During our March Friday Focus 4 Health Series, we have talked a lot about strategies for opioid misuse and best practices. We have touched on how easy it is for someone to become dependent on these medications and have accidental overdoses. Our team has also provided education on reversing those accidental overdoses. But what can we do to help someone who is dependent on opioids and no longer wants to be?
Medication Assisted Therapy. This was the topic of our March 24 session. If you missed it, you can access the recording, presentation slides and resources document on our Friday Focus 4 Health page.
Medication Assisted Therapy, also known as MAT, is the use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery.
Carolyne Tufte, LPN, Quality Improvement Advisor with Great Plains QIN, led the conversation. She shared how any facility can begin a MAT program if desired; there is no certification to do so.
Tufte introduced the toolkit, Practical Tools for Prescribing and Promoting Buprenorphine in Primary Care Settings, which was developed by the Substance Abuse and Mental Health Services Administration (SAMHSA). It provide step-by-step guidance for implementation, including dosing guidelines and best practices. The toolkit also includes intake forms for nurses, telephone screening forms, social needs tool and print outs of the DSM diagnostic criteria for overuse disorder.
Tufte also shared guides for those wanting to review and update existing processes as well as medication options that are safe to take while participating in a MAT program to best manage withdrawal symptoms.
Community Resources: Any individual whether for professional or personal use, could utilize these resources to find a professional who could help with an opioid use disorder.
- North Dakota First Link
- South Dakota Help Center
The Drug Addiction Treatment Act of 2000 created a Data-Waiver, often referred to as the X-waiver, to allow certain qualified practitioners to treat patients with buprenorphine outside of an opioid treatment program (OTP). Under this waiver, practitioners were subject to patient caps depending on length of time registered with the X waiver. In January of 2023, the DEA has announced that the X waiver is no longer required to treat patients with buprenorphine with opioid use disorders. With the removal of the need for the X-waiver went the patient cap requirements, which is a huge accomplishment. Learn more.
As with all high-risk medications, the risk of diversion is concern. A contract, or an agreement between provider and patient is always a good idea. These contracts should include the risks of taking the medication, expectations of the patient, expectations of the provider, and under what terms will the relationship with provider and patient be severed. Examples of contracts are provided during the session.
Another wonderful resource is the Mental Health First Aid program. Just as people are first aid certified across the country to improve outcomes by having more access to first line interventions – the same is being offered for mental health challenges. Review and register for upcoming events in both North and South Dakota
- North Dakota – Upcoming Events – FirstLink
- South Dakota – Trainings – Helpline Center
Take 30 minutes to review the recording of the Medication Assisted Therapy March 24 Session and be sure to join this Friday, May 31 as we conclude this Series on the topic of Diversion, which is taking medication from patients or healthcare facilities for personal or unauthorized use.
The Great Plains QIN Team hosted a series of sessions in January on this topic. View the recordings and presentations from each of the four sessions below on our Web site.
- Safe Opioid Prescribing Practices
- The Pharmacist’s Role
- Opioid Misuse and Adverse Drug Events
- A Patient-Centered Approach