TREATMENT STARTS HERE:
Resources for the treatment of substance use disorders from the acute care setting
Resources developed and shared by the CA Bridge program were developed by an interdisciplinary team based on published evidence and expert opinion. As the literature develops best practices may change. They should never be used as a substitute for clinical judgement. Individual providers are responsible for assessing the unique circumstances and needs of each case. Adherence to these guidelines will not ensure successful treatment in every situation.
CA Bridge Clinical Toolkit
This toolkit is updated periodically. The most recent version is dated NOVEMBER 2019.
A clinical guide for the treatment of opioid use disorder using buprenorphine in any setting
A clinical guide for pregnant patients with opioid use disorder in need of treatment from any setting: community health center, primary care physician, inpatient, emergency department
A clinical guide for administering buprenorphine following an overdose reversal using naloxone
ACUTE PAIN AND BUPRENORPHINE
Clinical guides for both Emergency Departments as well as Medical-Surgical Units to address acute pain management in patients undergoing buprenorphine treatment for opioid use disorder
Clinical guide for the treatment of opioid use disorder using methadone in the acute care setting.
CLINICAL PRACTICE UNDER DEVELOPMENT
Guidance for hospitals participating in the California Bridge Program who would like to incorporate treatment for alcohol use disorder into their emergency departments and inpatient settings
FREQUENTLY ASKED QUESTIONS
A helpful set of tips to guide hospitals toward the use of evidence-based practices within site-specific order sets that address the logistics of the treatment of substance use disorders
Many community and academic medical centers care for patients who are in custody. In these settings, providers often use evidence-based practices to treat opioid use disorder, opioid overdose, and opioid withdrawal with medications for opioid use disorder.
PATIENT FACING MATERIALS
A patient-facing guide to highlight the benefits and cautions associated with the use of medications for treating opioid use
A patient facing document that addresses questions that may arise before starting medication for opioid use disorder
Posters for hospital waiting rooms and triage can provide awareness that treatment for acute withdrawal is available which can invite patients to be honest about their illness within the acute care setting
Under the Drug Addiction Treatment Act of 2000 (DATA 2000), physicians are required to complete an eight-hour training to qualify for a waiver to prescribe and dispense buprenorphine. Providers Clinical Support System (PCSS) offers DEA X-Waiver training for MAT for physicians, nurse practitioners, and physicians assistants
HOW TO PAY FOR IT: MAT FOR HOSPITALIZED PATIENTS (California Health Care Foundation)
HOW TO PAY FOR IT: MAT IN THE ED (California Health Care Foundation)
SAFER PRESCRIBING FROM THE ED
Between 1997 and 2007 the use of prescription opioids more than quadrupled. Similarly, drug overdose deaths significantly increased for the 11th consecutive year in 2010. Although emergency physicians manage 28% of all acute care visits in the United States, only 5% of all opioid prescriptions are written by emergency physicians. As leaders in health care we are empowered do our part in reversing this alarming public health trend.
California ACEP has endorsed and is promoting the following safe prescribing guidelines that were updated in October 2018 and supported by numerous partners.