Navigation: Resource Topics | Newly Added
Navigation: Resource Topics | Newly Added
Click a resource topic to jump to that section on this page and see resources categorized by further sub-topics.
= resources/tools shared by ATSH teams
We’ve got tons of resources to help you and your team with your MAT program. Check out what resources have been newly added to the resource hub.
| Topic | Resource |
| COVID-19! (subsection: ATSH Team Resources) | COVID-19 Patient Flyer – shared by Santa Cruz County Health Services Agency |
| COVID-19! (subsection: ATSH Team Resources) | COVID-19 Script for Outreach – shared by La Clinica de La Raza |
| COVID-19! (subsection: Federal Guidance) | DEA guidance on allowing prescriptions of buprenorphine to new and existing patients with OUD via telephone. |
| Topic | Resource |
| Prescribing Medication (subsection: Buprenorphine, Naltrexone, and Naloxone 101) | ASAM releases the National Practice Guideline For the Treatment of Opioid Use Disorder 2020 Focused Update |
| Specialty Populations and Clinical Situations (subsection: OUD and Pregnancy) | “Methadone and buprenorphine pharmacotherapy of opioid use disorder in pregnancy” is featured in UpToDate, a clinical decision support resource. It discusses the administration and outcomes of both medications for pharmacotherapy of OUD during pregnancy and postpartum (including suggestions for initial and maintenance dosing), side effects, and short-term and long-term outcomes. Download the article here |
Addiction Treatment Starts Here Team Resources
| Marin City shared their MAT COVID-19 protocol which includes clinic rules, phases of care, and a one-page guide for patients. |
| Santa Cruz shared their MAT COVID-19 protocol which includes a patient flyer and MAT weekly follow-up workflow. |
| La Clinica de La Raza shared their COVID-19 script for outreach. |
| Informed Consent for Telemedicine from KCS |
CCI COVID-19 Webinar Series Materials
| March 25: Slides, webinar recording, and 6 key takeaways |
| April 1: Slides and webinar recording |
| April 8: Slides and webinar recording |
| April 15: Slides and webinar recording |
California Guidance
| DHCS shares updated Frequently Asked Questions about MAT and Telehealth, released April 7, 2020. |
| DHCS COVID-19 Response landing page |
| DHCS guidance around Medi-Cal Payment for Telehealth and Virtual/Telephonic Communications. Released March 24, 2020 |
| CA Office of Health Information Integrity (CalOHII) Disaster Response and Information Sharing during Emergencies, including specific references to SUD and MAT data sharing. (March 18, 2020) |
| DHCS guidance around Medi-Cal Payment for Telehealh and Virtual/Telephonic Communications. Released March 18, 2020. |
| DHCS guidance for behavioral health programs on providing behavioral health services via telephone and telehealth, adapting oversight requirements, and access to prescription medications. Released March 14, 2020. |
| DHCS FAQ on Behavioral Health Services in light of COVID-19, updated on March 13, 2020. |
| California’s “One-Stop Coronavirus Website” (not MAT specific) |
Federal Guidance
| DEA guidance on allowing prescriptions of buprenorphine to new and existing patients with OUD via telephone. |
| SAMHSA FAQ on prescribing buprenorphine (see question 4, which indicates that new patients can be prescribed buprenorphine via telephone outside an OTP). FAQ released on March 19, 2020. |
| SAMSHA guidance on the application of 42 CFR Part 2 in a public health emergency (released March 19, 2020). |
| SAMSHA MAT resource page including various guidance documents for OTPs. |
| HHS Health Information Privacy Page, including a notice allowing for enforcement discretion for remote communications (e.g., allowing use of non-HIPAA compliant devices for telehealth). |
| DEA COVID-19 Information Page |
| Changes to EMTALA regulations, in light of the public health emergency (updated March 15, 2020). |
| In a March 17, 2020 news release, CMS indicates that Medicare can pay for office, hospital and other visits furnished via telehealth starting March 6, 2020 and for the duration of the COVID-19 public health emergency. |
Remote Care Best Practices
| The California Telehealth Resource Center has created a COVID-19 page, offering resources such as a Telehealth 101 webinar and slides, a toolkit, sample forms and guidelines, and more. |
| The California Telehealth Resource Center has developed a telehealth needs assessment form. The assessment will facilitate the ability of health centers to understand various logistics and develop a telehealth plan that fits specific provider, specialty, patient and payor needs. |
| The California Telehealth Resource Center provides sample forms and guidelines for implementing a telehealth program. It also recently updated its Telehealth Reimbursement Guide, which includes telehealth reimbursement policies for Medicare, Medi-Cal Fee-For-Service, and Managed Care. |
| Elizabeth Morrison Consulting developed Empathic Communication on the Phone, a guide that consists of tips and tricks for engaging in high quality, connected conversations over the phone. |
Resources from Other Organizations
California Bridge Program
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| Yale Program in Addiction Medicine: Guidance for People Who Use Substances on COVID-19, focusing on harm reduction strategies. |
| Harm Reduction Coalition’s COVID-19 Virtual Office Hours (March 18, 2020). |
| Harm Reduction Coalition: Syringe Services and Harm Reduction During COVID-19 (updated March 11, 2020) and Safer Drug Use During the COVID-19 Outbreak (updated March 11, 2020). |
Team Care and Self-Care
| The California Surgeon General’s Playbook: Stress Relief During COVID-19 offers stress management information, specific “stress busting” strategies that can be used at home, and a self-care template for adults. |
| The California Surgeon General’s Playbook: Stress Relief for Caregivers and Kids During COVID-19 offers information on stress management for kids, specific “stress busting” strategies, and a self-care template for kids. |
| Guidance for Medi-Cal fee-for-service providers on Mitigating Health Impacts of Secondary Stress Due to the COVID-19 Emergency. |
| ACEs Aware hosted a webinar, Taking Care of Our Patients, Our Teams, and Ourselves: Trauma-Informed Practices to Address Stress Related to COVID-19, which reached more than 3,000 people. Future webinars will continue to offer practical information to help providers as they respond to the stress caused by the COVID-19 emergency. |
Virtual Recovery Resources
| SAMHSA Virtual Recovery Resource |
| Physical distancing poses some risk for on-going patients with opioid use disorder because the usual recommendation is “use with a buddy”. If a patient uses alone, there is a project called Never Use Alone. When patients call Never Use Alone, they will be connected to a phone operator who will ask about their location, possible allergies and medical conditions, then stay on the call with them while they use. If the patient doesn’t respond within a set time, they will notify emergency services about a possible overdose. |
Sub-Topics:
Assessing Levels of Care & Building Strong Referrals to Specialty Care and Community Services
| Substance Use Service & Bed Availability Tool – The SBAT is a web-based tool that provides a dashboard of available substance use services throughout Los Angeles County, including: outpatient and intensive outpatient treatment, different levels of residential treatment, withdrawal management, Opioid Treatment Programs (methadone clinics), Recovery Bridge Housing, and DUI programs. |
| ASAM Criteria – ASAM’s criteria defines one national set of criteria for providing outcome-oriented and results-based care in the treatment of addiction. Today the criteria have become the most widely used and comprehensive set of guidelines for placement, continued stay and transfer/discharge of patients with addiction and co-occurring conditions. |
| ASAM Levels of Care – The ASAM Criteria text describes treatment as a continuum marked by four broad levels of service and an early intervention level. Within the five broad levels of care, decimal numbers are used to further express gradations of intensity of services. |
Building Partnerships to Promote Collaboration Across Health Care Transition Points
| Bridging the Gap Between Emergency Medicine and Primary Care in Treating Opioid Use Disorders – This webinar explores ways in which primary care health centers can work with emergency departments in using medication-assisted treatment (MAT) for patients with opioid use disorder. |
| California’s Forum on Integration: Integrating Substance Use Disorder Services and Primary Care – This report provides background information on integrated SUD/primary care services. It presents key points from each of the Forum presentations and summarizes lessons learned that emerged throughout the Forum. |
| Community in Crisis: A Collaborative Approach to Responding to the Opioid Epidemic – This webinar describes the impact of opioid epidemic in North Carolina and southeastern North Carolina. Presenters describe components required build a collaborative response to a community problem and how to identify efforts and initiatives being implemented to combat the opioid epidemic in southeastern North Carolina. |
| Medication Assisted Treatment in The Emergency Room Setting – This webinar sets the stage of OUD and reviews the methods and approach for the initiation of MAT in the ER setting. Case examples are reviewed to demonstrate the approach. |
Sub-Topics:
Addressing Stigma
| SUD and Stigma Staff Training – Alameda Health System, Eastmont Wellness Center. This presentation is a staff training that defines SUD and stigma, how language and attitudes affect our perception of people with SUD, exploring using “person-first” language, and recognizing SUD as chronic diseases. |
| Stigma and Stigma Injury – coach Katie Bell – Download the PPT presentation shared by Coach Katie Bell. Topics discuss types of stigma, how to de-stigmatize SUD, and how stigma impacts the wellness of an individual. |
| Reducing Stigma Presentation – coach Katie Bell/Chapa-De – Download the PPT presentation shared by Coach Katie Bell from Chapa-De Indian Health. You can use/adapt this presentation for staff training and reducing stigma. This can be presented to Front Desk staff, call center teams, MA/Nursing teams, and other team members. |
| Understanding Drug-Related Stigma – Tobin Shelton, Venice Family Clinic – This is an example survey shared by Tobin Shelton from Venice Family Clinic. Staff can anonymously complete these surveys to give your team data about staff stigma toward patients with OUD and SUD. |
| The Evidence for Stigma Change: Ending Discrimination Against People with Mental and Substance Use Disorders – After reviewing a broad range of available evidence about what works to decrease stigma and to promote affirming attitudes and behaviors, recommendations are made for SAMHSA’s Office of Communications and Center for Behavioral Health Statistics and Quality in the areas of communications science and stigma research. |
| Stigma in Health Facilities: Why It Matters and How We Can Change It – This article seeks to assess how developments over the past 5 years have contributed to the state of programmatic knowledge regarding interventions to reduce stigma in health facilities,. |
| Perceived Stigma of Substance Abuse Scale – This can be used in research to determine perceived stigma. |
| Brief Opioid Stigma Scale – Another example of a perceived stigma scale survey. |
| The Association Between Perceived Stigma and Substance Use Disorder Treatment Outcomes: A Review – This paper examined empirical work intended to determine the impact of perceived social stigma and self-stigma on the process of recovering from SUDs with the assistance of formal treatment services. |
| The Stigma Scale: Development of a Standardised Measure of the Stigma of Mental Illness – This paper discusses how the 28-item stigma scale was developed. |
| Indiana’s Government Website – Their website has a section about opioid use disorder and addressing stigma. |
Building a Culture Around Treating Addiction as a Disease
| Management of opioid use disorder in the USA – Despite the strength of the evidence, reluctance exists to acknowledge opioid use disorder as a medical disorder and to treat the disorder with medications among many clinicians and the lay public. By conceptualizing opioid use disorder as a chronic illness, clinicians could better understand its course and treatment, how to achieve and sustain remission, and help prevent relapse. |
| Medications for Opioid Use Disorder Save Lives – 2019 Report – To support the dissemination of accurate, patient-focused information about evidence-based treatment for OUD, a committee examined the evidence base for medications to treat OUD and identified barriers that prevent people from accessing safe, effective, medication-based treatment. |
| Prevention and Treatment of Opioid Misuse and Addiction – This review discusses opioid pharmacology, physical dependence on opioids, opioid misuse and addiction, prevention and treatment. |
Building a Patient Centered Culture (Using Principles of Motivational Interviewing)
| No resources here yet. If you have any to share, please send them to us! |
Utilizing Decision Support Tools and Organization Readiness Approaches
| Capability Assessment: Integrating Medication for Addiction Treatment into Primary Care – This capability assessment was developed by Dr. Mark McGovern for CCI’s Addiction Treatment Starts Here: Primary Care program. |
| Implementing Care for Alcohol & Other Drug Use in Medical Settings: An Extension of SBIRT – This change guide is designed to assist primary care clinicians and leaders to integrate care for patients with unhealthy alcohol and/or other drug use into routine medical care. This guide expands on and updates the widely recognized model of Screening, Brief Intervention, and Referral to Treatment (SBIRT). |
Sub-Topics:
Billing/Reimbursement for Services
| Drug-MediCal ODS Same-Day Billing Matrix |
| ICD-10-PCS Codes – SUD and Behavioral Health |
Establishing Financial Sustainability for MAT Programs
| How to Pay for It: MAT in Community Health Centers This paper outlines five strategies that health centers might use to help fund their MAT programs, including, but not limited to: federally funded MAT expansion, visit design and Drug Medi-Cal Organized Delivery System. |
Financing Approaches
| Exploring Value-Based Payment to Encourage SUD Treatment in Primary Care – This brief examines how states and health plans are exploring VBP to promote SUD treatment in primary care, and offers considerations for implementing these models. |
| Financing Factors for Implementing Medication-Assisted Treatment This webinar identifies financial considerations for successfully implementing and sustaining MAT in a primary or behavioral health practice setting. While MAT financing can vary across provider type, state, and payer engagement, there are several common factors all organizations should consider to ensure sustainability and long-term success of MAT services and programs. |
| State and Local Policy Levers for Increasing Treatment and Recovery Capacity to Address the Opioid Epidemic This report summarizes financing and workforce policies that can be used by states to expand treatment access and capacity for opioid use disorder (OUD), focusing especially on medication-assisted treatment (MAT). Our evaluation team used a case-study approach and conducted an environmental scan and stakeholder interviews for five states: California, Missouri, New Hampshire, Ohio, and Virginia. The environmental scan and discussions with stakeholders identified five broad financing approaches to expand MAT capacity. |
Sub-Topics:
Developing, Implementing, and Scaling a MAT Model for Your Organization
| Medications for Addiction Treatment, Providing Best Practice Care in a Primary Care Clinic: Coaches Katie Bell and Shelly Virva created this comprehensive toolkit filled with practical information, tools and resources for developing MAT programs in primary care. |
| Phases of MAT Care Presentation: These slides highlight Alameda Health System’s and Marin City’s phases of treatment models. |
| Katie Bell shares Chapa-De’s phases of care program model. |
| MAT Brochure – Santa Cruz County This brochure includes Santa Cruz’s tiers of MAT treatment. |
| AHRQ Medication-Assisted Treatment for Opioid Use Disorder Playbook – This playbook serves as a comprehensive guide for implementing MAT in primary care and other ambulatory care settings. |
| AHRQ Medication-Assisted Treatment MAT Tools & Resources Collection – This tools and resource collection is for providers, staff, and patients who offer or use medication-assisted treatment (MAT) services. |
| Six Building Blocks to Managing OUD in Primary Care – This provides an evidence-based quality improvement roadmap to help primary care teams implement effective, guideline-driven care for patients with chronic pain and long-term opioid therapy patients. |
| MAT Resource Library – L.A. County Public Health |
| Technical Brief: Medication-Assisted Treatment Models of Care for Opioid Use Disorder in Primary Care Settings The purpose of this Technical Brief is to describe promising and innovative MAT models of care in primary care settings, describe barriers to MAT implementation, summarize the evidence available on MAT models of care in primary care settings, identify gaps in the evidence base, and guide future research. |
| Summary of Technical Brief: Primary Care–Based Models for the Treatment of Opioid Use Disorder This article summarizes findings of a technical report for the Agency for Healthcare Research and Quality describing MAT models of care for OUD, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT into primary care settings that could be considered for adaptation across diverse health care settings. Common components of existing care models include pharmacotherapy with buprenorphine or naltrexone, provider and community education, coordination and integration of OUD treatment with other medical and psychological needs, and psychosocial services and interventions. |
| Guidance Document on Best Practices: MAT for OUD This compendium of best practice recommendations and resources has been developed to provide guidance and support to initiate and expand MAT services for OUDs for patient populations in a variety of service settings as requested by health care and behavioral health professionals. |
| CIN Toolkit: Three Strategies to Help Primary Care Teams Treat Substance Use Disorders This document is a guide for primary care organizations and care teams working to integrate substance use disorder (SUD) treatment services. It provides proven strategies, best practices, and tools used by organizations within California to expand the capability of primary care teams in commercial and safety-net sectors to confidently and willingly provide SUD services. |
Group Visits and Refill Visits
| Group Visit Confidentiality Agreement – shared by Alliance Medical Center |
| Group Visit Provider Workflow – shared by Alliance Medical Center |
| Shared Medical Visit Form – shared by Venice Family Clinic |
| MAT 12-Week Group Curriculum – shared by Father Joe’s Villages |
| Shared Medical Visit Workflow – shared by Venice Family Clinic |
Sample Policies and Procedures
| Policies & Procedures Manual from Bartz-Altadonna Community Health Center |
| Triage after hours protocol example (download Word version). Shared by coach Shelly Virva. |
| After hours refill request decision tree (download Word version). Example shared by coach Shelly Virva. |
| Procedures for MAT in Primary Care (RAND) |
| SUMMIT Study Protocol (RAND) |
| Interagency Patient Information Form – shared by Venice Family Clinic |
| Alliance Medical Center – This zip file contains Alliance Medical Center’s examples of treatment protocols, coordination with emergency department, care team member workflows, treatment agreements, and more. |
| Santa Cruz Nurse Packet – Download zip file of the nurse packet that contains examples of MAT chief complaint forms, Suboxone and Vivitrol medication guides, smartphrases and more. |
| AUD/OUD Protocol with Vivitrol – shared by Family Health Care Centers of Greater Los Angeles |
Sample Workflows
| Patient Treatment Flow Chart – shared by Mountain Valleys Health Center |
| Point of Access Workflow – Advanced – shared by Venice Family Clinic |
| Point of Access Workflow – Simple – shared by Venice Family Clinic |
| Sample Buprenorphine Patient Registry – Download the excel tool to track your patients (shared by Coach Katie Bell/Chapa-De) |
| Substance Use Care Navigator Referral Process Intake Workflow – shared by Adventist Health – Reedley |
| TeleHealth Addiction Medicine ED Workflow – shared by Adventist Health – Reedley |
| Group Visit MA Workflow – shared by Alliance Medical Center |
| MAT Treatment Workflows – shared by Alliance Medical Center |
| MAT Procedures and Workflows – Santa Cruz County Health Services Agency |
| MAT Intake Process Decision Tree – shared by Father Joe’s Villages |
Sample Job Descriptions
Job Descriptions:
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| Nurse Care Manager Model of Office Based Addiction Treatment: Clinical Guidelines This manual represents an update to the prior version of Boston Medical Center’s Office Based Addiction Treatment (OBAT) clinical guidelines. The purpose of these clinical guidelines is to provide detailed policies and protocols of the OBAT program for the use of buprenorphine (alone and in combination with naloxone) and naltrexone (oral and extended-release injectable formulations) in the treatment of substance use disorders. |
| Implementing Screening, Brief Intervention and Referral to Treatment (SBIRT) Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based practice used to identify, reduce and prevent risky alcohol and drug use. |
| Expanding Access to Medication Assisted Treatment Utilizing Nurse Care Managers This webinar from CCI’s previous addiction treatment program in 2016 looks at the role nurses can play in building a team based model, assisting waivered primary care physicians provide high quality care, supporting the complex needs of patients with substance use disorder and the expansion of treatment. Elements covered include: clinical care, coordination of services among team-members, regulatory compliance, office workflow. |
Navigating Regulations for Confidentiality and MAT Operations
| Overcoming Data-Sharing Challenges in the Opioid Epidemic – This paper provides an overview of 42 CFR Part 2, how Part 2 relates to HIPAA, challenges with Part 2 and strategies for sharing Part 2 information. |
| Disclosure of Substance Use Disorder Patient Records: Does Part 2 Apply to Me? – These fact sheets help stakeholders understand their rights and obligations under 42 CFR Part 2 |
| I Provide SUD Services in an FQHC: Does Part 2 Apply to Me? – This flowchart helps you determine if you qualify as a 42 CFR Part 2 program. |
| Consent Form – English & Spanish – shared by Venice Family Clinic |
| Patient Confidentiality and MAT As California’s primary care clinics work to integrate MAT into services, they will encounter questions around legal regulations governing privacy of patient records. What is 42 CFR Part 2? What does it mean & how does it apply to primary care? Can certain program design elements allow unified medical charting by not activating this regulation? This webinar is an introduction to these issues, without giving any formal legal advice. |
| 42 CFR Compliant Patient Consent This is an example patient consent form that is 42 CFR compliant. |
| How to Build a Controlled Substance Review Committee in Your Primary Care Clinic: Why? Who? How? This webinar held as part of CCI’s previous addiction treatment program in 2016 discusses creating an internal peer-review committee for complex pain cases. These committees can improve the experience of both patients and providers. This webinar uses a case-based format to review the basic structure and composition of such a committee, the operations, and the benefits to its use. |
Selecting Models to Support Patient Centered Goals Inclusive of Abstinence and Risk Reduction
| The Treatment Effectiveness Assessment: An Efficient, Patient-Centered Instrument for Evaluating Progress in Recovery from Addiction The resulting Treatment Effectiveness Assessment (TEA) elicits patient responses that help the patient and the clinician quickly gauge patient progress in treatment and in recovery, according to the patients’ sense of what is important within four domains established by prior research. This article describes the development of the TEA and the initial phases of its application in clinical practice and in research. |
Brochures
| Buprenorphine home induction guide and symptom management guide from Alameda Health System’s Highland Wellness Center. |
| Buprenorphine Brochure – shared by Contra Costa Health Services |
| OUD & MAT Brochure – Family Health Centers of San Diego In addition to using brochures, FHCSD has set up relationships with other County outpatient and residential providers as part of the Drug Medi-Cal integration in San Diego County. FHCSD also receives referrals from their Hub and Spoke system. FHCSD providers refer internally to MAT and have set up referrals via their EHR system. Their webpage provides information and an e-mail address and one central referral phone number is used for patient’s to refer into. |
| SUD Brochure – Family Health Centers of San Diego This brochure may be shared in conjunction with the OUD & MAT brochure. |
| MAT Brochure – Marin City Health & Wellness Center |
| Suboxone & MAT Program Pamphlet – Mountain Valleys Health Center Download the PPT version of their pamphlet. |
| Pain Management Pamphlet – Mountain Valleys Health Center Download the PPT version of their pamphlet. |
| MAT Brochure – Neighborhood Healthcare |
| MAT Assessment Steps Flyer – Neighborhood Healthcare |
| Opioid Therapeutic Use, Dependence & Addiction Brochure – Plumas District Hospital This brochure helps initiate the discussion about MAT among chronic pain and opiate patients that the PHD team has concerns about. This is the literature that points patients in the direction of their MAT program. |
| MAT Brochure – Santa Cruz County This brochure describes Santa Cruz’s MAT program, including program requirements, what MAT is, and how patients can get started with treatment. |
| Support Group MAT Flyer (Small) – Santa Cruz County This is a flyer with information about MAT support group meetings. |
| Spanish & English – Support Group MAT Flyer (Full Page) – Santa Cruz County This is a full page flyer with information about MAT support group meetings. The flyer is available in Spanish and English. |
| Fentanyl Education – Santa Cruz This flyer educates patients about the prevention and reversal of fentanyl overdose, as well as other general information. |
| SUMMIT Services Info Sheet (Bilingual) – shared by Venice Family Clinic |
| Home Induction Handout – shared by School Health Clinics of Santa Clara County |
Forms
| Consent Form – English & Spanish – shared by Venice Family Clinic |
| 42 CFR Compliant Patient Consent This is an example patient consent form that is 42 CFR compliant. |
| Buprenorphine Patient Treatment Agreement – English & Spanish – Community Health Center, Inc. |
| Medication Management Agreement – shared by Livingston Community Health |
Patient Class Curriculum
| MAT group class content from El Dorado Community Health Center |
| Cherokee Health Systems shares their peer recovery class curriculum. |
Sub-Topics:
Buprenorphine, Naltrexone, and Naloxone 101
| California Substance Abuse Line – This is a free, 24/7 consultation service for California clinicians. This tele-consultation service is staffed by physicians and pharmacists who can answer questions about substance abuse evaluation and management and questions pertaining to medications for OUD. |
| Suboxone Flow Chart (download Word version) |
| XR – Naltrexone: A Step-by-Step Guide SAMHSA PCSS-MAT published a step-by-step guide for prescribing Naltrexone. |
| Buprenorphine Toolkit from CSAM Conference This Buprenorphine toolkit was presented at a CSAM Conference. The toolkit includes guidelines, protocols, assessment forms and patient education resources collected from a variety of sources. |
| Naloxone Prescribing in Primary Care This webinar examines the history of naloxone, evidence for prescribing it in primary care, tips for getting patient buy-in, and strategies for implementing prescription programs in resource-limited settings. |
| Buprenorphine-Naloxone-Suboxone Sample Note Templates This document contains sample note templates that prescribers can use. |
| Opioid Safety and How to Use Naloxone: A Guide for Patients and Caregivers This three-fold pamphlet published by the San Francisco Department of Public Health in 2016 is a guide for patients and caregivers for how to respond to an opioid overdose. It gives step by step instructions for steps to take when an overdose is suspected and detailed instructions for how to give naloxone. |
| Benzodiazepines and Buprenorphine: Safety Driven Medication Management This webinar reviews the evidence and discusses practical treatment strategies that clinicians can take in managing opioid agonist pharmacotherapies for opioid-use disorder in patients using prescribed or illicit benzodiazepines or other CNS depressants. |
| The Next Stage of Buprenorphine Care for Opioid Use Disorder This article reviews research findings in the following 7 areas: location of buprenorphine induction, combining buprenorphine with a benzodiazepine, relapse during buprenorphine treatment, requirements for counseling, uses of drug testing, use of other substances during buprenorphine treatment, and duration of buprenorphine treatment. For each area, evidence for needed updates and modifications in practice is provided. These modifications will facilitate more successful, evidence-based treatment and care. for patients with OUD. |
| The ASAM Appropriate Use of Drug Testing in Clinical Addiction Medicine ASAM developed the Appropriate Use of Drug Testing in Clinical Addiction Medicine document to provide guidance about the effective use of drug testing in the identification, diagnosis, treatment and promotion of recovery for patients with, or at risk for, addiction. |
| Buprenorphine-Naloxone-Suboxone FAQ For Patients (English) This document addresses common questions patients may have about the medications for the treatment of opioid use disorder. Buprenorphine-Naloxone-Suboxone FAQ For Patients (Spanish) This document addresses common questions patients may have about the medications for the treatment of opioid use disorder. You can give this to your Spanish-speaking patients. |
| Treatment Improvement Protocol: Pharmacotherapy for Opioid Use Disorder This Treatment Improvement Protocol (TIP) describes general principles of opioid use disorder (OUD) pharmacotherapy and discusses medication formulations, indications, and dosing for the three medications used to treat OUD—methadone, naltrexone, and buprenorphine. |
| Pharmacotherapy of Alcohol Use Disorders in 2017:What is the First Line Medication? Alcohol use disorder (AUD) is common in primary care where the bulk of these patients are seen -often for its complications- but medications to treat AUD remain underutilized in this setting. Primary care physicians can and should prescribe medications to help patients reduce their alcohol use. This practical webinar covered the basics of when to provide medications for this disorder and what patient characteristics to keep in mind when choosing from the 4 FDA approved medications available. |
| National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use The American Society of Addiction Medicine (ASAM) developed a webinar series on the National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. The purpose of these webinars is to educate physicians on the evidence-based clinical treatment of opioid use disorder and to assist them in the decision-making process for prescribing pharmacotherapies to patients with opioid use disorder. |
| Procedures for Medication-Assisted Treatment of Alcohol or Opioid Dependence in Primary Care This guide from RAND is divided into three parts: Part I reviews the approach that primary care providers should take in discussing alcohol or opioid dependence with their patients. Part II is a step-by-step guide to treating alcohol-dependent patients with extended-release, injectable naltrexone in primary care settings. Part III is a reference guide for primary care practitioners administering buprenorphine/naloxone to patients with opioid dependence. |
| National Practice Guideline for the Treatment of Opioid Use Disorder 2020 Focused Update The American Society of Addiction Medicine (ASAM) developed the National Practice Guideline to inform and empower clinicians, health system administrators, criminal justice system administrators and policymakers who are interested in implementing evidence-based practices to treat individuals with OUD. |
Effective Strategies for Tapering Patients on Long-Term Opioid Therapy
| Tapering Long-Term Opioid Therapy This webinar offers a brief background and reviews the available evidence to guide patient-centered tapering of long-term opioid therapy. It offers strategies for clinicians to discuss tapering with their patients and get patient buy-in as well as resources to help implement opioid tapers. |
Goal Setting, Including Harm Reduction
| Medication First Approach 1pgr – This document discusses the principles of this approach and do’s and don’ts of medical treatment for OUD. |
| Treatment Plan – English & Spanish – shared by Venice Family Clinic |
Managing Diversion
| Contingency Management Resources from Santa Cruz – CM description, patient agreement, incentive costs, tier template roster/dashboard |
| Effective Strategies for the Non-Adherent Buprenorphine Patient: Rational Monitoring and Contingency This webinar offers a simple framework to conceptualize the doctor-patient relationship which can empower you to remain in a compassionate stance toward risky or non-compliant patients, while also helping them modify their behavior toward safer and more appropriate use. The session covers how to interpret the prescription drug monitoring database, and urine toxicology tests, and integrate them in your practice. It also looks at what to do when these screening tests come up positive. |
| Urine Drug Tests: Ordering and Interpretation This guide provides information about frequency of testing, choosing the correct test, interpreting results, and other guidance. |
| Diversion and Abuse of Buprenorphine This brief article gives recommendations on how to reduce the risk of diversion and buprenorphine abuse. |
Managing MAT Initiation, Stabilization, and Maintenance
| Buprenorphine Induction Guidance This guide provides information for providers conducting buprenorphine inductions. It gives background and recommendations for observed inductions and home inductions. |
| Treatment Improvement Protocol: Pharmacotherapy for Opioid Use Disorder This Treatment Improvement Protocol (TIP) describes general principles of opioid use disorder (OUD) pharmacotherapy and discusses medication formulations, indications, and dosing for the three medications used to treat OUD—methadone, naltrexone, and buprenorphine. |
| Parameters for the Use of Medications for Addiction Treatment in Individuals with Co-Occurring Substance Use Disorders – This document describes situations in which MAT should be used to treat co-occurring substance use disorders in LAC DMH programs. |
| National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use The American Society of Addiction Medicine (ASAM) developed a webinar series on the National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. The purpose of these webinars is to educate physicians on the evidence-based clinical treatment of opioid use disorder and to assist them in the decision-making process for prescribing pharmacotherapies to patients with opioid use disorder. |
| Procedures for Medication-Assisted Treatment of Alcohol or Opioid Dependence in Primary Care This guide from RAND is divided into three parts: Part I reviews the approach that primary care providers should take in discussing alcohol or opioid dependence with their patients. Part II is a step-by-step guide to treating alcohol-dependent patients with extended-release, injectable naltrexone in primary care settings. Part III is a reference guide for primary care practitioners administering buprenorphine/naloxone to patients with opioid dependence. |
| How to Start Buprenorphine/naloxone at Home (Suboxone Induction) This guide has home start instructions. |
| Buprenorphine – Beginning Treatment These home induction instructions include picture visuals to help patients understand the medication instructions. |
| MAT Induction Guidelines – shared by Alliance Medical Center |
Patient Identification and Selection
| Sample Buprenorphine Patient Registry – Download the excel tool to track your patients (shared by Coach Katie Bell/Chapa-De) |
| Office-Based Buprenorphine: Patient Selection, Induction, and Management This webinar from 2016 was hosted by CSAM and featured speaker Soraya Azari, MD, Assistant Professor, Department of Medicine, UCSF School of Medicine. This webinar will help you to: be more confident in deciding between home- and office-based induction with buprenorphine and understand best practices for conversion from methadone or long-acting opioids to buprenorphine. |
| DSM-V Worksheet – Criteria for Diagnosis of Opiate Use Disorder This worksheet outlines the DSM-V diagnostic criteria for diagnosis of opiate use disorder. Criteria from American Psychiatric Association (2013). |
| GAD7 – English & Spanish |
| PHQ9 – English & Spanish |
Waiver Training
| Online MAT Waiver Training This website offers MAT waiver trainings for physicians, nurse practitioners and physician assistants wishing to apply for a waiver to prescribe buprenorphine for the treatment of opioid use disorders. |
| Buprenorphine Waiver Training: Advanced Review This slide deck is relevant for providers who have completed waiver trainings and would like to review and refresh their skills and knowledge. |
Alcohol Use Disorder
| Pharmacotherapy of Alcohol Use Disorders in 2017:What is the First Line Medication? Alcohol use disorder (AUD) is common in primary care where the bulk of these patients are seen -often for its complications- but medications to treat AUD remain underutilized in this setting. Primary care physicians can and should prescribe medications to help patients reduce their alcohol use. This practical webinar covered the basics of when to provide medications for this disorder and what patient characteristics to keep in mind when choosing from the 4 FDA approved medications available. |
| Anticonvulsants for Ambulatory Alcohol Withdrawal Management Guide, developed by Brian Hurley, MD |
Sub-Topics:
Community Reinforcement and Family Training & Network Therapy
| Community Reinforcement and Family Training (CRAFT): Engaging Unmotivated Drug Users in Treatment This report describes the development and initial testing of a CSO counseling strategy specifically designed to address drug problems in adults. |
| Community Reinforcement and Family Training Support and Prevention (CRAFT-SP) The CRAFT approach is designed for those family members and friends who would like to improve their relationship with the drinker / addict and want to encourage their loved one to reduce or end his/her substance abuse. |
Contingency Management Treatment
| Effective Strategies for the Non-Adherent Buprenorphine Patient: Rational Monitoring and Contingency This webinar offers a simple framework to conceptualize the doctor-patient relationship which can empower you to remain in a compassionate stance toward risky or non-compliant patients, while also helping them modify their behavior toward safer and more appropriate use. The session covers how to interpret the prescription drug monitoring database, and urine toxicology tests, and integrate them in your practice. It also looks at what to do when these screening tests come up positive. |
| Contingency Management Treatments for Stimulant and Other SUDs: What They Are and How They Work This webinar explores ways in which primary care health centers can use contingency management, or motivational incentives with tangible rewards, to influence behavior change for patients with substance use disorders. |
Focused Counseling
| No resources here yet. If you have any to share, please send them to us! |
Motivational Interviewing
| Motivational Interviewing for Clinical Practice The webinar provides a clear presentation of Motivational Interviewing that is readily transferable to everyday clinical practice. |
| Motivational Interviewing: Brushing up on the Basics This webinar will review the basic concepts and skills of Motivational Interviewing (MI) and will employ MI skills and tools, to illustrate the practical applicability of these tools in clinical practice for their addiction and other patient populations. |
| Brief Treatment for Substance Use Disorders: A Guide for Behavioral Health Providers This is a clinician guidebook that describes a six-session brief treatment for patients with alcohol and opiate use disorders who are screened in a primary care setting. The goal of this treatment is to reduce or stop substance use. The intervention uses a motivational enhancement/cognitive behavioral therapy (MET/CBT) approach to build motivation to initiate substance use change and maintain recovery; the approach employs motivational interviewing principles and relapse prevention strategies. |
Offering Harm Reduction Resources
| Harm Reduction Coalition The Harm Reduction Coalition provides links and resources on drug information, blogs about harm reduction and overdose prevention, and educational materials. |
Sub-Topics:
Driver Diagrams
| Driver Diagram Template A Click the link to download the word document template. |
| Driver Diagram Template B Click the link to download the word document template. |
| Example Completed Driver Diagram Download the PDF driver diagram example. |
PDSA Worksheets
| PDSA Worksheet Template Click the link to download the word document template. |
| PDSA Template – shared by Venice Family Clinic |
Project Plans
| 60 Day Workplan Sample Instructions – Behavioral Health |
| 60 Day Workplan Template – Behavioral Health |
| Project Plan Template – Primary Care – Click the link to download the word document |
| Sample Project Plan – Primary Care – Click the link to download the word document example of a completed project plan. |
Workflow Maps
| Sample MAT Workflow Maps Download these example MAT workflow maps. |
Sub-Topics:
Adolescents
| Medications for Maintenance Treatment of Opioid Use Disorder in Adolescents – This article reviews and synthesizes the published evidence about the efficacy and potential risks (including safety concerns) associated with methadone, buprenorphine, or naltrexone for the treatment of OUD in adolescents and compare their benefits and risks with that of no treatment or treatment without medications. |
| Webinar: MAT in Youth: How to Develop and Manage Treatment for Youth and Young Adults – This webinar was held for CCI’s Addiction Treatment Starts Here programs on December 9, 2019. Sarah Bagley, MD, MSc from Boston Medical Center discusses how to structure a program to provide MAT to youth and young adults and discusses approaches to tailor psychosocial support for this population. |
| Opioid Use Disorder (OUD) Education Resources The California Youth Opioid Response compiled a list of resources for youth related to prevention, treatment and recovery. This list is updated quarterly. |
Justice Involved Patients
| MAT in Justice Settings Video – This video highlights DHCS’ MAT in criminal justice setting project. The project is funded under the Opioid State Targeted Response (STR) and State Opioid Response (SOR) federal grants. |
| Medication-Assisted Treatment in Correctional Settings CHCF and the California Department of Health Care Services are collaborating with partners to increase access to medication-assisted treatment (MAT) in correctional settings. Learn more about these efforts. |
Managing Complex Chronic Pain
| Psychological/Behavioral Strategies for Pain Control: Tools to Use in a 20-Minute Visit Many primary care providers who work with chronic pain patients have limited or no access to psychological resources to help patients struggling with daily pain. This webinar included psychological and behavioral techniques PCPs can use during their brief visits with patients to facilitate coping strategies and adherence. Case examples and techniques to help manage provider burn out were covered. |
| Managing Acute and Perioperative Pain in Patients on MAT This webinar discusses the best evidence for management of acute and perioperative pain for patients on buprenorphine, methadone and naltrexone formulations for substance use disorders. It covers strategies for patient preparation and communication with the perioperative team. |
| Complex Chronic Pain, Opioid Prescribing and Opioid Use Disorder In this case-based webinar, presenters discuss practical approaches to diagnosis and treatment with a special focus on communication tips to support patients, providers, and staff as they navigate challenging clinical scenarios. |
| Converting High Dose Opioid Patients to Buprenorphine This case-based webinar covers the needs of patients with chronic non-cancer pain who have been maintained on high-dose opioids for months or years without improvement in functioning. The speaker presents his approach to these patients, including the clinical importance of withdrawal and harm reduction strategies such as supporting patients through tapering, what to do if tapers fail, transitioning patients to buprenorphine from higher-dose opioids, and naloxone kits. Language effective in talking about the opioid taper process with vulnerable patients is also discussed. |
OUD and Pregnancy
| Naltrexone to Treat Opioid Use Disorder During Pregnancy, Favorable for Mom, Baby – A new study, lead by researchers at Boston Medical Center, found that infants born to mothers taking naltrexone to treat opioid use disorder during pregnancy showed no signs of neonatal opioid withdrawal syndrome (NOWS) during their hospitalization. |
| Treating Maternal Opioid Addiction: Buprenorphine Basics This webinar reviews the basics of buprenorphine treatment in pregnancy: what rural clinicians need to know to improve outcomes for women and infants exposed to opioids. |
| The ASAM National Practice Guideline Special Populations Webinar This webinar discusses obstetrical risks of opioid use disorder in pregnant women. The webinar provides an overview of the recommendations and in-depth information on treating pregnant women from ASAM’s National Practice Guideline. |
| Buprenorphine During Pregnancy Reduces Neonate Distress A multisite clinical trial lays groundwork for improving care for mothers and babies affected by opioid dependence. |
| Neonatal Abstinence Syndrome after Methadone or Buprenorphine Exposure A double-blind, double-dummy, flexible-dosing, randomized, controlled study in which buprenorphine and methadone were compared for use in the comprehensive care of 175 pregnant women with opioid dependency at eight international sites. |
| Opioid Use Disorder in Pregnancy The purpose of this article is to provide information and guidance for clinicians working with and treating pregnant women with OUD. |
| Prenatal Buprenorphine Versus Methadone Exposure and Neonatal Outcomes: Systematic Review and Meta-Analysis The goals of this study were to conduct a systematic review of the published literature, to perform a meta-analysis of the association of prenatal BMT versus MMT exposure on the neonate, and to explore potential sources of heterogeneity and bias among studies. |
| Managing opioid dependence in pregnancy This article provides an overview of treatment principles for managing opioid dependence in pregnancy, and reviews current treatment guidelines for use of opioid-substitution therapy in pregnant women. |
| Mother and Baby Substance Exposure Toolkit This toolkit, developed by the California Maternal Quality Care Collaborative at Stanford, clarifies best practices to support and improve care for mothers and newborns affected by substance use disorder. |
| “Methadone and buprenorphine pharmacotherapy of opioid use disorder in pregnancy” is featured in UpToDate, a clinical decision support resource. It discusses the administration and outcomes of both medications for pharmacotherapy of OUD during pregnancy and postpartum (including suggestions for initial and maintenance dosing), side effects, and short-term and long-term outcomes. Download the article here |
| Addiction Free California is a website developed as part of the state’s MAT Expansion Grants. The Mother & Baby Substance Exposure Initiative section of the website features a range of 10 – 20 minute webinars, such as Breastfeeding Considerations for Women with OUD or on MAT and Considerations for Treatment of Opioid Use Disorder Before and During Pregnancy. |
