Care Management Council submission date: August Contact Information
|
|
- Olivia Carter
- 8 years ago
- Views:
Transcription
1 Clinical Practice Approval Form Clinical Practice Title: Acute use of Buprenorphine for the Treatment of Opioid Dependence and Detoxification Type of Review: New Clinical Practice Revisions of Existing Clinical Practice Original Approval date: Care Management Council submission date: August 2013 Clinical Practice Owner / Author: (e.g., CCG and WG Lead(s) named) Behavioral Health CCG Contact Information Type of Clinical Expected Recommended Optional Practice: Brief Description of Clinical Practice Patients age with some physician discretion, presenting to a Banner Behavioral Health facilities as short-acting opioid dependent will be evaluated and assessed for the use of buprenorphine for the purposes of detoxification in acute withdrawal from short-acting opioids. Departments/Disciplines Affected Hospitalist Consult liaison team (Consult Service) Reviewed History Reviewed by (name/group): Buprenorphine (Subutex) WG June Behavioral Health CCG June P & T CCG July Hospital Medicine CCG June CMO July CNO July Clinical Practice Toolkit Link: Date: Upon Care Management Council Approval Clinical Practices enter DESIGN Phase in Care Management. Care Management Council Approval Returned to Author for Revision Date: Comments: X Approved by Care Management Council Date: August 22 nd 2013
2 TITLE: Number: Acute use of Buprenorphine for the treatment of opioid dependence and detoxification - Adult Date Posted: Type: Clinical Practice Contact: Approved Date: Implementation Date: Deactivation Date: Facilities: Approved by: Acute use of Buprenorphine for the treatment of Opioid Dependence and Detoxification Adult (16-65) PRACTICE APPROACH: Expected Clinical Practice PRACTICE STATEMENT: Patients age with some physician discretion, presenting to a Banner Behavioral Health facilities as short-acting opioid dependent will be evaluated and assessed for the use of buprenorphine for the purposes of detoxification in acute withdrawal from short-acting opioids. RATIONAL: Increasing hospital visits for emergency and detoxification treatment for heroin and short-acting prescription opioids has led to a need for more effective and safer pharmacological treatment options. Methadone has been demonstrated to be effective in decreasing opioid use, but the availability of treatment programs and ineffective short-term detoxification (Center for Substance Abuse Treatment, 2004; Oreskovich et al., 2005). Clonidine has been used as a common standard of acute detoxification for its ability to manage noradrenergic hyperactivity symptoms of withdrawal, but is limited of managing all symptomology and less effective with purer forms of heroin (Center for Substance Abuse Treatment, 2004; Oreskovich et al., 2005). Buprenorphine use for acute opioid detoxification in the acute inpatient has been well evaluated in the literature for both rapid withdrawal management and continued maintenance treatment (Center for Substance Abuse Treatment, 2004; Oreskovich et al., 2005). Buprenorphine is an opioid partial agonist/antagonist and available as a monotherapy Subutex or combination therapy Suboxone (buprenorphine plus naloxone (4:1)). When compared to full agonist opioids, it is a favorable choice for detox in the acute behavioral health setting due to a lower abuse potential; lower level of withdrawal symptoms, higher dose maximum effect (ceiling effect); and reduced overdose risk and respiratory depression. Banner Health Use of Buprenorphine Clinical Practice Page 2 of 5
3 Although not in itself directly life-threatening event, acute withdrawal from opioids presents a severe risk to patients experiencing it, including relapse to abusing short-acting opioids and co-morbid symptoms that can be a danger to the patient and to others. Inpatient treatment based on recognized standards provides for increased patient safety as well as comfort by controlling the acute withdrawal symptoms in a systematic manner. This allows for the prevention or control of co-morbid symptoms as well as providing for a higher rate of successful detoxification with reduced risk of harm or relapse to this patient population. Buprenorphine has emerged as a preferential treatment option for acute opioid detoxification in the acute inpatient setting due to its safety, demonstrated effectiveness in short withdrawal regimens, and lower abuse potential (Center for Substance Abuse Treatment, 2004; Oreskovich et al., 2005). The use of buprenorphine is indicated for use in supervised detoxification from opioid physical dependence, while at the same time promoting a transition to further rehabilitation and relapse prevention. While buprenorphine is effective as initial strategy towards being opioid-free, continued rehabilitation with opioid antagonist treatment or opioid abstinence is necessary to prevent relapse. Patients should be evaluated for their desire and ability to engage in an ongoing rehabilitation program with the goal of achieving a long-term opioid-free state. CLINICAL APPROACH: Patients requiring medically supervised withdrawal (detoxification) will undergo assessment/screening for shortacting opioid use and readiness to participate to treatment with a goal to become opioid-free. Upon entering opioid withdrawal, patients are initiated on an induction phase of buprenorphine followed by either a rapid tapering or maintenance phase dosing depending on individual needs and progress. Patients requiring ongoing maintenance beyond an inpatient admission will require a community referral for continued monitoring, dose management and rehabilitation therapy. Screening and Assessment for Buprenorphine Objectives of Screening and Assessment 1. Identify patients who are at risk or have developed drug or alcohol abuse problems. 2. Establish the diagnosis or diagnoses 3. Determine the biopsychosocial of the patient with addiction issues 4. Develop treatment plan that includes pharmacological and rehabilitation options 5. Identify and explore contraindications to buprenorphine treatments 6. Assess other medical problems or conditions that need to be addressed before or during buprenorphine treatments Inclusion Criteria for patient to use Buprenorphine 1. Diagnosis of opioid addiction/opioid dependence a) Patients meeting the criteria for opioid abuse may benefit from a short-period detoxification. 2. Between the ages of 16 and Patients initiated on buprenorphine should: a) Consent for treatment for opioid addiction b) Free of contraindications for buprenorphine c) Agree to buprenorphine treatment and compliant with safety precautions d) Understand the risk and benefits Exclusion/Caution Criteria Conditions and Circumstances That Preclude a Patient as a Candidate for Inpatient/Outpatient Buprenorphine treatment (as per SAMSHA Guidelines): Comorbid dependence on high doses of benzodiazepines or other central nervous system depressants (including alcohol and sedative/hypnotics) Banner Health Use of Buprenorphine Clinical Practice Page 3 of 5
4 Significant untreated psychiatric comorbidity Active or chronic suicidal or homicidal ideation or attempts Significant medical complications Conditions that are outside the area of the treating physician s expertise CLINICAL PRACTICE Conditions and Circumstances that requires further Psychiatric or Addiction Medicine Consult before buprenorphine initiation Multiple previous treatments for drug abuse with frequent relapses Methadone or levo-alpha-acetyl-methadol (LAAM) Acute ETOH Withdrawal Chronic Pain Seizures Unstable Psychiatric Condition The following medical conditions require evaluation of risk to-benefit of buprenorphine use and lower dosing maybe indicated. Pregnancy HIV treatment Impaired Hepatic Function ***Note: Buprenorphine/Naloxone combination is an absolute contraindicated for use in pregnant women and therefore only monotherapy buprenorphine be used. Management for Buprenorphine The goals of treatment: To stabilize the patient as rapidly as possible To minimize withdrawal symptoms Prevent further use of illicit opioids Initiation of withdrawal using buprenorphine will begin within hours after last known use of short-acting opioids and initial withdrawal symptoms present. Depending on the type of opioid (heroin vs prescription med), length of use (chronic) and amount of use/dosage levels, withdrawal symptoms may occur rapidly or delayed. Treatment should be initiated based on history of use and presence of withdrawal symptoms as early detoxification may precipitate opioid withdrawal syndrome. Tapering and Maintenance Treatment Course of Tapering and Maintenance Long-term reduction/maintenance treatment (12 months-lifetime) is preferable to shorter period detoxification. An opioid free state can be achieved over a day period in combination with rehabilitation. Patients in the acute hospital setting may desire and/or require rapid reduction to an opioid free state, including buprenorphine. Discontinuation of buprenorphine can be achieved over a 3 day period, however, relapse and successful outcomes from short-period reduction are unknown and a moderate period reduction should be employed when possible. 1. Long-Period tapering and maintenance 2. Moderate-Period tapering and maintenance 3. Short-Period tapering and maintenance Banner Health Use of Buprenorphine Clinical Practice Page 4 of 5
5 Waiver to Dispense According to the Drug Addiction Treatment Act of 2000 (DATA 2000), prescribers of buprenorphine have to obtain a waiver to prescribe/dispense buprenorphine for opioid detoxification without a primary medical problem. The waiver requires completing 8 hours of CE to obtain a Drug Addiction Treatment Act (DATA) waiver.[banner providers dispensing buprenorphine will have a DATA waiver] REFERENCES: Center for Substance Abuse Treatment. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40. DHHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, Oreskovich et al. (2005) A double-blind, double-dummy, randomized, prospective pilot study of the partial Mu opiate agonist, buprenorphine, for acute detoxification from heroin. Drug and Alcohol Dependence 77 (2005) KEYWORDS AND KEYWORD PHRASES: Clinical Practice Buprenorphine Subutex Opioid dependence Detoxification Banner Health Use of Buprenorphine Clinical Practice Page 5 of 5
KAP Keys. For Physicians. Based on TIP 40 Clinical Guidelines for the Use of Buprenorphine in the Treatment. of Opioid Addiction
Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction Knowledge Application Program KAP Keys For Physicians Based on TIP 40 Clinical Guidelines for the Use of Buprenorphine
More informationPrior Authorization Guideline
Prior Authorization Guideline Guideline: CSD - Suboxone Therapeutic Class: Central Nervous System Agents Therapeutic Sub-Class: Analgesics and Antipyretics (Opiate Partial Agonists) Client: County of San
More informationSubstitution Therapy for Opioid Dependence The Role of Suboxone. Mandy Manak, MD, ABAM, CCSAM Methadone 101-Hospitalist Workshop, October 3, 2015
Substitution Therapy for Opioid Dependence The Role of Suboxone Mandy Manak, MD, ABAM, CCSAM Methadone 101-Hospitalist Workshop, October 3, 2015 Objectives Recognize the options available in treating opioid
More informationUse of Buprenorphine in the Treatment of Opioid Addiction
Use of Buprenorphine in the Treatment of Opioid Addiction Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Executive Summary Which of the following is an
More informationQuick Guide. For Physicians. Based on TIP 40 Clinical Guidelines for the Use of Buprenorphine in the Treatment. of Opioid Addiction TIP
Buprenorphine Clinical Guide Quick Guide For Physicians Based on TIP 40 Clinical Guidelines for the Use of Buprenorphine in the Treatment Clinical Guidelines for the Use of Buprenorphine in the Treatment
More informationUpdate on Buprenorphine: Induction and Ongoing Care
Update on Buprenorphine: Induction and Ongoing Care Elizabeth F. Howell, M.D., DFAPA, FASAM Department of Psychiatry, University of Utah School of Medicine North Carolina Addiction Medicine Conference
More informationMedication Assisted Treatment
Medication Assisted Treatment Tanya Hiser, MS, LPC State Opioid Treatment Authority Bureau Of Prevention, Treatment, & Recovery State of Wisconsin Elizabeth Collier, MSW, CSAC, ICS, LCSW TANF Best Practice
More informationInformation for Pharmacists
Page 43 by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. Information for Pharmacists SUBOXONE (buprenorphine HCl/naloxone HCl
More informationTreatment of opioid use disorders
Treatment of opioid use disorders Gerardo Gonzalez, MD Associate Professor of Psychiatry Director, Division of Addiction Psychiatry Disclosures I have no financial conflicts to disclose I will review evidence
More informationConsiderations in Medication Assisted Treatment of Opiate Dependence. Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT
Considerations in Medication Assisted Treatment of Opiate Dependence Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT Disclosures Speaker Panels- None Grant recipient - SAMHSA
More informationOpioid/Opiate Dependent Pregnant Women
Opioid/Opiate Dependent Pregnant Women The epidemic, safety, stigma, and how to help. Presented by Lisa Ramirez MA,LCDC & Kerby Stewart MD The prescription painkiller epidemic is killing more women than
More informationOpioid Treatment Services, Office-Based Opioid Treatment
Optum 1 By United Behavioral Health U.S. Behavioral Health Plan, California Doing Business as OptumHealth Behavioral Solutions of California ( OHBS-CA ) 2015 Level of Care Guidelines Opioid Treatment Services,
More informationProgram Assistance Letter
Program Assistance Letter DOCUMENT NUMBER: 2004-01 DATE: December 5, 2003 DOCUMENT TITLE: Use of Buprenorphine in Health Center Substance Abuse Treatment Programs TO: All Bureau of Primary Health Care
More informationNeurobiology and Treatment of Opioid Dependence. Nebraska MAT Training September 29, 2011
Neurobiology and Treatment of Opioid Dependence Nebraska MAT Training September 29, 2011 Top 5 primary illegal drugs for persons age 18 29 entering treatment, % 30 25 20 15 10 Heroin or Prescription Opioids
More informationThe Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office
The Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office Adopted April 2013 for Consideration by State Medical Boards 2002 FSMB Model Guidelines
More informationDeath in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery
Death in the Suburbs: How Prescription Painkillers and Heroin Have Changed Treatment and Recovery Marvin D. Seppala, MD Chief Medical Officer Hazelden Betty Ford Foundation This product is supported by
More informationPractice Protocol. Buprenorphine Guidance Protocol
Practice Protocol Buprenorphine Guidance Protocol Developed by the Arizona Department of Health Services Division of Behavioral Health Services Effective Date: 02/23/11 Title Buprenorphine Guidance Protocol
More informationOne example: Chapman and Huygens, 1988, British Journal of Addiction
This is a fact in the treatment of alcohol and drug abuse: Patients who do well in treatment do well in any treatment and patients who do badly in treatment do badly in any treatment. One example: Chapman
More informationBUPRENORPHINE TREATMENT
BUPRENORPHINE TREATMENT Curriculum Infusion Package (CIP) Based on the Work of Dr. Thomas Freese of the Pacific Southwest ATTC Drug Addiction Treatment Act of 2000 (DATA 2000) Developed by Mountain West
More informationOpiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio
Governor s Cabinet Opiate Action Team Promoting Wellness and Recovery John R. Kasich, Governor Tracy J. Plouck, Director Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio November 14,
More informationUsing Buprenorphine in an Opioid Treatment Program
Using Buprenorphine in an Opioid Treatment Program Thomas E. Freese, PhD Director of Training, UCLA Integrated Substance Abuse Programs Director, Pacific Southwest Addiction Technology Transfer Center
More informationNew York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery
New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery USING THE 48 HOUR OBSERVATION BED USING THE 48 HOUR OBSERVATION BED Detoxification
More informationADVANCED BEHAVIORAL HEALTH, INC. Clinical Level of Care Guidelines - 2015
The Clinical Level of Care Guidelines contained on the following pages have been developed as a guide to assist care managers, physicians and providers in making medical necessity decisions about the least
More informationMinimum Insurance Benefits for Patients with Opioid Use Disorder The Opioid Use Disorder Epidemic: The Evidence for Opioid Treatment:
Minimum Insurance Benefits for Patients with Opioid Use Disorder By David Kan, MD and Tauheed Zaman, MD Adopted by the California Society of Addiction Medicine Committee on Opioids and the California Society
More informationTreatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone )
Treatment of Opioid Dependence with Buprenorphine/Naloxone (Suboxone ) Elinore F. McCance-Katz, M.D., Ph.D. Professor and Chair, Addiction Psychiatry Virginia Commonwealth University Neurobiology of Opiate
More informationIntegrating Medication- Assisted Treatment (MAT) for Opioid Use Disorders into Behavioral and Physical Healthcare Settings
Integrating Medication- Assisted Treatment (MAT) for Opioid Use Disorders into Behavioral and Physical Healthcare Settings All-Ohio Conference 3/27/2015 Christina M. Delos Reyes, MD Medical Consultant,
More informationHow To Treat Anorexic Addiction With Medication Assisted Treatment
Medication Assisted Treatment for Opioid Addiction Tanya Hiser, MS, LPC Premier Care of Wisconsin, LLC October 21, 2015 How Did We Get Here? Civil War veterans and women 19th Century physicians cautious
More informationMEDICAL ASSISTANCE BULLETIN
ISSUE DATE SUBJECT EFFECTIVE DATE MEDICAL ASSISTANCE BULLETIN NUMBER *See below BY Prior Authorization of Opiate Dependence Treatments Pharmacy Service Leesa M. Allen, Deputy Secretary Office of Medical
More informationJohn R. Kasich, Governor Orman Hall, Director
John R. Kasich, Governor Orman Hall, Director 2 3 Epidemics of unintentional drug overdoses in Ohio, 1979-2011 1,2,3 1800 1600 1400 1200 1000 800 Prescription drugs are causing a larger overdose epidemic
More informationEPIDEMIOLOGY OF OPIATE USE
Opiate Dependence EPIDEMIOLOGY OF OPIATE USE Difficult to estimate true extent of opiate dependence Based on National Survey of Health and Mental Well Being: 1.2% sample used opiates in last 12 months
More informationMEDICAL ASSISTANCE BULLETIN
ISSUE DATE September 4, 2015 SUBJECT EFFECTIVE DATE September 9, 2015 MEDICAL ASSISTANCE BULLETIN NUMBER *See below BY Prior Authorization of Opiate Dependence Treatments, Oral Buprenorphine Agents - Pharmacy
More informationMedication-Assisted Treatment for Opioid Addiction
Medication-Assisted Treatment for Opioid Addiction This document contains a general discussion of medications approved by the U.S. Food and Drug Administration (FDA) for use in the treatment of opioid
More informationTreatment of Opioid Dependence: A Randomized Controlled Trial. Karen L. Sees, DO, Kevin L. Delucchi, PhD, Carmen Masson, PhD, Amy
Category: Heroin Title: Methadone Maintenance vs 180-Day psychosocially Enriched Detoxification for Treatment of Opioid Dependence: A Randomized Controlled Trial Authors: Karen L. Sees, DO, Kevin L. Delucchi,
More informationOffice-based Treatment of Opioid Dependence with Buprenorphine
Office-based Treatment of Opioid Dependence with Buprenorphine David A. Fiellin, M.D Professor of Medicine, Investigative Medicine and Public Health Yale University School of Medicine Dr. Fiellin s Disclosures
More informationBeyond SBIRT: Integrating Addiction Medicine into Primary Care
Beyond SBIRT: Integrating Addiction Medicine into Primary Care Community Clinic Association of Los Angeles County 14 th Annual Health Care Symposium March 6, 2015 Keith Heinzerling MD, Karen Lamp MD; Allison
More informationSPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT ALCOHOL MISUSE
SPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT OF ALCOHOL MISUSE Date: March 2015 1 1. Introduction Alcohol misuse is a major public health problem in Camden with high rates of hospital
More informationMAT Counselor (MATC) Exam Questions Packet Certification Exam
MAT Counselor (MATC) Exam Questions Packet Certification Exam Course No: Course Title: Objective: MT-1921 Medication-Assisted Treatment Counselor (MATC) Certification Exam Tests the Medication-Assisted
More informationHeroin Overdose Trends and Treatment Options. Neil A. Capretto, D.O., F.A.S.A.M. Medical Director
Heroin Overdose Trends and Treatment Options Neil A. Capretto, D.O., F.A.S.A.M. Medical Director Type date here www.gatewayrehab.org Drug Overdose Deaths Increasing in Allegheny County Roberta Lojak holds
More informationMedication-Assisted Treatment (MAT) & What It Means Long-Term Gary K. Byrd., M.Ed., MAC, CCS, CAMS Methadone is the Gold Standard for treatment of chronic heroin addiction Gary Byrd 2015 1 Gary Byrd 2015
More informationMEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION
MEDICATION ASSISTED TREATMENT FOR OPIOID ADDICTION Sidarth Wakhlu,M.D. Addiction Team Leader North Texas VA Health Care System Addiction Psychiatry Fellowship Director Associate Professor Of Psychiatry
More informationOpioid Agonist Therapy: The Duration Dilemma Edwin A. Salsitz, MD, FASAM Mount Sinai Beth Israel, New York, NY March 10, 2015
Q: I have read 40 mg of methadone stops withdrawal, so why don t we start at 30mg and maybe later in the day add 10mg? A: Federal Regulations stipulate that 30mg is the maximum first dose in an Opioid
More informationOpioids for Pain Treatment. Opioids for Chronic Pain and Addiction Treatment. Outline for Today. Opioids for pain treatment
Opioids for Chronic Pain and Addiction Treatment Joseph Merrill M.D., M.P.H. University of Washington February 24, 2012 Outline for Today Opioids for pain treatment Trends Problems High dose prescribing
More informationTENNESSEE BOARD OF MEDICAL EXAMINERS POLICY STATEMENT OFFICE-BASED TREATMENT OF OPIOID ADDICTION
TENNESSEE BOARD OF MEDICAL EXAMINERS POLICY STATEMENT OFFICE-BASED TREATMENT OF OPIOID ADDICTION The Tennessee Board of Medical Examiners has reviewed the Model Policy Guidelines for Opioid Addiction Treatment
More informationPatients are still addicted Buprenorphine is simply a substitute for heroin or
BUPRENORPHINE TREATMENT: A Training For Multidisciplinary Addiction Professionals Module VI: Myths About the Use of Medication in Recovery Patients are still addicted Buprenorphine is simply a substitute
More informationTreatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction [NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call
More informationST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;03/13;06/14;07/15
ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;/13;06/14;07/15 WRITTEN BY Jim Johnson Page 1 REVISED BY AUTHORIZED BY Jessica Moeller Debra Johnson I. APPLICATION: THUMB
More informationUse of Pharmacotherapies by Substance Abuse Treatment Facilities
Use of Pharmacotherapies by Substance Abuse Treatment Facilities Cathie E. Alderks, PhD Substance Abuse and Mental Health Services Administration Department of Health and Human Services November 2007 1
More informationPhysician Information. Answers to Frequently Asked Questions
Page 31 Physician Information Answers to Frequently Asked Questions Who is qualified to prescribe SUBOXONE or SUBUTEX? Physicians who: Meet one or more of the following training requirements Hold a subspecialty
More informationThe CCB Science 2 Service Distance Learning Program
S2S 2055 DETOXIFICATION Module 1 Post-Test 1. A common use of a biochemical marker is. a. to support or refute other information that leads to proper diagnosis b. for forensic purposes c. in detecting
More informationSubstance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates
Substance Abuse During Pregnancy: Moms on Meds Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates 2010 National Survey on Drug Use and Health An estimated 4.4% of pregnant women reported
More informationPsychiatric Residential Treatment Facility (PRTF): Aligning Care Efficiencies with Effective Treatment. BHM Healthcare Solutions 2013 1
Psychiatric Residential Treatment Facility (PRTF): Aligning Care Efficiencies with Effective Treatment 1 Presentation Objectives Attendees will have a thorough understanding of Psychiatric Residential
More informationOhio Legislative Service Commission
Ohio Legislative Service Commission Bill Analysis Brian D. Malachowsky H.B. 378 130th General Assembly () Reps. Smith and Sprague BILL SUMMARY Prohibits a physician from prescribing or personally furnishing
More informationOpioid Dependence Treatment with Buprenorphine/Naloxone: An Overview for Pharmacists and Physicians
Opioid Dependence Treatment with Buprenorphine/Naloxone: An Overview for Pharmacists and Physicians Phyllis A. Grauer, PharmD, CGP, CPE Clinical Pharmacist Legislation Passed Enabling Office Based Treatment
More informationBUPRENORPHINE: A GUIDE FOR NURSES
BUPRENORPHINE: A GUIDE FOR NURSES Technical Assistance Publication (TAP) Series 30 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance
More informationMagee-Womens Hospital
Magee-Womens Hospital Magee Pregnancy Recovery Program: History Pregnancy Recovery Center A Medical Home Model Approach to Strengthen Families Bawn Maguire, MSN, RN Programmatic Nurse Specialist Stephanie
More informationIN THE GENERAL ASSEMBLY STATE OF. Ensuring Access to Medication Assisted Treatment Act
IN THE GENERAL ASSEMBLY STATE OF Ensuring Access to Medication Assisted Treatment Act 1 Be it enacted by the People of the State of Assembly:, represented in the General 1 1 1 1 Section 1. Title. This
More informationTreatment Approaches for Drug Addiction
Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call 1-800-662-HELP(4357)
More informationBest Practices in Opioid Dependence Treatment
Best Practices in Opioid Dependence Treatment Anthony L. Jordan Health Center Linda Clark, MD, MS Medical Director Alana Ramos, BS Suboxone Clinic Manager Case Studies Nicole White female 27 years of age
More informationSUBOXONE /VIVITROL WEBINAR. Educational Training tool concerning the Non-Methadone Medication Assisted Treatment Policy that is Effective on 1/1/12
SUBOXONE /VIVITROL WEBINAR Educational Training tool concerning the Non-Methadone Medication Assisted Treatment Policy that is Effective on 1/1/12 WEBINAR INTRODUCTIONS Cynthia Parsons- Program Manager
More informationBUPRENORPHINE: A GUIDE FOR NURSES
BUPRENORPHINE: A GUIDE FOR NURSES Technical Assistance Publication (TAP) Series 30 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance
More informationAddiction Psychiatry Fellowship Rotation Goals & Objectives
Addiction Psychiatry Fellowship Rotation Goals & Objectives Table of Contents University Neuropsychiatric Institute (UNI) Training Site 2 Inpatient addiction psychiatry rotation.....2 Outpatient addiction
More informationTriage, Assessment & Treatment Methadone 101/Hospitalist Workshop
Triage, Assessment & Treatment Methadone 101/Hospitalist Workshop Launette Rieb, MSc, MD, CCFP, FCFP Clinical Associate Professor, Dept. Family Practice UBC American Board of Addiction Medicine Certified
More informationMAT Disclosures & Consents 1 of 6. Authorization & Disclosure
MAT Disclosures & Consents 1 of 6 Authorization & Disclosure ***YOUR INSURANCE MAY NOT PAY FOR ROUTINE SCREENING*** *** APPROPRIATE SCREENING DIAGNOSES MUST BE PROVIDED WHEN INDICATED*** Urine Drug Test
More informationDRUG AND ALCOHOL DETOXIFICATION: A GUIDE TO OUR SERVICES
01736 850006 www.bosencefarm.co.uk DRUG AND ALCOHOL DETOXIFICATION: A GUIDE TO OUR SERVICES An environment for change Boswyns provides medically-led drug and alcohol assessment, detoxification and stabilisation.
More informationBUPRENORPHINE TREATMENT
BUPRENORPHINE TREATMENT Curriculum Infusion Package (CIP) Based on the Work of Dr. Thomas Freese of the Pacific Southwest ATTC Drug Addiction Treatment Act of 2000 (DATA 2000) Developed by Mountain West
More informationMEDICAL POLICY Treatment of Opioid Dependence
POLICY........ PG-0313 EFFECTIVE......11/11/14 LAST REVIEW... 07/14/15 MEDICAL POLICY Treatment of Opioid Dependence GUIDELINES This policy does not certify benefits or authorization of benefits, which
More informationTREATMENT MODALITIES. May, 2013
TREATMENT MODALITIES May, 2013 Treatment Modalities New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) regulates the addiction treatment modalities offered in New York State.
More informationSubstance Abuse lifestyle Concern for mother - fetus - and - neonate
OBJECTIVES Learn about types of opioids and associated withdrawal symptoms Learn what medications are available to treat opioid addiction Understand the pros and cons associated with each medication Understand
More informationANCILLARY STABILIZATION AND WITHDRAWAL. The Why And How Of Stabilizing The Patient In A Comprehensive Treatment Setting
ANCILLARY STABILIZATION AND WITHDRAWAL The Why And How Of Stabilizing The Patient In A Comprehensive Treatment Setting About CASAColumbia A science-based, multidisciplinary organization Focused on transforming
More informationThe ABCs of Medication Assisted Treatment
The ABCs of Medication Assisted Treatment J E F F R E Y Q U A M M E, E X E C U T I V E D I R E C T O R C O N N E C T I C U T C E R T I F I C A T I O N B O A R D The ABCs of Medication Assisted Treatment
More informationQuick Guide. For Clinicians. Based on TIP 43 Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs
Quick Guide For Clinicians Based on TIP 43 Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs Medication- Assisted Treatment Contents Why a Quick Guide?....................2
More informationINSTRUCTIONS AND PROTOCOLS FOR THE IMPLEMENTATION OF MEDICATION-ASSISTED TREATMENT FOR OPIOID/OPIATE DEPENDENCE
201 Mulholland Bay City, MI 48708 P 989-497-1344 F 989-497-1348 www.riverhaven-ca.org Title: MAT Protocol Original Date: March 30, 2009 Latest Revision Date: December 16, 2013 Approval/Release Date: January
More informationTufts Health Care Institute Program on Opioid Risk Management Pharmacotherapy for Prescription Opioid Addiction: Implications for Pain Management
Tufts Health Care Institute Program on Opioid Risk Management Pharmacotherapy for Prescription Opioid Addiction: Implications for Pain Management June 10 and 11, 2011 Executive Summary Introduction Opioid
More informationNew Haven/Fairfield Counties Ryan White Part A Program Substance Abuse Service Standard SUBSTANCE ABUSE
I. DEFINITION OF SERVICE New Haven/Fairfield Counties Ryan White Part A Program Substance Abuse Service Standard SUBSTANCE ABUSE CORE MEDICAL SERVICE Support for Substance Abuse Treatment Services-Outpatient,
More informationHulpverleningsmodellen bij opiaatverslaving. Frieda Matthys 6 juni 2013
Hulpverleningsmodellen bij opiaatverslaving Frieda Matthys 6 juni 2013 Prevalence The average prevalence of problem opioid use among adults (15 64) is estimated at 0.41%, the equivalent of 1.4 million
More informationDeveloping Medications to Treat Addiction: Implications for Policy and Practice. Nora D. Volkow, M.D. Director National Institute on Drug Abuse
Developing Medications to Treat Addiction: Implications for Policy and Practice Nora D. Volkow, M.D. Director National Institute on Drug Abuse Medications Currently Available For Nicotine Addiction Nicotine
More informationFrom the street to the NICU. Richard Christensen, PA, CAS
From the street to the NICU Richard Christensen, PA, CAS Treatment works Truths Disconnect with pregnant women seeking treatment Disconnect between community and science Medication is not a stand-alone
More informationMEDICALLY SUPERVISED OPIATE WITHDRAWAL FOR THE DEPENDENT PATIENT. An Outpatient Model
MEDICALLY SUPERVISED OPIATE WITHDRAWAL FOR THE DEPENDENT PATIENT An Outpatient Model OBJECTIVE TO PRESENT A PROTOCOL FOR THE EVALUATION AND TREATMENT OF PATIENTS WHO ARE CHEMICALLY DEPENDENT ON OR SEVERLY
More informationMAT Counselor Education Course Exam Questions Packet Part 1
MAT Counselor Education Course Exam Questions Packet Part 1 Course No: Course Title: Course Objective: MA-1901P1 Medication-Assisted Treatment (MAT) Counselor Education Course Part 1 Includes primer on
More informationBuprenorphine Therapy in Addiction Treatment
Buprenorphine Therapy in Addiction Treatment Ken Roy, MD, FASAM Addiction Recovery Resources, Inc. River Oaks Hospital Tulane Department of Psychiatry www.arrno.org Like Minded Doc What is MAT? Definition
More informationVarious therapies are used in the
National Survey of Substance Abuse Treatment Services The N-SSATS Report January 28, 2010 Overview of Opioid Treatment Programs within the United States: 2008 In Brief In 2008, a total of 1,132 (8 of all
More informationSuboxone Programs: Treating Opioid Dependence in CHCs Andrew Putney, MD Medical Director SSTAR ATS and CHC, Fall River, Massachusetts
Suboxone Programs: Treating Opioid Dependence in CHCs Andrew Putney, MD Medical Director SSTAR ATS and CHC, Fall River, Massachusetts Educational Objectives: Review epidemiology of opioid addiction in
More informationNon medical use of prescription medicines existing WHO advice
Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations
More informationIdentifying and Managing Substance Use During Pregnancy
Identifying and Managing Substance Use During Pregnancy Joseph B. Landwehr, Jr., MD Director, Perinatal Center IU Health Ball Memorial Hospital OBJECTIVES Overview of illicit drug use in pregnant women
More informationARCHIVED BULLETIN. Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E
BULLETIN INTELLIGENCE Product No. 2004-L0424-013 SEPTEMBER 2004 U. S. D E P A R T M E N T O F J U S T I C E NDIC Within the past 2 years buprenorphine a Schedule III drug has been made available for use
More informationTriage, Assessment & Treatment
Triage, Assessment & Treatment Launette Rieb, MSc, MD, CCFP, FCFP, dip ABAM Clinical Associate Professor, Dept. Family Practice, UBC Physician Director, St. Paul's Hospital Goldcorp Addiction Medicine
More informationUsing Drugs to Treat Drug Addiction How it works and why it makes sense
Using Drugs to Treat Drug Addiction How it works and why it makes sense Jeff Baxter, MD University of Massachusetts Medical School May 17, 2011 Objectives Biological basis of addiction Is addiction a chronic
More informationOVERVIEW OF MEDICATION ASSISTED TREATMENT
Sarah Akerman MD Assistant Professor of Psychiatry Director of Addiction Services Geisel School of Medicine/Dartmouth-Hitchcock Medical Center OVERVIEW OF MEDICATION ASSISTED TREATMENT Conflicts of Interest
More informationJoel Millard, DSW, LCSW Dave Felt, LCSW
Joel Millard, DSW, LCSW Dave Felt, LCSW 1. Provide an overview of the effectiveness of medication assisted treatment, to include a discussion of the different types of medications and how they are used
More informationDosing Guide. For Optimal Management of Opioid Dependence
Dosing Guide For Optimal Management of Opioid Dependence KEY POINTS The goal of induction is to safely suppress opioid withdrawal as rapidly as possible with adequate doses of Suboxone (buprenorphine HCl/naloxone
More informationAugust 2011. A. Introduction
Recommendations of the Expert Group on the Regulatory Framework for products containing buprenorphine / naloxone and buprenorphine-only for the treatment of opioid dependence August 2011 A. Introduction
More informationGuidance for Disease Management in Correctional Settings OPIOID DETOXIFICATION
1145 W. Diversey Pkwy. 773-880-1460 Chicago, Illinois 60614 www.ncchc.org Guidance for Disease Management in Correctional Settings OPIOID DETOXIFICATION NCCHC issues guidance to assist correctional health
More informationACUTE TREATMENT SERVICES (ATS) FOR SUBSTANCE USE DISORDERS LEVEL III.7
ACUTE TREATMENT SERVICES (ATS) FOR SUBSTANCE USE DISORDERS LEVEL III.7 Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance
More informationHow To Know If You Can Get Help For An Addiction
2014 FLORIDA SUBSTANCE ABUSE LEVEL OF CARE CLINICAL CRITERIA SUBSTANCE ABUSE LEVEL OF CARE CLINICAL CRITERIA Overview Psychcare strives to provide quality care in the least restrictive environment. An
More informationOpiate Abuse and Mental Illness
visited on Page 1 of 5 LEARN MORE (HTTP://WWW.NAMI.ORG/LEARN-MORE) FIND SUPPORT (HTTP://WWW.NAMI.ORG/FIND-SUPPORT) GET INVOLVED (HTTP://WWW.NAMI.ORG/GET-INVOLVED) DONATE (HTTPS://NAMI360.NAMI.ORG/EWEB/DYNAMICPAGE.ASPX?
More informationOpioids Research to Practice
Opioids Research to Practice CRIT Program May 2011 Daniel P. Alford, MD, MPH Associate Professor of Medicine Boston University School of Medicine Boston Medical Center 32 yo female brought in after heroin
More informationJoanna L. Starrels. 2 ND YEAR RESEARCH ELECTIVE RESIDENT S JOURNAL Volume VIII, 2003-2004. A. Study Purpose and Rationale
Outpatient Treatment of Opiate Dependence with Sublingual Buprenorphine/Naloxone versus Methadone Maintenance: a Randomized Trial of Alternative Treatments in Real Life Settings Joanna L. Starrels A. Study
More informationPatient Information and Consent to Treatment with Buprenorphine
1063 Lower Main St, Ste C212 JEFFREY H. CHESTER, DO Phone 808.249.8887-6006 www.ponohealthcare.com Board Certified by American Board of Physical Medicine & Rehabilitation Board Certified by American Society
More informationKarol Kaltenbach, PhD Maternal Addiction Treatment Education and. Jefferson Medical College Thomas Jefferson University
Benzodiazepines and the Pregnant Patient: Special Challenges Karol Kaltenbach, PhD Maternal Addiction Treatment Education and Research Jefferson Medical College Thomas Jefferson University Outline Introduction
More informationMEDICAL POLICY SUBJECT: OPIOID ADDICTION TREATMENT. POLICY NUMBER: 3.01.04 CATEGORY: Behavioral Health
MEDICAL POLICY SUBJECT: OPIOID ADDICTION TREATMENT PAGE: 1 OF: 6 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical
More information