MOUD in Other Settings

Guidance

• ED OUD Treatment Playbook: Includes resources on how to treat OUD in ED and implementing organizational change
• American Academy of Emergency Medicine (AAEM) White Paper: A white paper on management of OUD in ED. Includes medication initiation and considerations of patient morbidities and other factors.
• AAEM Toolkit for Managing OUD in ED (American College of Emergency Physicians (ACEP)): The Emergency Department Toolkit for Managing Patients with Opioid Use Disorder
• ACEP Information Paper: Discussion of transitions of care models for OUD patients from ED to outpatient settings. Includes suggestions for staffing model to coordinate transitions.
• ACEP: Models for Addressing Transitions of Care for Patients with Opioid Use Disorder: An Information Paper (American College of Emergency Physicians (ACEP)): Discussion of transitions of care models for OUD patients from ED to outpatient settings. Includes suggestions for staffing model to coordinate transitions.
• ACEP ED Naloxone Distribution: Key Considerations and Implementation Strategies (American College of Emergency Physicians (ACEP))
• TIP 63: Medications for Opioid Use Disorder – Executive Summary & Full Document: Guideline for Treatment of Opioid Use Disorder that includes topics on screening, assessment, diagnosis and management, follow up and referral. Includes guidance for MAT management in ED and inpatient settings.
  • Executive Summary
  • Full Guideline
• How to Pay for It: MAT in the Emergency Department: FAQ (California Health Care Foundation (CHCF))

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Substance Use Navigators/Peer Support

• Peers (Substance Abuse and Mental Health Services (SAMHSA))
• Substance Use Navigators: The SUN is a hospital employee embedded within either an emergency department or an inpatient setting to help patients begin and remain in addiction treatment.
• Christiana Care Health’s Project Engage: Program that screens ED patients who exhibit signs of a substance use disorder, and asks them if they would like to talk to a peer counsellor about the problem; if they say yes, the counsellor works with a hospital social worker to connect patients with community resources that put them on the path to recovery.
• A Qualitative Study on Peer Support Workers: A study from National Council on engaging individuals surviving opioid overdoses (Peer Support Workers) in Emergency Departments

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Examples of ED OUD Programs

Minnesota Programs

• North Memorial
• Allina
• HealthPartners
• North Memorial Health
  

National Programs

• Project ASSERT: To improve Alcohol & Substance Use Disorder Services, Education and Referral to Treatment (Boston Medical Center): Project ASSERT was the first nationally published program in an ED to deploy peer counselors/educators as motivators and navigators to identify and intervene with patients with unhealthy alcohol and drug use. The Project ASSERT team of outreach workers provided the “in-reach” that the ED staff needed to bridge the gap between what patients needed and what they had the capacity to provide.
• Christiana Care Health’s Project Engage (American Hospital Association (AHA)): Program that screens ED patients who exhibit signs of a substance use disorder, and asks them if they would like to talk to a peer counsellor about the problem; if they say yes, the counsellor works with a hospital social worker to connect patients with community resources that put them on the path to recovery.
• Emergency Care for the Opioid Epidemic: Leaders Discuss Medication-Assisted Treatment in the ED (California Health Care Foundation (CHCF)): CA focused, but may be helpful to others to understand what’s needed to implement

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Guidance

• Blueprint for Acute Care Hospital use of Buprenorphine
• Blueprint for Hospital Opioid Use Disorder Treatment (CA Bridge): This tool provides step-by-step guidance on how to set up a MAT program in an acute care hospital. Originally implemented in California.
• Hospital Reimbursement (Inpatient Settings): A resource on how to get reimbursed for MAT services in acute inpatient settings
• Hospitalized Patients and OUD Treatment: Discussion of policy and practice to expand opportunities to engage patients with OUDs in opioid agonist treatment during their inpatient hospitalizations.
• Expanding Treatment Opportunities for Hospitalized Patients with Opioid Use Disorders (Winetsky et al. J. Hosp. Med. 2018 January;13(1):62-64.): Discussion of policy and practice to expand opportunities to engage patients with OUDs in opioid agonist treatment during their inpatient hospitalizations.
• How to Pay for It: MAT for Hospitalized Patients (California Health Care Foundation (CHCF)): A resource on how to get reimbursed for MAT services in acute inpatient settings

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Substance Use Navigators

• Guide: Hiring a Substance Use Navigator (CA Bridge)
• Substance Use Navigator (SUN) – Frequently Asked Questions (CA Bridge): FAQs on SUN credentials, legal implications, etc.
• Substance Use Navigator (SUN) and Prescriptions – Frequently Asked Questions (CA Bridge): FAQs on SUNs and prescriptions. Includes example scenarios.
• Guide: SUN & Clinician Champion Collaboration (CA Bridge)

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Examples of Hospital OUD Programs

• Support for Hospital Opioid Use Treatment (Project SHOUT) (California Health Care Foundation (CHCF)): Project SHOUT helps hospitals start buprenorphine and methadone during ED visits and inpatient hospitalizations.

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Guidance

• Treatment of Opioid Use Disorder in Correctional Settings Guideline – June 2020 (American Society of Addiction Medicine (ASAM))
• Treatment in Correctional Settings Toolkit (American Society of Addiction Medicine (ASAM))
• Medication-Assisted Treatment for Opioid Use Disorder in Jail and Prisons: A Planning and Implementation Toolkit (Vital Strategies/National Council for Behavioral Health)
• Jail-Based Medication-Assisted Treatment: Promising Practices Guidelines and Resources for the Field – 2018 (National Sheriff’s Association)
• Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings – April 2019 (Substance Abuse and Mental Health Services Administration (SAMSHA))
• Best Practices for Successful Reentry for People Who Have Opioid Addictions – November 2018 (National Re-entry Resource Center)
• Opioid Addiction and the Criminal Justice System Webinars (National Re-entry Resource Center)
• Care for Patients with Opioid Use Disorder Who Are in Custody (CA Bridge)
• Opioid Treatment FAQs (National Commission on Correctional Health Care)

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Examples of MAT Programs in Corrections

• Strategies for Connecting Justice Involved Populations to Substance Use Disorder Treatment (Webinar & Audio) (Medicaid Innovation Accelerator Program (IAP))
  • Webinar
  • Audio
• Opioid Addiction Treatment in Jail (Healthcare Resource Centers (HCRC))
• Opioid Use Disorder Treatment in Jails and Prisons (Pew Trusts)
• Medication-Assisted Treatment in Correctional Settings (California Health Care Foundation (CHCF))
• Responding to the Opioid Overdose Epidemic (Maryland Department of Public Safety and Correctional Services)
• Safe Withdrawal in Jail Settings Preventing Deaths, Reducing Risk to Counties and States (The Center for Health and Justice is a division of TASC, Inc.)

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