dedicated her career to inpatient psychiatry, advancing clinical care, education, and interdisciplinary practice. In 2019, she established and became the inaugural Program Director of Oklahoma's first PGY2 Psychiatric Pharmacy Residency at LPCH, where she continues to lead and mentor future specialists in the field. |
May 6, 2026
Navigating Buprenorphine Initiation Amid Evolving Policies
Case Overview: The case will be centered around an individual with opioid use disorder (OUD) who is interested in starting a medication for opioid use disorder (MOUD) with the goal to stop using non-prescribed opioids, but has some reservations given his past experiences with MOUD including experiencing precipitated withdrawal. This session will discuss the role of the psychiatric pharmacist in increasing low-barrier buprenorphine access and the impact of the recent executive order on "Ending Crime and Disorder on America's Streets" on different buprenorphine induction strategies.
Moderator: Aaron Salwan, PharmD, MPH, BCPP
Case Presenters:
 | Aya Ide, PharmD | PGY2 Psychiatric Pharmacy Resident Aya Ide is a PGY2 psychiatric pharmacy resident at Zuckerberg San Francisco General Hospital (ZSFG). She completed her PharmD at the University of California, San Francisco and her PGY1 pharmacy residency at ZSFG. She works with a patient population with a high prevalence of co-occurring mental health and substance use disorder diagnoses. During her PGY1 and PGY2 residency, she had the opportunity to rotate with psychiatric pharmacists in outreach-based positions to start and manage buprenorphine for individuals living in supportive housing units. |
 | Michelle Geier, PharmD, APh, BCPP, FAAPP Michelle Geier is a psychiatric clinical pharmacist for the San Francisco Department of Public Health. She is a Board Certified Psychiatric Pharmacist and has a special interest in substance use disorders. She manages a case load of patients in a County Mental Health clinic who are primarily dual diagnosis and experiencing homelessness upon entry to the clinic. She supports access to opioid use disorder treatment access throughout the San Francisco Department of Public Health (SFDPH). She is the Residency Program Director of the PGY2 in Psychiatric Pharmacy for the Zuckerberg San Francisco General Hospital. Michelle is the Past President of AAPP. |
June 3, 2026
Sublingual vs. Oral Buprenorphine: A Case That Challenges What We Thought We Knew
Case Overview: Sublingual administration has long been the standard route for buprenorphine treatment. However, growing awareness of dental complications associated with transmucosal formulations may be shifting patient preferences toward swallowing the medication instead, despite limited clinical guidance on this practice. This session will review buprenorphine pharmacokinetics, dental concerns affecting route choice, and implications for acute pain management. It will review a hospitalized patient with opioid use disorder who chose to swallow their buprenorphine rather than take it sublingually due to significant dental concerns. Unexpectedly, her plasma buprenorphine level suggested far greater systemic exposure than anticipated, with notable implications for her pain control during hospitalization. This case highlights emerging questions about real-world pharmacokinetics, receptor occupancy, and acute pain management when patients deviate from labeled administration routes. It also underscores the need for clinicians to anticipate and address patient-driven modifications in buprenorphine use as dental concerns gain prominence.
Moderator: Sarah T. Thomason, PharmD, BCPP, BCACP, FAAPP
Case Presenter:
 | Lauren Linder Wier, PharmD, BCPP Dr. Lauren Linder Wier is a Board Certified Psychiatric Pharmacist and Assistant Professor at the University of South Carolina College of Pharmacy. She earned her PharmD from Presbyterian College School of Pharmacy in 2015 and completed her PGY2 Psychiatric Pharmacy Residency at the Medical University of South Carolina in 2017. For the past seven years, she has served as the lead pharmacist for MUSC’s Project ECHO on Opioid Use Disorder, providing statewide case-based education and clinical consultation to prescribers and interdisciplinary teams. Her expertise spans the pharmacotherapy of substance use disorders, including opioid, alcohol, and stimulant use disorders, with a particular focus on buprenorphine, pain management in OUD, and harm reduction. Through her work with the SCORxE Academic Detailing Service, Dr. Wier has developed and delivered AMA-accredited education on SUD treatment, safer opioid prescribing, and perioperative pain management. She is now establishing a psychiatric pharmacy practice site within a psychiatric hospital setting to further expand access to evidence-based SUD care and continues to mentor trainees across disciplines in this area. |
Previous SUD Scoop Presentations:
August 6, 2025 | Naltrexone for Alcohol Use Disorder or Opioid Use Disorder
Case Overview: A patient with a long-standing history of opioid use disorder (OUD) and alcohol use disorder (AUD) presents a compelling case. Successfully managed on buprenorphine/naloxone for eight years, their OUD remained well-controlled. However, recurrent hospitalizations for complicated alcohol withdrawal syndrome underscore the challenges of managing co-occurring disorders. In an effort to address AUD between hospitalizations, the patient was prescribed oral naltrexone (50 mg daily). Unfortunately, after just two doses, they were readmitted with acute opioid withdrawal—highlighting the critical need for coordinated medication strategies and vigilant monitoring in dual-diagnosis patients.
Moderator: Aaron Salwan, PharmD, MPH, BCPP
Case Presenters:
 | Lindsey Hedgepeth Kennedy, PharmD Dr. Kennedy, a psychiatric pharmacist at UNC Health and Assistant Clinical Professor at UNC Chapel Hill School of Medicine, earned her PharmD from UNC School of Pharmacy in 2003 and completed a Psychiatric Pharmacy Residency at Audie L Murphy VA in San Antonio, Texas in 2007. Dr. Kennedy has worked in a variety of patient care settings, from OR pharmacy, inpatient neurology, inpatient psychiatry, to community pharmacy. In 2023, she joined the faculty of the Addiction Medicine Program at UNC and is the pharmacist subject matter expert for NC STAR Network. She continues to practice independent pharmacy with her father in Henderson, NC. |
November 5, 2025 | Quick Switch, Big Risks: Predicting Buprenorphine Outcomes
Case Overview: Rapid inductions of buprenorphine is an increasingly common strategy to reduce barriers to treatment and increase retention. Aligning with practice and research, package inserts for buprenorphine extended-release injections now include rapid initiation options. This session will focus on a patient largely stable on methadone that was rapidly switched to buprenorphine resulting in relapses and hospitalizations. It will briefly review the existing data on predictors of buprenorphine failure.
Moderator: Lindsey Hedgepeth Kennedy, PharmD
Case Presenters:
 | Archana Jhawar, PharmD, BCPP Dr. Jhawar is a Clinical Pharmacy Practitioner on the inpatient psychiatric unit at Jesse Brown VA, and a Clinical Assistant Professor at University of Illinois Chicago Retzky College of Pharmacy since 2012. Her practice includes providing care for patients with a variety of mental health conditions including substance use disorders such as alcohol use disorder, opioid use disorder, and cocaine use disorder. Her clinical research also includes published cases and ongoing research assessing safe and appropriate use of buprenorphine. |
 | Shannon Menard-Okoroike, PharmD Dr. Menard-Okoroike is a clinical pharmacist practitioner working on a multidisciplinary team treating patients with serious mental illness and substance use disorders in the residential setting at the Jesse Brown VA Medical Center. She graduated from the University of Illinois at Chicago Retzky College of Pharmacy and completed postgraduate training at Jesse Brown VA Medical Center. |
Webinar Series Dates (Add to Calendar)
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Disclosure
The SUD Scoop Series is an unaccredited member-driven initiative to facilitate dialogue among psychiatric pharmacy professionals. While presenters are encouraged to disclose any conflicts and to use the best evidence available, the presentations are not peer reviewed and attendees should accordingly verify details prior to making significant practice changes.
Continuing Education Credit and Disclosures
AAPP owns the copyright, is licensed or has received permissions for use of, or is otherwise permitted to use copyrighted materials within any CPE activity. Authors and speakers are required to obtain necessary copyright permissions for content in CPE activities. AAPP complies with copyright laws and regulations.