CliniCal appliCations of the prinCiples in

treatment of addiCtions and substanCe abuse

14th AnnuAl

ConferenCe

January 24 - 25, 2014

embassy suites

lexington, KentuCKy

2014 CAPtASA ConferenCe Weekend SChedule

thurSdAy, JAnuAry 238:00-9:00pm Open 12-Step MeetingfridAy, JAnuAry 247:00-8:15am Registration Continental Breakfast 8:15-8:30am Welcome and Announcements – Brian Fingerson, RPh8:30-10:20am Marijuana: Myths and Realities – J. Randle Adair, DO, PhD and Eric Martin, MAC, CADCIII, CPS 10:30-11:20am Reefer Madness?: A Frank Discussion About the Myths and Realities of Cannabis Use – J. Randle Adair, DO, PhD; Eric Martin, MAC, CADCIII; Quintin Thomas Chipley, MA, MD11:20-11:35am Additional Q & A11:35-1:00pm Lunch1:00-1:50pm Dual Presentation An Update on KASPER – David R. Hopkins KASPER and House Bill 1 – Van Ingram2:00-2:50pm How to Discuss Drug Issues With a Patient – Greg L. Jones, MD with special guest Robert E.2:50-3:10pm Break 3:10-4:00pm The Changing Face of the Addicted – Ken Thompson, MD, FASAM4:10-5:00pm Using the Drug Court Model to Provide Residential Treatment Services Within a Criminal Justice Facility – Roland Gray, MD; Samuel MacMaster, PhD; Judge Seth Norman, JD; and Jeri Thomas, MS5:00-5:15pm Q & A5:15-6:45pm Break 6:45-7:45pm Conference Banquet7:45-8:00pm Break8:00-9:00pm Banquet Speaker – Lynn M. (Ann Arbor, MI)9:10pm Open AA Meeting9:10pm Al-Anon MeetingSAturdAy, JAnuAry 256:30-7:30am Closed AA Meeting7:30am Continental Breakfast 8:15-9:05am Neonatal Abstinence Syndrome and Renewal House: Improving Outcomes Utilizing a Family-Centered Continuum of Care – Roland Gray, MD; Laura Berlind, CEO; and Mary Beth Heaney-Gárate, LCSW 9:15-10:05am Disclosure to Colleagues and Patients – Brian Fingerson, BS Pharm, RPh, FAPhA and Marie Ruf, LCSW, LMFT10:05-10:30am Break 10:30-11:20am Both Brains – Melissa Lee Warner, MD11:30am-12:20pm Professional Ethics: Avoiding Burnout – Chip Abernathy, LPC, MAC12:20-12:35pm Q & A

CAPtASA AnnuAl ConferenCe

tArget AudienCeAttendees will include physicians, nurses, pharmacists, dentists, chemical dependency counselors, psychologists, therapists, social workers, employee assistance professionals and other health care providers, as well as recovering professionals.

leArning obJeCtiveSAfter completing this course, the participant should be able to:• Define burnout for helping professionals• List at least four warning signs for professional burnout• Describe several examples of management strategies for burnout• Identify the role of the endocannabinoid system in normal body function• Separate marijuana’s pharmacology and toxicology• Examine the effects of marijuana on motor and cognitive performance• Show an increase in knowledge of family centered care as an effective means of preventing NAS• Show an increase in knowledge of the services that are part of an integrated family centered continuum of care• Understand the cognitive effects of both acute and chronic cannabis use• Understand the ethical implications and professional consequences of cannabis use• Understand and explain the potentiation of anxiety and psychosis by cannabis use• Discuss tolerance to drugs with patients competently• Be able to ask the right questions for Addiction Risk Assessment• Learn and understand ways patients can con and manipulate prescribers• Understand and explain the present effects of House Bill 1• Understand changes to KASPER• Understand and discuss current trends in Rx abuse• Understand and describe prescription drug abuse and diversion issues in Kentucky• Explain current statutory and regulatory requirements for KASPER• Discuss KASPER program information and controlled substance prescribing and usage trends• Show an increased knowledge of models of substance abuse treatment delivery• Demonstrate an increase in awareness of consistent sustained monitoring and consequences for relapse as an appropriate model for substance abuse treatment• Show an increased awareness of the ability of substance abuse treatment to be effective with individuals with long histories of substance dependence and criminal justice activity• Identify ethical dilemmas as relates to disclosure• Explore and understand possible consequences of disclosure• Learn what differences there may be among the various professions in disclosing to colleagues and patients• Learn appropriate resolutions for legal, moral, and ethical dilemmas encountered with disclosure• Demonstrate an increased understanding of the neuro-anatomy of Addictive Disorders• Understand and recommend adjustments to patient recovery activities to reduce relapse risk• Understand ways to mediate the phenomenon of craving• Describe three ways in which patients present that is evidence of the changing patient• Describe three barriers to long term recovery not seen in the past• Describe how the conventional treatment centers are adapting to the changing needs of patients and medication assisted treatment

fACulty

ChiP AbernAthy, lPC, CAC Chip Abernathy is the Program Coordinator of Recovering Professionals Services at Ridgeview Institute. He has worked in addiction and psychiatric treatment for over 25 years. He holds a Masters degree in psychology, is a Licensed Professional Counselor, a Certified Relapse Prevention Specialist through Gorski-CENAPS, a Certified Addiction Counselor, and a Certified Clinical Supervisor. He has provided training and consultation to government organizations, professional organizations, and in the private sector.

J. rAndle AdAir, do, PhdDr. Adair received his Bachelor’s Degree in Biology from

Georgetown University in 1969, his PhD in Physiology from Emory University in 1974. Subsequently, he did postdoctoral fellowships in Biomedical Engineering, at John Hopkins University, and Pharmacology, at Georgetown University Schools of Medicine.

His Chemical Dependency training occurred at the Chemical Dependency Training Institute at University of Miami in 1986. In 1987, he was asked to participate in developing the first school-based prevention, intervention and treatment program in the nation, called Project TRUST, which cared for over 300,000 students and their families enrolled in Miami-Dade Public Schools between 1987 and 1993.

While living in Miami, he also served as Clinical Director for the DUI Court System. Beginning in 1990, he was a professional supervisor for physicians in the Florida Professionals Recovery Network. He also performed that service for Alabama physicians while at University of South Alabama.

In 1993, Dr. Adair enrolled in medical school, receiving his medical degree in 1997, from Nova Southeastern University College of Osteopathic Medicine. He completed Residency training in Internal Medicine at University of South Alabama in 2000.

He became Board Certified in both Internal Medicine (2000) and Addiction Medicine (2002). While practicing both Internal Medicine and Addiction Medicine, as a Hospitalist, in Albuquerque, New Mexico, since 2003, he has also served as Chair of the Provider Aid Committee for the largest healthcare system in New Mexico.

Dr. Adair is currently Director of the Healthcare Professionals Program at Hazelden Springbrook in Newberg, Oregon.

Quinn t. ChiPley, MA, Md Dr. Chipley was born and raised in Memphis, Tennessee.

He has degrees from Rice University, Houston, Texas (B.A. - 1978), Southeastern Theological Seminary, Wake Forest, North Carolina (M. Div. - 1984), University of Louisville, Clinical Psychology (M.A. - 1992) and University of Louisville, M.D. (2000). He is currently a Ph.D. student in the Humanities program of the University of Louisville.

Dr. Chipley also serves as the Counseling Coordinator for the students enrolled in the medical, dental, nursing and graduate schools of the University of Louisville at the Health Sciences Center campus. He considers it the ideal position where he can practice psychology against the background of a medical education. Prior mental health profession work experiences have included Director of Staff Development and Training, Central State Hospital ICF/MR, Louisville, Kentucky, a brief stint in the psychiatry residency of the University of Louisville affiliated hospitals, six years of full-time private practice in psychology with Ragsdell and Associates, Louisville, Kentucky.

Dr. Chipley’s other work opportunities in life have been so varied as to include alumni fundraising for Rice University, three years of teaching in Kenya, East Africa, and bookkeeping for a small Louisville company. Volunteer passions have included active service and board membership for both Alley Cat Advocates and the Drepung Gomang Institute. He is a board member of the Kentucky Physicians Health Foundation, and he was pleased and honored in 2007 to be invited to help with the CAPTASA planning group, a service opportunity he still maintains and cherishes.

lAurA h. berlind, Ceo, reneWAl houSe

Laura joined Renewal House as the organization’s third CEO in January of 2011 . Renewal House is a nonprofit organization located in Nashville that provides comprehensive treatment and support services to women-led families in recovery from addiction.

Laura is a native of Nashville who brings with her almost ten years of nonprofit and government finance experience, including two years at Vanderbilt University and six years in the public finance department of Ambac Financial Group in New York, NY. Her clients at Ambac consisted of a wide range of nonprofit organizations, state and local governments, and government agencies. Laura holds a Master in Public Policy degree from Harvard University, where her work focused on the integral relationship between business and government in the public and nonprofit sectors. Her decision to join the Renewal House team was driven by her passion for the organization’s family-focused mission and its message of resilience and

fACulty

hope. Laura and her husband, Andreas, live in Nashville with their daughter and always enthusiastic mutt, Sully.

briAn fingerSon, rPh Brian Fingerson is President of Kentucky Professionals Recovery Network-KYPRN, a company formed to educate health care professionals about the disease of chemical dependency as well as administering the recovery programs for nine Kentucky Boards of Professional Licensure, and is involved in assisting chemically dependent professionals in their recovery process and supporting their return to active practice. He has worked in this field since 1986. Brian Fingerson is Adjunct Assistant Professor at the University of Kentucky Colleges of Pharmacy and Dentistry, Sullivan University College of Pharmacy, and several other Schools of Pharmacy, and is a faculty member at the University of Utah School on Alcoholism and Other Drug Dependencies. Mr. Fingerson received his BS Pharm from North Dakota State University College of Pharmacy in 1973. He has practiced Community Pharmacy as well as Institutional Pharmacy with the Kentucky Dept. of Corrections over his career. Mr. Fingerson has presented on addiction and recovery at a multitude of conferences and seminars at the local, state, and national levels.

rolAnd W. grAy, Md Roland W. Gray, M.D., has served as Medical Director of the

Tennessee Medical Foundation’s Physicians Health Program since January 2002. Since 1997, Dr. Gray has served as the volunteer Medical Director for the Davidson County Drug Court, helping drug offenders to reclaim their lives. He performs the same service with addicted mothers and their children for the Renewal House, a long term residential treatment facility for addicted women since 1996.

He is a fellow of the American Academy of Pediatrics as well as the American Society of Addiction Medicine. Dr. Gray has lectured nationally and internationally on addictions and prescription drug abuse. He serves as a Special Government Employee and Consultant to the FDA Subcommittee on Drugsand Medical Risk management.

MAry beth heAney-gArAte, lCSWChief CliniCAl offiCer - reneWAl houSe

Mary Beth Heaney-Gárate, LCSW, is the Chief Clinical Officer at Renewal House in Nashville, Tennessee. With over 24 years in the field, Ms. Heaney-Gárate has spent the last 10 years directing Family Residential Services at Renewal House where

mothers and their children recover from addiction together in a transitional housing/therapeutic community environment. With her recent promotion to Chief Clinical Officer, Ms. Heaney-Gárate now guides the prevention, early intervention, outpatient treatment, recovery support, housing, and wraparound services for the entire agency. In 2009, Ms. Heaney-Gárate led implementation of the agency’s first federally funded expansion, adding onsite mental health services earning Renewal House its co-occurring capable designation from the State of Tennessee Department of Mental Health and Substance Abuse Services. In 2012, she was the chief architect of a second proposal to the Children’s Bureau which is funding additional services and enhancing the region’s capacity to serve women, children, and families affected by addiction. In 2013, Ms. Heaney-Gárate was nationally recognized as a leader in the field when she was selected to participate in the Women’s Addiction Services Leadership Institute. She completed her training this summer and as a WASLI 2013 graduate looks forward to mentoring the next generation of leaders.

Jeri hollAdAy-thoMAS, MCJ Jeri Holladay-Thomas, MCJ, is the Executive Director of the Nashville Drug Court Support Foundation. The NDCSF, a 501c3 community-based non-profit organization, has providedassistance to the criminal justice system since 1996. The NDCSF seeks to raise awareness and combat the impact of substance use and related criminal activity on the community. The NDCSF has been instrumental in working with Judge Seth W. Norman and various state agencies related to the design, development and implementation of a second residential drugtreatment/criminal justice facility in the State of Tennessee, Morgan County Residential Recovery Court, which doubles the number of residential treatment beds in the state.

dAvid r. hoPkinS, kASPer ProgrAM Mgr. David Hopkins is Program Manager for the Kentucky All Schedule Prescription Electronic Reporting system also known as KASPER. KASPER is operated by the Office of Inspector General in the Kentucky Cabinet for Health and Family Services. In this position he is responsible for KASPER training; managing federal Prescription Drug Monitoring Program Grants that provide funding support for the program; and for analysis and research using KASPER data. Mr. Hopkins graduated from The Ohio State University with a Bachelor of Science in Computer and Information Science, and has over 30 years experience in Information Technology consulting

fACulty

and project management. Mr. Hopkins is a member of the National Association of Drug Diversion Investigators, National Association of State Controlled Substances Authorities, and is the Kentucky representative to the Alliance of States with Prescription Monitoring Programs.

vAn ingrAM

Van Ingram is the Executive Director for the Kentucky Office of Drug Control Policy. Van joined ODCP in November 2004, shortly after it was created with the mission of coordinating Kentucky's substance abuse efforts in enforcement, treatment and prevention/education.

Van served with the Maysville Kentucky Police Department for more than 23 years, the last six as Chief of Police. He is a former President of the Kentucky Association of Chiefs of Police, and was named "Kentucky Chief of the Year" in 2001. He is a former recipient of the Governor's Award for Outstanding Contribution to Law Enforcement, as well as the Melvin Shein Award for distinguished service to Kentucky law enforcement.

Van is a certified law enforcement instructor and has trained officers across the state on a variety of topics, including community oriented policing, interview and interrogation, and case management. He is a frequent speaker on a variety of substance abuse issues and has recently presented to numerous groups and national organizations on the topic of prescription drug abuse.

greg JoneS, Md Dr. Jones has a BA in Chemistry from Huntingdon College in Montgomery, Alabama. His medical degree is from the Medical College of Georgia in Augusta, GA.

His Family Practice training was in Anniston, Alabama, where he also served on the faculty of the Residency until 1992. During his years in Anniston, he was President of the Alabama Academy of Family Physicians and the Director of the Residency program.

He moved to Paducah, Kentucky, working for Lourdes Hospital and then to Danville, Kentucky, working for Ephraim McDowell in Family Medicine.

After completing an Addiction Medicine Fellowship at Willingway Hospital in Statesboro, Georgia, he returned to Kentucky to start the first Medical Detox unit in eastern Kentucky at Pikeville Methodist Hospital, serving as Medical Director.

From there he became the Director of Medical Services at Eastern State Hospital in Lexington. His practice included full in-patient Family Medicine and Addiction Medicine. While

in Lexington he was also on the Board of Directors of the Kentucky Physicians Health Foundation and the Shepherd's House in Lexington.

Dr. Jones returned to Willingway Hospital in 2010 as a Staff Physician and remained there until late 2011 . He is currently the Medical Director of the Kentucky Physicians Health Foundation.

He is Board Certified in Family Medicine by ABFM and in Addiction Medicine by ABAM.

SAMuel MACMASter, Phd Samuel MacMaster, Ph.D., is a tenured Associate Professor at the College of Social Work at the University of Tennessee, where he teaches courses in addictions and research. He serves as an evaluation consultant to the Nashville Drug Court Support Foundation. He has authored three books and over sixty peer-reviewed articles on addiction.

eriC MArtin, MAC, CAdC iii, CPS Eric Martin is the Past President & Director Emeritus of the Addiction Counselor Certification Board of Oregon. Eric is an Adjunct Faculty member with the University of Oregon SAPP program and a contract instructor with Oregon's Child Welfare Division. Eric is a state & nationally certified addictions counselor with 26 years of clinical experience in Inpatient Psychiatric Hospitalization, Residential and Outpatient Addictions Treatment and ATOD Prevention. Eric is an international presenter and treatment advocate. Eric has served on several Governor's advisory boards, the Governor's Council on Substance Abuse Programs and the Governor's Advisory Board on Drugs & Violent Crime. Eric has also produced a number of videos, including "Reunited", a video designed for methamphetamine addicted mothers entering the child welfare system. Eric has been honored with numerous awards in light of his 26 years of service in Addiction Treatment & Prevention. Most notably, he is the recipient of the Governor's Council Award of Excellence, presented by Oregon Governor John Kitzhaber, and he is the recipient of the National Association of Alcohol and Drug Abuse Counselors-National, William F. Callahan Award for Sustained and Meritorious Service at the national level to the profession of addiction counseling, presented in Washington D.C. in 2010. Eric currently serves in a leadership capacity to numerous community boards including: New Columbia CREW, special consultant to the African American Addiction Recovery & Counseling Association, Voices of Problem Gambling Recovery, and as the Legislative Liaison for the Addiction Counselor Certification Board of Oregon.

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Judge Seth norMAn

Judge Seth Norman is currently the Judge of Division IV Criminal Court. Elected to the bench in 1990, Judge Norman was reelected without opposition in 1998 and again in 2006. He is a Korean War Veteran, having served 5 years in the U.S. Air Force.

Judge Norman received his J.D. Degree from the Nashville School of Law in 1962. He practiced law in Nashville for 28 years in the law office of Jack Norman, Sr.

Judge Norman founded the Davidson County Drug Court, along-term residential treatment program for non-violent felony offenders, over which he presides alongside his responsibilities as a criminal court judge. The program is the only court-operated residential drug court in the United States.

As of 2009, Norman serves on the Governor's Criminal Justice Committee and the Safe & Drug Free Schools and Communities Advisory Committee for the United States Department of Education. He has written many articles on drug courts and his drug court has been cited in many national publications.

MArie S. ruf, lCSW, lMft Marie Ruf is a Licensed Clinical Therapist in the state of Kentucky. In addition to seeing clients in her private practice in Louisville, KY, Ms. Ruf is also an Adjunct Faculty Member of the American Association of Marriage and Family Therapy and an AAMFT Approved Clinical Supervisor. Ms. Ruf is also an approved Clinical Supervisor for Certified Social Workers in the state of Kentucky. She is a member of the American Association of Pastoral Counselors and serves on the Board of the Kentucky Collaborative Family Network. She received her Master of Science in Social Work degree from the University of Louisville Kent School of Social Work in 1988 and her Master of Arts in Marriage and Family Therapy degree from the Louisville Presbyterian Theological Seminary in 1999.

kenneth W. thoMPSon, Md, fASAM Dr. Thompson has worked in the field of addiction medicine for over 25 years and is currently the Medical Director of Caron Treatment Centers. He has been involved in the care and follow-up of professionals including physicians and attorneys for much of his career. Dr. Thompson was originally certified by the American Society of Addiction Medicine in 1990 and is a Past President of the Florida Society of Addiction Medicine. He is a Fellow of the American Society of Addiction Medicine and is Board Certified in both Addiction Medicine and Internal Medicine. Dr. Thompson was instrumental in the development

and opening of the Florida Recovery Center, the University of Florida College of Medicine's first addiction treatment facility that specialized in the treatment of impaired professionals. He has been involved in the training of Fellows in Addiction Medicine since 1998 and is a Clinical Associate Professor in the Department of Psychiatry at Pennsylvania State University. Dr. Thompson has a special interest in treatment of healthcare professionals, chronic pain and addiction, spirituality, and the therapeutic and diagnostic value of step work.

MeliSSA lee WArner, Md Dr. Melissa Lee Warner is Chief Medical Officer for Lakeview Health. A graduate of Eastern Virginia Medical School, she completed her Family Practice residency at Case Western Reserve University in Cleveland, Ohio and a fellowship in Addiction Medicine at Willingway Hospital in Statesboro, Georgia; with a concurrent faculty development fellowship in Family Medicine at UNC Chapel Hill. Dr. Warner is known for her cutting edge lectures on the "The Big Book" and has a special interest in non-intoxicating approaches to pain management for recovering patients, as well as nicotine sobriety. Passionate about health, wellness and spiritual development, Dr. Warner is a Diplomate of the American Board of Family Medicine and the American Board of Addiction Medicine.

ACCreditAtion StAteMentS

for CAPtASA ConferenCe 2014

Kentucky Medical Association • This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Kentucky Medical Association and CAPTASA. The Kentucky Medical Association is accredited by the ACCME to provide continuing medical education for physicians. • The Kentucky Medical Association designates this continuing medical education activity for a maximum of 8.25 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.Kentucky Board of Dentistry • This conference has been approved by the Kentucky Board of Dentistry for 11 hours of Category B continuing education credits. This offering is approved by the Commonwealth of Kentucky Board of Dentistry Provider Number 3409. • Credit Designation- Number of CE Points: 11 Category B. • Approved for KASPER requirement CE.Kentucky Board of Medical Licensure • The Kentucky Board of Medical Licensure has approved 4.5 total CME hours for attendance at all sessions on Friday, January 24th, as meeting the mandated requirements for House Bill 1. There will be no HB1 hours awarded for Saturday, January 25th, attendance.Kentucky Board of Nursing • KBN approved nursing continuing education contact hours will be awarded for each date of attendance at this conference. (7.0 contact hours – 1/24/14 and 4.0 contact hours – 1/25/14). The KBN approval of an individual nursing continuing education provider does not constitute endorsement of the offering content.Kentucky Board of Pharmacy • Seven hours on Friday and four hours on Saturday for a total of 11 hours of continuing education have been applied for through the Kentucky Board of Pharmacy. Note: this approval is for CE hours in Kentucky only - it has not been submitted for ACPE approval.Kentucky Board of Examiners of Psychology • CAPTASA is authorized by the Kentucky Board of Examiners of Psychology to provide up to 8.8 CE credits for professionals licensed by the Board and not for students. Kentucky Board of Social Work • This conference has been planned and implemented in accordance with the requirements of the Kentucky Board of Social Work. A maximum of 11 CEU's have been approved for attendance at the entire conference through the Kentucky Board of Social Work.Licensed Marriage and Family Therapists • This conference is planned and implemented in accordance with the requirements of the Kentucky State Board of Licensed Marriage and Family Therapists. A maximum of 11 CEU’s have been approved for attendance at the entire conference through the Kentucky State Board of Licensed Marriage and Family Therapists.Certified Alcohol and Drug Counselors • Contact hours will be awarded.Licensed Professional Counselors • Contact hours will be awarded.Physical Therapy • 11 contact hours (Category 1) upon course completion - application for CE credit has been submitted.Kentucky Employee Assistant Professionals Association • 11 contact hours have been submitted for approval by the Employee Assistance Certification Commission.

hotel inforMAtion

ConferenCe Site & ACCoMModAtionSAll conference sessions will be held at the Embassy Suites in Lexington. A special conference rate has been arranged for overnight accommodations at the Embassy Suites. Please contact the hotel directly to make your hotel reservations prior to the cut-off date. Be sure to mention the “Clinical Applications of Principles in Treatment of Addictions and Substance Abuse” (CAPTASA) Conference to ensure that you receive the conference rate.

Room Rates - $125 single or doubleCut-off Date - January 10, 2014

To make hotel reservations attendees may either call the hotel directly at the number listed below or by online registration via the link provided.

Your web page address is: http://embassysuites.hilton.com/en/es/qroups/personalized/L/LEXESES-CAP-20140122/index.jhtml

Group Name: CAPTASA 2014 Group Code: CAP Check-in: 22-JAN-2014 Check-out: 25-JAN-2014 Hotel Name: Embassy Suites Lexington Hotel Address: 1801 Newtown Pike Lexington, Kentucky 40511 Phone Number: 859-455-5000

For Additional InformationSandy Patrick, Office ManagerKentucky Physicians Health Foundation9000 Wessex Place, Suite 305, Louisville, KY 40222Phone: (502) 425-7761 FAX: (502) 425-6871Email: sandyp@kyrecovery.org Website: www.captasa.org

First _____________________________________________ MI ______ Last _____________________________________

Profession/Credentials ________________________________________________________________________________

Name for Nametag ___________________________________________________________________________________

Institution/Organization ________________________________________________________________________________

Mailing Address ______________________________________________________________________________________

City ________________________________________________ State _____ Zip __________________________________

Phone ______________________________________________ Fax ___________________________________________

Email ______________________________________________________________________________________________

Please list any special needs you may have: _______________________________________________________________

___________________________________________________________________________________________________PAYMENT INFORMATION• Personal or institutional check made payable to: CAPTASA Conference• Credit cards NOT accepted• Cost of Banquet INCLUDED in registration fee.• No one day or group rate

NO REFUNDS AFTER JANUARY 10, 2014

$150 Early Registration Fee (postmarked by Jan. 10, 2014) $ _________$175 Regular Registration Fee (postmarked after Jan. 10, 2014) $ _________

I plan to attend the banquet Friday night _______Yes _______No(cost of the banquet ticket is included in the registration fee)MUST CHECK IF YOU PLAN TO ATTEND

Guest Banquet Ticket(s): # Tickets ______ x $30 per ticket = $ _________

Handouts @ $35 per set: # Sets _______ x $35 per set = $ _________MUST PRE-ORDER - NOT AVAILABLE FOR PURCHASE AT CONFERENCE

Total Amount Enclosed: $ _________

Mail to: CAPTASA Conference c/o Kentucky Physicians Health Foundation 9000 Wessex Place, Suite 305 Louisville, KY 40222

regiStrAtion forM

CAPTASA ConferenceJanuary 24-25, 2014 Embassy Suites- Lexington, KY

Registration Form

Addiction Recovery CareAlcoholics AnonymousAl-AnonAlkermes, Inc.Baptist Health – CorbinBaptist Health Counseling – LouisvilleBradford Health ServicesThe Brook HospitalsBurning TreeConfirmatrix LaboratoryCornerstone of RecoveryCumberland HeightsEnglish Mountain RecoveryThe Farley Center at Williamsburg PlaceFirstLabFlorida Recovery Center / ShandsThe Genesis ShopHazelden FoundationThe Healing Place

2014 CAPtASA ConferenCe exhibitorS

At tiMe of Printing

Kentucky Physicians Health FoundationKentucky Professionals Recovery NetworkKentucky Dental Association MedicineK.A.R.E. for Nurses Program, Kentucky Board of NursingKentucky Association of Addiction ProfessionalsKentucky Chapter of Employee Assistance Professionals AssociationKentucky Psychological AssociationKentucky Board of Social Workers

SuPPorting & PlAnning orgAnizAtionS

Kentucky Medical AssociationKentucky Board of PharmacyKentucky Society of Health Systems Pharmacists

SPeCiAl SuPPort froM

Kentucky Cabinet for Health and Family ServicesLakeview HealthLincoln Trail Behavioral Health SystemLindner Center of HopeMetro Atlanta Recovery Residences (MARR)Millennium LaboratoriesThe Morton CenterNew VisionThe Pavillon Pine Grove Behavioral HealthQuesthouseRecovery WorksThe Ridge Behavioral HealthRidgeview InstituteSanté Center for HealingSeven Counties Services, Inc.Sheperd HillSt. Christopher’s Addiction Wellness CenterWillingway Hospital

CAPtASAiS StAying green!

What this means for participants: We will no longer be making copies of presentation handouts for each conference attendee. All presentations will be available at our website www.captasa.org one week prior to the con-ference so that you may download and print your own copies. This will save greatly on pa-per, which means fewer trees will be killed! It will also allow us to avoid an increase in registration fees. For those participants who prefer handouts be provided for them there will be an additional charge of $35 per set. We hope you support us in this endeavor to do our little part to save the environment. We look forward to seeing you in January 2014!

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CAPTASA Conferencec/o Kentucky Physicians Health Foundation9000 Wessex Place, Suite 305Louisville, KY 40222

Presort StandardU.S. Postage

PAIDLouisville, KY

Permit No. 1823