Keynote

Philomena Kebec, J.D.

Chief Judge

Sokaogon Chippewa Tribal Court

Philomena Kebec, J.D., an enrolled member of the Bad River Band of Lake Superior Chippewa currently serves as the Chief Judge of the Sokaogon Chippewa Community Tribal Court and an attorney at Osterby Law Office, LLC, where she represents public-defender eligible litigants in state criminal cases and civil clients in tribal courts. Philomena teaches Federal Indian Law at the University of Minnesota Duluth Masters in Tribal Government and Administration Program and is a DrPH student and Bloomberg American Health Initiative Fellow at Johns Hopkins School of Public Health. Along with Aurora Conley, she founded Gwayakobimaadiziwin Bad River Harm Reduction in 2015. 

Breakout Session 1.1

Buprenorphine Beyond the Clinic: Expanding Addiction Care Through Street Medicine

Elizabeth Lownik, MD, MPH, FAAFP; Sarah Brown; Michael Fitzpatrick; Emily Reimer

Opioid-related deaths are overrepresented amongst communities without stable housing; however, access to lifesaving buprenorphine treatment is often limited in this population. Integrating buprenorphine treatment in non-traditional settings has been identified as a recommendation to reduce barriers to buprenorphine treatment amongst people experiencing homelessness. To improve access, the St. Clare Health Mission in partnership with the Gundersen Family Medicine Department in La Crosse, Wi implemented an addiction medicine component to their weekly Rotary Mobil Clinic street medicine outreach. Within the first 12 months of operation, the team was able to obtain and distribute >400 doses of naloxone, offer point of care fentanyl testing, and support 45 addiction-related street medicine encounters and 15 buprenorphine initiations with successful follow up. Additional support is facilitated for patients who are interested and able to access it through local community resources, with the goal of transitioning people to more stable housing and care. 

In this presentation, we will describe the development of this low-barrier buprenorphine outreach program, including the lessons we have learned, challenges with implementation, and early program outcomes. We will then take time to facilitate a group discussion on opportunities to adapt and expand similar outreach-based addiction care models across diverse Wisconsin communities.

Breakout Session 1.2

Integrating Peer Recovery into Outpatient Care: Lessons from Implementation, Lived Experience, and Collaboration

Christina Mundschau MS, SAC-IT, CRPS; Page Feller

This interactive session explores real-world learnings from the implementation of peer recovery support services within Rogers Behavioral Health’s outpatient grant-funded programs, including WORTH IT and Women’s services. Grounded in lived experience, evidence-based practices, and resilience-oriented care, presenters will share practical insights on how peer support roles can be effectively integrated into multidisciplinary treatment teams while maintaining their unique value.

Rather than focusing solely on theory, this session prioritizes lessons learned—including wins, challenges, boundary considerations, and evolving role clarity—drawn directly from program implementation. Participants will explore how peer recovery specialists differ from, overlap with, and complement roles such as therapists and case managers; how peers navigate the intersection of personal and professional experience; and how peer support enhances engagement, retention, and recovery outcomes—particularly for underserved and marginalized populations.

The session will include brief educational framing, program data highlights, case examples, and facilitated discussion to encourage shared learning and collaboration across systems.

Breakout Session 2.1

Responding to Risk of Arrest and Incarceration in Perinatal Substance Use Disorder

Elise Wessol, DO; Ruchi Fitzgerald, MD, FAAFP, FASAM; Cayse Powell, MD, MPH; Sammi Shay, LCSW, PMH-C; Lexi Gonzalez

This capacity-building workshop equips clinicians with practical skills to

meet the moment of rising rates of criminal legal system involvement

among pregnant and postpartum people with substance use disorders

(SUD), a trend associated with disrupted care, worsening maternal and

neonatal outcomes, and increased barriers to evidence-based treatment.

Importantly, legal system involvement is often driven less by substance

use severity itself and more by social determinants of health, systemic

bias, mandated reporting practices, and lack of access to supportive

services. Evidence consistently demonstrates that punitive approaches are

associated with worse maternal and neonatal outcomes, decreased

prenatal care engagement, and increased overdose risk.

Breakout Session 2.2

Ketamine the Chameleon: Exploring Applications and Uses Across Clinical Settings

Chantelle Thomas, PhD

Medication diversion—the use of prescribed medication by someone other than the intended patient—is a recognized challenge in Medication for Opioid Use Disorder (MOUD) programs. It cannot be completely prevented and is difficult to measure, yet its consequences can be substantial: increased overdose risk among opioid-naïve individuals, stigma around MOUD as a legitimate treatment, and heightened scrutiny from law enforcement and regulators, including the DEA.

Despite these concerns, critical questions remain: How dangerous is diversion? How often does it occur? This session will review the available literature to address both.

We will then outline the components of a comprehensive Diversion Control Plan (DCP), providing a framework for understanding how programs can systematically approach diversion prevention while balancing patient care.

A central focus is medication call backs (MCBs)—procedures requiring patients to present remaining medication within a specified timeframe. We examine the challenges, benefits, and harms of MCBs, drawing on data from a system of over 60 Opioid Treatment Programs with more than 35,000 MCBs from 2019–2025, including how frequently MCBs are conducted, the proportion of patients who pass or fail, and the impact of failed MCBs on patient retention.

Breakout Session 3.1

A Family Affair: Practical Strategies for Treating Both Parents and Adolescents

Molly Perri, MD; Danielle Rodriguez; Nicole Gastala; Arushi Joshi

Substance use affects entire families, yet parents and adolescents are often treated in isolation. Through the evolving case of a 17-year-old with opioid use disorder and his mother, this interactive workshop will examine substance use from both the parent and child perspectives. Participants will explore how stigma, trauma, family separation, housing instability, and barriers to care shape treatment engagement and recovery. The session will provide practical guidance on trauma-informed and harm-reduction care, thoughtful interpretation of urine drug screening, comprehensive adolescent assessment, developmentally appropriate motivational interviewing, and legal considerations related to minor consent and confidentiality. Ultimately, the workshop will challenge attendees to imagine a more integrated, family-centered model of substance use care.

Breakout Session 3.2

Who, What, Where, When, Why, and How: Leveraging Overdose Data to Action

Caitlin Murphy, PhD

An overview of current overdose trends and emerging data in Wisconsin will be provided, including key patterns and recent developments shaping prevention and response efforts. Participants will then engage in a practical, step-by-step guide focused on turning data into action and will learn how to use information strategically to inform programs, practice, partnerships, policies, and community response.

Breakout Session 4.1

Solution-Focused Brief Therapy for Perinatal Substance Use: Clinical Applications Workshop

Matthew Stohs, MD; Sarah Trost, PhD; McKenzie Paige, MD, MS

Discover valuable resources from SFBT to equip patients with substances use disorders in a peripartum setting.

Breakout Session 4.2

Safer Smoking: Emerging Risks, Harm Reduction Strategies, and Clinical Applications in Wisconsin and Beyond

Elizabeth Salisbury-Afshar, MD, MPH; Jake Niesen