Trainings and Resources

The Substance Abuse and Mental Health Services Administration released a notice of proposed rulemaking that would allow certified opioid treatment programs to begin prescribing the drug via audio-only or video-enabled telehealth. See additional information under Policy Updates below. The proposed changes come on top of recent findings by HHS of the positive impact of its revised Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder that removed two longstanding requirements for obtaining a waiver to treat up to 30 patients with buprenorphine: 1) the requirement for specific training, and 2) the need for otherwise eligible clinicians to certify their ability to provide or refer patients for counseling and other services. Rural primary care providers have obtained the DEA waiver at a lower rate than urban clinicians; decreased burden and greater flexibility in the guidelines, along with broader use of telehealth could help close that gap.

On March 16, 2020, to facilitate access to methadone treatment from opioid treatment programs (OTPs) during the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration allowed states to request blanket exceptions to provide up to 28 and 14 days of take-home methadone for stable and less stable patients, respectively; this signaled a shift in practice because most patients historically receive methadone daily from OTPs.

The goal of treatment for opioid addiction or opioid use disorder (OUD) is remission of the disorder leading to lasting recovery. Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential.1 This Treatment Improvement Protocol (TIP) reviews the use of the three Food and Drug Administration (FDA)-approved medications used to treat OUD—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support recovery for people with OUD.

IMPORTANCE Thousands of pregnant people with opioid use disorder (OUD) enter US jails annually, yet their access to medications for OUD (MOUD) that meet the standard of care (methadone and/or buprenorphine) is unknown. OBJECTIVE To assess the availability of MOUD for the treatment of pregnant individuals with OUD in US jails.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with RTI International to conduct a scoping review of the scientific literature on non-fatal opioidinvolved overdose (NFOO) to better understand the health outcomes and health care implications associated with opioid epidemic. NFOO is a significant cause of opioid-related morbidity in the United States, and is of heightened interest to ASPE given the sharp increase in fatal and nonfatal opioid overdoses as a result of the current fentanyl crisis. Compared to the first and second phases of the opioid epidemic, when the majority of opioid-related morbidity and mortality was associated first with prescription opioids and then with heroin, illicitly-manufactured fentanyl (IMF) is now the leading cause of fatal opioid overdoses (CDC, 2017; O’Donnell, Gladden, & Seth, 2017). People who consume IMF, either wittingly or unwittingly, are at higher risk for accidental overdose, experience comparatively atypical overdose-related side effects, have unique risk profiles, and are at higher risk for poorer health outcomes (Somerville, 2017). To our knowledge, no investigation has been conducted to examine whether the sharp increase in NFOOs over the last several decades is negatively impacting overdose victims’ chronic physical and mental health outcomes. To investigate the status of the scientific literature regarding the consequences of NFOO on victims’ physical and mental health, we conducted a scoping review of the existing knowledge in multiple stages: (1) publication identification; (2) selection of publications; and (3) data extraction, charting, and synthesis. Key findings from our review are presented below.

This News Brief describes the need for harm reduction and treatment services in rural areas for people who use psychostimulants and how those services can be provided by the opioid treatment program

This toolkit provides correctional administrators and health care providers the information necessary to plan and implement MAT programs within jails and prisons.

This resource is a State Health official letter issued by the Center for Medicaid providing guidance on implementation throughout the Medicaid program of the provision pursuant to Section 1006(b) of the Support for Patients and Communities Act. Within the scope of the SUPPORT Act provision, state Medicaid programs are now required to provide and cover medication-assisted treatment (MAT) and behavioral therapy for opioid use disorders.

The Addiction and Public Policy Initiative collaborated with the Legislative Analysis and Public Policy Association (LAPPA) to write model legislation for access to medication-based treatment for opioid use disorder in correctional settings. Implementing medication-based treatment in jails and prisons is crucial to increasing positive outcomes for incarcerated individuals with substance use disorders.

Pharmacists can play an important role in improving access to medication for opioid use disorder (MOUD), especially for individuals living in rural areas where health care workforce shortages are pervasive. Learn how pharmacists can provide Medication Administration Services (MAS) and establish Collaborative Practice Agreements (CPA) in coordination with one or more treating health care providers.