The following educational and training resources are​ designed to assist providers with improving treatment of patients with substance use and mental health disorders, chronic pain or other health problems affected by the use or misuse of controlled substance (CS) prescription drugs.

 

According to the American Society of Addiction Medicine (ASAM), addiction is a primary, chronic disease that, without treatment or engagement in recovery activities, is progressive and can result in disability or death. If you believe your patient may have a substance use disorder, it is important that the patient is assessed for the severity and specificity of the disorder and, if necessary, referred to the appropriate type of behavioral health provider. 

 

Below are steps you can take to assist your patients on their path to recovery, including Screening, Brief Intervention and Referral to Treatment (SBIRT):

 

Screening - Use standardized screening tools to identify patients engaging in risky substance use

Brief Intervention - Engage your patient in a short conversation to increase insight and awareness about their substance use and motivation for behavioral change 

Referrals to Treatment - There are resources available to assist you with linking your patients to specialty behavioral healthcare. When contacting Jurisdictional Coordinators or certified service providers, you may want to inquire about a full assessment for your patient to ensure they are placed in the appropriate level and type of care. See links following SBIRT information for how to access these providers.

 

For more information on screening for and treating substance use disorders, how to be reimbursed for SBIRT and other relevant topics, see the Maryland SBIRT webpage:  ​

Beacon Health Options Ma​ryland​ for management of substance use disorders for Medicaid  toll-free numbers: Call: 800-888-1965 TTY: 866-835-2755

Hours of Operation: Monday through Friday 8:00am – 6:00pm EST

Each Maryland county and Baltimore City have a coordinator for substance use disorder treatment services. These coordinators are a local resource for patients who 

need access to treatment and recovery support services.

Approved for clinical use in October 2002 by the Food and Drug Administration (FDA), buprenorphine represents the latest advance in medication-assisted treatment (MAT). Medications such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid dependency. When taken as prescribed, buprenorphine is safe and effective.

Provided by the federal Substance Abuse and Mental Health Services Administration (SAMHSA), this locator has information on physicians who are authorized to prescribe buprenorphine products (including Suboxone) for the treatment of opioid dependence.

For more information on buprenorphine, medication-assisted treatment, and receiving a waiver, please visit: http://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine​

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Released in March 2016, the CDC’s opioid prescribing guidelines can help providers make informed decisions about pain treatment in primary care settings. The site has a wealth of research, infographics, and trainings to encourage providers to implement best practices for responsible prescribing through education on non-opioid pain treatment therapies, proper dosage, and tapering and addictions screening.

Clinicians are encouraged to reference the Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use​, published by HHS, for guidance on safe and effecting tapering practices and discontinuation of opioid therapy.  

For more information, visit the CDC Guidelines website for Providers

And for more information on best practices and resources for responsible opioid prescribing:

 

Naloxone (NARCAN®, EVZIO®) is a prescription medication that safely and effectively reverses an opioid overdose. Naloxone does NOT: “enable” someone's drug use, have “street” or resale value, or make a prescriber liable for a patient’s overdose. Medical providers can prescribe naloxone directly to patients, become an ORP to certify patients and provide naloxone through a standing order, or refer patients to a local ORP training.  Newly promulgated Maryland regulations (COMAR 10.13.03) support the co-prescribing of naloxone, the opioid overdose reversal agent, to these patients.  See Naloxone Co-Prescribing​​​. ​

The Maryland Department of Health (MDH) also authorizes public and private practices and organizations to become ORPs, which provide standardized training on the signs of an overdose and proper response steps, including naloxone administration. Once an individual is trained and certified through an ORP, they can obtain naloxone at a pharmacy without a prescription.

For more information on naloxone formulations and upcoming ORP training, along with instructions on becoming an ORP, please visit: NaloxoneMD.org

 

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National Institute on Drug Abuse (NIDA): Prescription Drugs: Abuse and Addiction ​​​

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