California Bridge has partnered with California Poison Control System to offer 24/7 support for Emergency Department clinicians to discuss buprenorphine starts. The California Poison Control System can help you with: identification of opioid withdrawal, dosing of buprenorphine to treat opioid withdrawal, solutions or troubleshooting a plan to bridge patients to outpatient buprenorphine maintenance therapy, treatment of opioid withdrawal in special populations (e.g. pregnancy, pediatrics), treatment of precipitated withdrawal, and treatment of patients with other underlying toxicological conditions.
From 6am-5pm (Monday-Friday), non-urgent consultation requests may also be directed to addiction-certified physicians or clinical pharmacists who can provide same-day responses. The Warmline is open to questions from internal medicine, surgery, pharmacy, anesthesia, primary care/other ambulatory, obstetrics/women’s health practices, and other specialty care.
How to use a naloxone kit in the event of an overdose.
Buprenorphine has been used internationally for the treatment of opioid use disorder (OUD) since the 1990s and has been available in the United States for more than a decade. Initial practice recommendations were intentionally conservative, were based on expert opinion, and were influenced by methadone regulations. Since 2003, the American crisis of OUD has dramatically worsened, and much related empirical research has been undertaken. The findings in several important areas conflict with initial clinical practice that is still prevalent. This article reviews research findings in the following 7 areas: location of buprenorphine induction, combining buprenorphine with a benzodiazepine, relapse during buprenorphine treatment, requirements for counseling, uses of drug testing, use of other substances during buprenorphine treatment, and duration of buprenorphine treatment. For each area, evidence for needed updates and modifications in practice is provided. These modifications will facilitate more successful, evidence-based treatment and care for patients with OUD.
Find resources to help build a bridge program at your ED such as protocols, provider education, signage, and more.
A tool for opioid use disorders in the ED: buprenorphine, Suboxone.
Harm Reduction Coalition is a national advocacy and capacity-building organization that works to promote the health and dignity of individuals and communities who are impacted by drug use.
(Title 21, Code of Federal Regulations, Part 1306.07(b)), allows a practitioner who is not separately registered as a narcotic treatment program or certified as a “waivered DATA 2000 physician,” to administer (but not prescribe) narcotic drugs to a patient for the purpose of relieving acute withdrawal symptoms while arranging for the patient’s referral for treatment, under the following conditions: 1) not more than one day’s medication may be administered or given to a patient at one time? 2) this treatment may not be carried out for more than 72 hours and 3) this 72hour period cannot be renewed or extended.
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. Find information about the eight-hour buprenorphine waiver training courses that are required for physicians to prescribe and dispense buprenorphine.
OVERCOMING DATA-SHARING CHALLENGES IN THE OPIOID EPIDEMIC: Integrating Substance Use Disorder Treatment in Primary Care
(July 2018) In response to the opioid epidemic, states and the federal government have sought to increase the availability of substance use disorder (SUD) treatment. Through medication-assisted treatment (MAT) programs and other efforts, primary care practices have taken a more prominent role in providing SUD care.1 Primary care practices are stepping up to treat addiction due to many factors — recognition of the role of the medical system in driving opioid overuse and addiction, shifting of attitudes about addiction with acceptance of SUD as a chronic disease, and insufficient specialized treatment resources to address growing demands, especially in rural areas. However, common roadblocks for primary care practices are the inability to efficiently and effectively communicate with SUD providers and a lack of clear guidance about how to share SUD and primary care treatment information.
(June 2018) The Urban Institute – This report provides a rapid review of evidence on the potential cost savings associated with providing screening, brief intervention, and referral to treatment for individuals with substance use disorders (SUDs) related to alcohol and drug use in emergency departments (EDs).