ACAAM Fellow Lightning Round Presentations-2026 ACAAM Fellow Lightning Round Presentations

Video Transcription

Video Summary

The transcript covers the 2026 ACAM Fellow Lightning Round, a rapid series of short addiction medicine presentations featuring cases, quality improvement projects, and conceptual frameworks.<br /><br />Highlights included:<br />- A case linking methadone to intermittent hypoglycemia, likely through endogenous hyperinsulinemia and suppression of counter-regulatory glucose responses.<br />- Research on prenatal alcohol exposure education showing many providers support early counseling, but time, training, and workflow barriers limit routine delivery.<br />- A framework for drug-related stigma, dividing stigma into person-related, substance-related, and disorder-related domains, and showing how each shapes policy, care access, and racial inequities.<br />- A case in which a teenager’s internet and dark web use contributed to extensive polysubstance misuse, highlighting the need to ask adolescents about online behavior.<br />- A quality improvement project showing low rates of FIB-4 liver fibrosis screening in patients with alcohol use disorder, despite guideline support.<br />- A case of severe gabapentin withdrawal successfully managed with a phenobarbital taper.<br />- A successful transition from high-dose methadone to buprenorphine after methadone-associated torsades.<br />- Emerging cases of xylazine/metatomidine withdrawal emphasizing that opioid withdrawal scales alone may be insufficient and alpha-2 agonist withdrawal must be treated directly.<br />- Additional cases included methadone-induced secondary adrenal insufficiency, atypical opioid withdrawal with dystonia, sexual and reproductive health disparities for people who use substances, street medicine buprenorphine access, pregnancy complicated by metatomidine withdrawal, and concurrent phenobut and alcohol withdrawal.<br /><br />Overall, the session showcased practical, real-world addiction medicine challenges and creative clinical responses.

Keywords

addiction medicine

methadone

hypoglycemia

prenatal alcohol exposure

drug-related stigma

polysubstance misuse

FIB-4 screening

gabapentin withdrawal

buprenorphine transition

xylazine withdrawal

metatomidine withdrawal

secondary adrenal insufficiency

street medicine