opioidlibrary.caronova.orgOnline Library for Opioid Stewardship - CaroNova Opioid Library

Library Created By: Online Library for Opioid Stewardship Technical Assistance Data Dashboard Events About Technical Assistance Data Dashboard Events About Online Library for Opioid Stewardship Welcome CaroNova’s Online Library for Opioid Stewardship is a compilation of best practice tools and resources that have been assembled by a team of subject matter experts from across North and South Carolina. It is intended to be used by healthcare professionals for the prevention, intervention, and treatment of opioid use disorder. These resources may not be duplicated, sold, or used for profit in any way without direct permission from the author. Addressing Stigma Stigma is a range of negative attitudes, beliefs and behaviors that are associated with certain conditions such as addiction. Studies have shown that stigma can hinder access to appropriate Substance Use Disorder (SUD) treatment. Strategies Stigma reduction strategies include: Using person-centered language Emphasizing societal vs. individual causes of addiction Incorporating solution messages Using sympathetic narratives Emphasizing that effective treatment exists Contact-based training and education programs targeting medical students and professionals Sources National Academies of Science, Engineering, and Medicine; Guiding Principles for Addressing the Stigma on Opioid Addiction ; The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review Explore A Caring Culture in Healthcare Read More Addiction Neuroscience 101 Read More How Addiction Hijacks the Brain Read More Words Matter – Terms to Use and Avoid When Talking About Addiction Read More Alternatives to Opioids Alternatives to opioids include non-opioid medications and non-pharmacologic approaches to managing pain. Strategies According to the CDC’s 2022 Clinical Practice Guideline for Prescribing Opioids for Pain :​ Nonopioid therapies are at least as effective as opioids for many common types of acute pain​. Nonopioid therapies are preferred for subacute and chronic pain​. There are options for noninvasive nonpharmacologic approaches and nonopioid medications for Acute, Subacute, and Chronic Pain​. Opioid therapy is indicated in some circumstances, as described in the guidelines. Explore Best Practices for Back Pain Read More CDC Clinical Practice Guideline for Prescribing Opioids for Pain Read More Opioid Tapering: Patient Education Video Read More Patient Education & Prevention Read More TIP SC Non-Drug Strategies for Non-Cancer Acute and Chronic Pain Read More Connections to Care Experts in the Carolinas emphasize the importance of care coordination, warm handoffs, and connections to care for individuals with opioid use disorder. According to the CDC , "People with SUDs [Substance Use Disorders] often have concurrent medical or behavioral health conditions involving complex medical histories that can require the expertise of clinicians from across various specialties. Care coordination is particularly important for patients to ensure that all their medical needs are met while they are being treated for one or more SUDs." Strategies Individuals with opioid use disorder need connections to ongoing SUD treatments that support their recovery. Practices that can contribute to success include engaging peer support specialists; working with family and friends; prescribing naloxone; health system/community collaboration; and leveraging telehealth. Although care coordination models vary widely, common elements include an individualized plan of care with a lead provider, discharge planning from a hospital visit, continual data-sharing, and education for both providers and patients. Sources CDC Care Coordination in Treatment of Substance Use Disorders Care Coordination Strategies for Patients Can Improve Substance Use Disorder Outcomes Explore Buprenorphine Treatment Locator Read More ED Peer Support Implementation Guide Read More Implementation of a Telemedicine Program for MOUD Read More Innovations in Telehealth in Mental Health and Substance Use During COVID-19 Read More SAMHSA Treatment Locator Read More SC DAODAS Treatment Locator Read More The Project Lazarus Model Read More Harm Reduction In South Carolina, opioid-involved overdose deaths rose from 876 in 2019 to 1,400 in 2020. In North Carolina, overdose deaths (all medications and drugs) rose from 3,304 in 2020 to 4,041 in 2021. Harm reduction is an approach to preventing drug-related deaths that emphasizes engaging directly with people who use drugs to prevent overdose and infectious disease transmission, improve the physical, mental, and social wellbeing of those served, and offer low-threshold options for accessing substance use disorder treatment and other health care services (SAMHSA). Strategies Harm reduction strategies include overdose education, counseling and referrals to treatment for infectious disease and SUD; naloxone; syringe services programs; testing drugs with fentanyl test strips ; and stigma reduction. Strategies Harm reduction strategies include: Overdose education, counseling and referrals to treatment for infectious disease and SUD Distribution of opioid reversal medications (e.g., naloxone) Syringe services programs that promote the use of new or sterile injection equipment for each injection Reducing the stigma associated with substance use Sources: SC DHEC; NC DHHS; SAMHSA Explore How to Use a Naloxone Kit in the Event of an Overdose (NC) Read More Narcan Instructional Video (SC) Read More National Harm Reduction Coalition- Harm Reduction Resources Near You Read More North Carolina Naloxone Distribution Toolkit Read More North Carolina’s Syringe Services Program Listing Read More Reducing Harms from Injection Drug Use & OUD with Syringe Services Programs Read More SC Community Naloxone Distributors Read More South Carolina Naloxone Distribution Information Read More Health Equity U.S. drug overdose data show troubling trends and widening disparities between different groups. Strategies To help reduce disparities and improve equity, SAMHSA recommends the following community-informed strategies (in addition to standard treatments such as MAT/MOUD and naloxone): Implement a comprehensive, holistic approach Involve the community and develop multi-sectoral, diverse community partnerships Increase culturally relevant public awareness Employ culturally specific engagement strategies Create a culturally relevant and diverse workforce Source: The Opioid Crisis and the Black/African American Population: An Urgent Issue Explore Drug Overdose Deaths Rise, Disparities Widen Read More Healthcare Access and Quality as a Social Determinant of Addiction (Webinar) Read More The Opioid Crisis and the Black/African American Population: An Urgent Issue Read More Medications for Opioid Use Disorder (MOUD) MOUD (such as buprenorphine) is an evidence-based treatment for OUD, yet 30% of U.S. counties don’t have any clinicians who can prescribe buprenorphine. Strategies Access to MOUD can be improved by initiating it in hospitals and other settings, such as primary care and outpatient settings. The removal of the federal X-Waiver requirement means that all practitioners who have a current DEA registration that includes Schedule III authority may now prescribe buprenorphine for Opioid Use Disorder in their practice if permitted by applicable state law. Sources: Gaps in NC addiction treatment disproportionately hit rural residents of color ; Evidence-Based Strategies for Preventing Overdose Explore Academic Detailing Brochure: Emergency Department (ED) Initiated Buprenorphine & Referral to Treatment Read More ASAM National Practice Guideline – 2020 Updated Treatment Guideline for OUD Read More Blueprint for Hospital Opioid Use Disorder Treatment Read More Buprenorphine Algorithm/Workflow Read More Buprenorphine Use in the Emergency Department Tool Read More Discharge and Treatment Referral: A Guide for Patients Beginning Buprenorphine...