MOUD Resources

APU Learning Community Webinars
Title: Nurse Practitioner Best Practices: Overdose Prevention, Narcan, and Harm Reduction
Description: This training gives critical knowledge and confidence to effectively respond to an overdose in public or in a workplace setting. This training addresses ways that NPs and other medical professionals can utilize harm-reduction and overdose prevention techniques, specifically Narcan induction, in their practice. Participants can expect to learn tools they can use themselves, as well as teach to their patients with opioid use disorders or who are at-risk for substance use or misuse.
Click here to view training webinar

If you work with Youth Populations Visit:
Youth System of Care team that puts on clinical trainings for youth providers. https://youthsystemofcare.publichealthcloud.com/www/lms/default.aspx

If you work with Substance Using Populations Visit:
Los Angeles County Department of Public Health Substance Abuse Prevention & Control –SAPC – provides monthly trainings on topics related co-occurring disorders and specialty system standards. Visit the SAPC training Calendar for list of active trainings available: http://publichealth.lacounty.gov/phcommon/public/cal/index.cfm?unit=sapc&prog=pho&ou=ph&cal_id=24

APPLYING FOR A PRACTITIONER WAIVER

Learn more on the SAMHSA website how to apply for a practitioner waiver to prescribe or dispense buprenorphine under the Drug Addiction Treatment Act of 2000 (DATA 2000).
- Qualified practitioners include physicians, Nurse Practitioners (NPs), Physician Assistants (PAs), Clinical Nurse Specialists (CNSs), Certified Registered Nurse Anesthetist (CRNAs), and Certified Nurse-Midwifes (CNMs).

MAT RESOURCES
LA County MAT Resources

Los Angeles county provides a resource library that provides useful information for both providers and patients interested in knowing more about MAT Treatment. For providers the focus is to supply them with information needed for the expansion of MAT programs for those struggling with addictive disorders. For patients, the focus is on educating them on the benefits and options surrounding MAT treatment.
Safe Med LA is a coalition made up of the LA County Department of Public Health and numerous other Healthcare Organizations and Providers throughout Los Angeles. View their website to find resources, events, and learn about their strategic plan to reduce drug-related deaths in Los Angeles County.

California Hub & Spoke System

The website explains the Hub & Spoke model in a clear and easy to understand way. It also describes the importance of learning collaboratives within the model, and provides links to resources for further research on the H&SS.This site also includes profiles of the different H&SS sites.
For those who are looking for an Opiod Treatment options near them, a useful tool is the Opioid Treatment Program Directory

Webinars and Courses

Brown University's On-Demand Courses cover "Translating Buprenorphine Training into Practice". Use these courses to learn more about specific applications of the information learned in your MAT Waiver Trainings. CEU credits are available.
Northeast Ohio Medical University's YouTube Channel is part of the Ohio Opiate ECHO (Extension for Community Healthcare Outcomes) system. Over 94 recorded webinars are available on topics including: the pharmacology of MAT medications, motivational interviewing and stages of change, difficult cases and unexpected challenges, provider burnout, and more!

MOUD PRACTICE MANUALS/GUIDES
SUMMIT Study Implementation Manual:

This 2017 resource includes the procedures for providing brief interventions, screenings, and Opioid & Alcohol Use Disorder treatment services in the primary care setting. It should be helpful for those looking to better understand the implementation of integrated collaborative care for OAUD treatment in the primary carer setting. Learn more here.

National Practice Guideline for the Treatment of Opioid Use Disorders

The American Society of Addiction Medicine created this updated ASAM guide to give information on updated EBT’s for opioid use disorder. This version is intended to replace the information provided in the 2015 version. The intended audience of this document is healthcare providers and educators working with Opioid Disorder treatment (healthcare educators, healthcare professionals in training, clinical care managers, etc.). This resource includes information on a wide variety of topics, ranging from Assessment & Diagnosis of OUDs to treatment for those in the criminal justice system.

An Organizational Readiness Intervention and Randomized Controlled Trial to Test Strategies for Implementing Substance Use Disorder Treatment Into Primary Care.

A 2015 study examines the gaps in health care service for those with SUDs. Some of these barriers include the need for greater access to treatment, and increased uptake of Evidence Based Practices in primary care settings. The study focuses on increasing organization preparedness for implementing and sustaining EBPs. Find more information on this study here.

Assessing and improving organizational readiness to implement substance use disorder treatment in primary care: findings from the SUMMIT study

A 2017 research study focused on assessing organizational readiness through the use of pre- and post- intervention surveys with prescribing medical providers, behavioral health providers and general clinic staff. The research showed that the “organizational readiness implementation intervention” was helpful for “practice acceptability and appropriateness.”

SBIRT Pocket Guide (via Advanced Practice Nurses Association and Opioid Response Network)

This pocket guide provides a brief screening and referral guideline for nurses as well as national resources to provide patients.

Medications for Opioid Use Disorder For Healthcare and Addiction Professionals, Policymakers, Patients, and Families

This guide contains an overview of methadone, naltrexone, and buprenorphine as well as providing an overview of several others strategies and services for MAT recovery support. It provides information on the medications, on addressing OUDs in the general medical setting, coordination of counselors with clients and health care professionals, and provides resources for OUDs. Learn more about this guide here.

OPIOID USE DISORDER TREATMENT IN SPECIAL SETTINGS
Organizational factors associated with practitioners' support for treatment of opioid use disorder in the emergency department.

If you are looking to learn more about organizational readiness for MAT in the emergency department, this paper is a good place to start. The results of this study showed that physicians were less inclined to support MAT services and other practices for OUD treatment in the emergency department. Despite this, physicians have less bias against patients suffering from an OUD than nurses. The study also found that the emergency department’s support for MAT was positively associated with the ED’s climate for innovation and practitioners' openness to change.

SUMMIT Study MAT Manual:

This SUMMIT guide for MAT suggests approaches for dialogues about OAUD’s between primary care providers and their patients. It also includes a guide to patients with alcohol-dependence in primary care settings. Lastly, it includes a guide for practitioners who administer buprenorphine/naloxone to patients OUDs.

National Practice Guideline for the Treatment of Opioid Use Disorders

The American Society of Addiction Medicine (ASAM) created this updated guide to give information on updated EBT’s for opioid use disorder. This version is intended to replace the information provided in the 2015 version. The intended audience of this document is healthcare providers and educators working with Opioid Disorder treatment (healthcare educators, healthcare professionals in training, clinical care managers, etc.). This resource includes information on a wide variety of topics, ranging from Assessment & Diagnosis of OUDs to treatment for those in the criminal justice system. Learn more about these resources here.

Medication-Assisted Treatment for Opioid Use Disorder in Jails and Prisons

This toolkit highlights the concern that many people in the correctional system are involved with substance abuse and those needs are not being met. This toolkit provides professionals in the correctional administration field and healthcare professionals with beneficial information for strategically implementing MAT programs in jails and prisons. In this toolkit readers will find various resources for implementation, including action steps, questions to consider before implementation, case examples, and other helpful tools.

Caring for Women with Opioid Use Disorder: A Toolkit for Organization Leaders and Providers

This toolkit from the Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) addresses special considerations for treating women with opioid use disorders. Topics include statistics and background on this population, tools for treatment, and considerations for both providers and organization leaders to shift the culture around addiction and treatment as well as to develop strong community resources and partnerships.

EXPLORING BARRIERS in MOUD TREATMENT
Sustaining OAUD Treatment in Primary Care Paper:

The purpose of this study was to better understand the factors that affect a primary care settings’ ability to provide and sustain treatment delivery for substance use. The results of this multi-year implementation intervention revealed that participants perceived gaining access to external funding, training, and staff support as major barriers to treatment and continually sustaining care. Learn more about the barriers to providing substance use treatment delivery in a primary care setting here.

Barriers to Implementing OAUD:

The purpose of this study was to look at perceived barriers to executing OAUD care in community-based primary care organizations. The study examined preparation for implementation, early implementation, and implementation at full capacity. According to the study many of the barriers decreased as time continued, and participants felt better able to deliver OAUD treatment successfully. The five barriers the study focused on was reimbursement for services, funding for medications, funding additional staff, insurance authorization, and funding stability. You can learn more about these barriers to implementing treatment here.

APU LEARNING COMMUNITY WEBINARS
Watch recordings of 3 Learning Community Webinars held in Fall/Winter 2020:

"A Brief Overview of Opioid Use Disorders (OUD) and Implementation of Medications for Addiction Treatment (MAT) in Nursing Settings" presented by Dr. Sherry Larkins, PhD, and Kendall Darfler, MS.
"Medications for Opioid Use Disorders Implementation: Initiation, Induction, & Follow-Up Visits” presented by Dr. Brian Hurley, MD, MBA, DFASAM.
“Medications for Opioid Use Disorders Implementation: Clinically Challenging Visits and Cases” presented by Dr. Matthew A. Torrington, MD.