Reminder: the Opioid Response Network has accumulated a list of resources and trainings that may be useful to you during this public health crisis. Resources can be found here.

The Opioid Epidemic and COVID-19: How Social Determinants of Health Create Differential Impacts

The Opioid Response Network is also developing appropriate educational materials related to COVID-19 and updating other virtual resources specific to substance use disorder prevention, treatment and recovery with a focus on special populations and addressing social determinants of health. Please read and share this material on how social determinants of health create differential impacts.

ORN Enhances Staff Skills at Leading Outpatient Center

Valley Health Associates (VHA) in Salinas, CA, reached out to the Opioid Response Network when looking for support to build capacity and sustainability for the organization’s medication assisted treatment and recovery programs. Amy Bravo, Executive Director, VHA, asked ORN to play a part in building up the skills of her substance use disorder staff. ORN provided local training and technical assistance for VHA on many fronts. More than 200 staff participated in six separate trainings during the summer of 2019. Read the full story here.

Community Collaborations in Monroe, Louisiana

Through 2019, ORN planned and executed eight community collaborations across the country. In December, ORN partnered with the Northeast Delta Human Services Authority and the Louisiana Department of Health to facilitate strategic discussions around addressing substance use disorders and the opioid epidemic in the Delta region.

More than 20 people attended the two-day event. Topics covered included evidence-based approaches to prevention, treatment and recovery; effective approaches for youth and adolescents; family-centered care; and stigma reduction approaches. A significant part of the meeting focused on hearing about the impactful work happening across the Northeast Delta region and Louisiana and identifying strategies that can support the state's ongoing initiatives to more effectively address the opioid epidemic.

ORN received an increase in requests within Louisiana to support capacity building. Communities across the country can plan similar meetings by submitting a technical assistance request here.

Educational Video Series to Support Substance Use Disorder Treatment

The Boston Medical Center’s Office Based Addiction Treatment Training and Technical Assistance team has launched a video series aimed at providing clinical care teams with education on topical issues in the field of addiction treatment. The videos were produced by 1623 Studios out of Gloucester, MA and are accessible in the Opioid Response Network repository and here.

American Indian/Alaska Native Technical Assistance Support

To help address the opioid crisis in tribal communities, SAMHSA provided ORN with supplemental funding in 2018 to increase access to culturally appropriate and evidence-based education and resources. The ORN American Indian/Alaska Native workgroup, which was born as a result, has developed presentation slides to illustrate the support it can provide. The slides are intended for those audiences whose providers or community are Tribal, or work with Tribal communities and can be found

here.

Intimate Partner Violence and Child Abuse Considerations During COVID-19

From SAMHSA: As the COVID-19 pandemic continues, Americans are required to stay home to protect themselves and their communities. However, the home may not be safe for many families who experience domestic violence, which may include both intimate partners and children. To help families and communities address intimate partner violence and child abuse health concerns, please read the following, which contains resources.

FY 2020 Comprehensive Opioid, Stimulant and Substance Abuse Site-Based Program

From the Bureau of Justice Assistance: The Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) was developed as part of the Comprehensive Addiction and Recovery Act (CARA) legislation. COSSAP’s purpose is to provide financial and technical assistance to states, units of local government, and Indian tribal governments to develop, implement, or expand comprehensive efforts to identify, respond to, treat, and support those impacted by illicit opioids, stimulants, and other drugs. The closing date is May 21, 2020. More here.

Join our LIVE Webinar April 27, 2020 at 5:00 PM EDT Register Now Speakers

Laura R. Lander, MSW, AADC Emily Chilko, LICSW

This is the second webinar in the telehealth series for the Opioid Response Network (ORN). Learning Objectives: Define teletherapy Review federal regulations regarding provision of teletherapy during COVID-19 national emergency Identify HIPAA compliant teletherapy platforms Describe strategies for conducting both group and individual teletherapy sessions Discuss management of OUD in the context of social distancing, stay at home, and shelter in place orders Coding/billing for teletherapy visits Access resources regarding teletherapy and OUD This webinar, hosted by the American Osteopathic Academy of Addiction Medicine through a Opioid Response Network STR-TA grant, will present ways to incorporate telemedicine into treatment programming for substance use disorders, including how to evaluate and expand access to medication-assisted treatment (MAT) using telemedicine, types of telehealth provider settings, implementation of PCSS best practices and evolving barriers. Billing codes will also be addressed. Funding for this initiative was made possible (in part) by grant no. 6H79TI080816 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Download the PDF

The Drug Enforcment Agency (DEA) has partnered with the Substance Abuse and Mental Health Services Administration (SAMHSA) to ensure authorized practitioners may admit and treat new patients with opioid use disorder (OUD) during the COVID-19 public health emergency. In light of the extraordinary circumstances presented by the COVID-19 public health emergency, and being mindful of the exemption issued by SAMHSA, DEA likewise advises that, only for the duration of the public health emergency (unless DEA specifies an earlier date), OTPs should feel free to dispense, and DATA-waived practitioners should feel free to prescribe, buprenorphine to new patients with OUD for maintenance treatment or detoxification treatment following an evaluation via telephone voice calls, without first performing an in-person or telemedicine evaluation. [Read full DEA letter]

Join our LIVE Webinar March 27, 2020 at 3:00 PM EDT

REGISTER NOW

The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 enacted by Congress on March 6, 2020. As a result, this would allow broader use of and payment for telehealth services for Medicare beneficiaries during the emergency period as defined under the legislation. These recent changes in telemedicine regulations open new opportunities in patient assessment for Medications for Addiction Treatment for Opioid Use Disorders. Many communities are adopting telehealth as one way to address gaps in access to treatment for mental and substance use disorders for Rural, Urban, Tribal, Limited-Transportation, Emergency Medical Crisis Disposition and Justice-Involved Populations. This webinar, hosted by the American Osteopathic Academy of Addiction Medicine through a Opioid Response Network STR-TA grant, will present ways to incorporate telemedicine into treatment programming for substance use disorders, including how to evaluate and expand access to Medications for Addiction Treatment (MAT) using telemedicine, types of telehealth provider settings, implementation of PCSS best practices and evolving barriers. Billing codes will also be addressed. Speaker: William Morrone, DO, MS, MPH, DABAM, FACOFP, DAAPM Funding for this initiative was made possible (in part) by grant no. 6H79TI080816 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

For as long as the Secretary of the Department of Health’s designation of a public health emergency remains in effect, DEA-registered practitioners may issue prescriptions for buprenorphine and other controlled substances to patients for whom they have not conducted an in-person medical evaluation, provided all of the following conditions are met:

·     The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice

·     The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.

·     The practitioner is acting in accordance with applicable Federal and State law.

Provided the practitioner satisfies the above requirements, the practitioner may issue the prescription using any of the methods of prescribing currently available and in the manner set forth in the DEA regulations. Thus, the practitioner may issue a prescription either electronically (for schedules II-V) or by calling in an emergency schedule II prescription to the pharmacy, or by calling in a schedule III-V prescription to the pharmacy. [Learn more]

Resources for Physicians:

• • Centers for Disease Control and Prevention COVID-19 Resources
• • CDC: COVID-19 Preparation for Healthcare Facilities
  • CDC: Caring for Patients with Confirmed or Possible COVID-19 Infection
  • CDC: Interim Infection Prevention & Control Recommentations
• • CMS COVID-19 Partner Toolkit
  • U.S. Government Response to COVID-19
  • Coronavirus: 8 Ways Doctors Can Protect Themselves
  • AOA Meeting, Conference and Certification Exam Status
  • The DO: COVID-19 Updates - What to Know This Week
  • CMS Current Emergencies
  • ACOEP: COVID-19 - EM Perspective and What You Need to Know

Resources for Patients and the Public:

Resources for Families

AOAAM COVID - 19 Page

• NIDA Director Dr. Volkow has published two new blog posts:

1. COVID-19: Potential Implications for Individuals with Substance Use Disorders: https://www.drugabuse.gov/about-nida/noras-blog/2020/03/covid-19-potential-implications-individuals-substance-use-disorders
2. Connection between Sleep and Substance Use Disorders: https://www.drugabuse.gov/about-nida/noras-blog

• The next meeting of the NIH HEAL Initiative’s Multi-Disciplinary Working Group (MDWG) will take place on March 18, 2020 at 8:30 am. The MDWG includes external experts in pain and addiction research from across the scientific and advocacy communities and convenes regularly to ensure broad engagement with the initiative’s research aims and plans. The meeting will be webcast: https://videocast.nih.gov/summary.asp?live=35980&bhcp=1

The agenda is here: https://heal.nih.gov/events/2020-03-mdwg

• National Drug & Alcohol Facts Week® is coming up: March 30-April 5

NDAFW is a week of educational events that annually brings together teens and scientific experts to SHATTER THE MYTHS® about substance use and addiction. For more information and to learn how your organization can participate, please see: https://www.drugabuse.gov/news-events/news-releases/2019/11/event-registration-opens-10th-anniversary-national-drug-alcohol-facts-weekr.

• Resources from NIH on Coronavirus Disease 2019 (COVID-19), including NIH Guidance on Travel and Meetings is available here: https://www.nih.gov/health-information/coronavirus#!/detail/403327

New ORN Impact Data

The Opioid Response Network is reaching more people in effort to help states, organizations and individuals address the opioid crisis at the community level through free education and training. Since the beginning of the initiative (February 2018 - January 2020) we have reached 3,020,695 people. 

Lessons Learned

Over 35 States Represented in Rhode Island on Treating Opioid Use Disorder in Corrections Settings 

What started as a technical assistance request from the Rhode Island Department of Corrections (RIDOC) became a national conference for department of corrections staff and others in the justice system to learn promising models in implementing Medications for Opioid Use Disorder (MOUD).

The free, 2.5-day meeting was held from January 28-30, 2020 in Providence, RI. It highlighted RIDOC's model (one of the first states to incorporate MOUD state-wide, offering all three FDA approved medications), as well as other evidence-based delivery models from around the country.

Over 230 people, representing 34 states, attended the conference, which featured plenary sessions with leading behavioral health, clinical, justice and corrections experts followed by skills development workshops. Read More 

Conferences and Events

Pilot Projects Uses Standardized Patients to Train Clinicians

In an effort to help providers with the waiver to prescribe medications and to enhance their comfort level, the Physician Assistant Education Association (PAEA), an ORN partner organization, hosted a pilot project using standardized patients. The intent was to help prescribers feel more confident in prescribing medications to treat opioid use disorders.

The training was held on January 25, 2020 and included a small group of physicians, a physician assistant and a nurse practitioner. All were waivered, but have not yet prescribed. Participants were asked to run an assessment for opioid use disorder and then develop a treatment plan. The training provided an opportunity for the prescribers to ask the standardized patient/actor questions and learn from an experienced prescriber.

According to PAEA's John Lopes, DHSc, PA-C, all participants indicated that the experience helped improve their..... Read More

Addressing Stigma in the Emergency Room

On January 23, 2020, ORN partner organization, the American College of Emergency Physicians (ACEP), convened a summit called Addressing Opioid Stigma in the Emergency Department. The 46 attendees included federal partners from the Department of Health and Human Services, Center for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, Drug Enforcement Agency and National Institute on Drug Abuse, as well as health care physicians, providers and leaders in the field of medicine.

The summit was an opportunity to discuss and share lessons learned and ideas about how to limit the impact of stigma on the care of emergency room patients with opioid use disorder. From the session, ACEP is developing a policy statement, a policy resource and education paper, and a paper on the role of stigma in the emergency department and how to effectively eliminate it. Read more.

Read the full ORN Bulletin

At the Maine Osteopathic Association meeting, UNECOM students recently presented a poster addressing the utilization of geographic information systems in developing best practices in containing and controlling the opiate epidemic in Maine. Clusters of overdosed citizens were plotted. This led to other maps addressing the need for medication assisted treatment and increasing access to qualified certified Addiction Medicine professionals.

UNECOM students placed 3rd in this competition. Congratulations to a job well done!