The Improving Addiction Care Team – IMPACT

Evidence Ranking: Promising

This collection compiles research and implementation materials from the Improving Addiction Care Team (IMPACT) program from Oregon Health & Science University (OHSU). IMPACT is an interprofessional, hospital-based addictions team that provides addiction medicine consults to patients being treated at OHSU who have a substance use disorder (SUD).

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ED-Initiated Buprenorphine – Resources for Providers

Evidence Ranking: Proven

Source: Yale School of Medicine

The Yale School of Medicine’s website contains comprehensive resources for providers interested in setting up a program to initiate buprenorphine treatment for individuals with opioid use disorder (OUD) seen in the emergency department (ED).

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Improving Addiction Care Team (IMPACT) – A Summary

Evidence Ranking: Promising

Source: Dr. Honora Englander

The Improving Addiction Care Team, or IMPACT, is an interprofessional hospital-based addictions team that meets people with substance use disorder (SUD) during the reachable moment of hospitalization at Oregon Health & Science University.

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Comparative Effectiveness of Analgesics To Reduce Acute Pain in the Prehospital Setting

Evidence Ranking: Proven

Source: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services

A systematic review prepared for the Agency for Healthcare Research and Quality that evaluated the effectiveness and harms of opioids compared to nonopioid analgesics in the emergency department.

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Pennsylvania Warm Hand-Off Care Map

Evidence Ranking: Promising

Source: Pennsylvania Department of Health

In 2016 the Pennsylvania Department of Drug and Alcohol Programs required all county addiction authorities to develop a warm hand-off plan for individuals treated for opioid overdose in a hospital or emergency department. This document is the official “warm hand-off care map” or care algorithm for the program.

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Spotlight: Pennsylvania’s Warm Hand-Off

Evidence Ranking: Promising

Source: Addiction Policy Forum

A brief overview of Pennsylvania’s program to implement warm hand-off’s to treatment for individuals seen in hospitals and emergency departments for addiction related issues. In 2016 the state Department of Drug and Alcohol Programs required all county addiction authorities to develop a warm hand-off plan for individuals treated for opioid overdose in a hospital or emergency department. The program has significantly increased the percentage of patients who enter treatment after receiving a screening and assessment and a direct referral to treatment through this program. Part of the Addiction Policy Forum’s Spotlight series which highlights innovative programs to address the opioid crisis.

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Spotlight: AnchorED Rhode Island

Evidence Ranking: Potential

Source: Addiction Policy Forum

A brief overview of the AnchorED program in Rhode Island which connects patients seen in the emergency department (ED) for an opioid-related overdose with a trained peer recovery coach. ED staff call the AnchorED hotline which dispatches recovery coaches to meet patients 24 hours a day, 7 days a week. The coaches provide the patient with information about recovery supports and resources and may educate the patient or caregivers on naloxone use to treat overdose. Preliminary evaluation reports show that more than 80 percent of patients who meet with the coaches engage in some recovery support services upon discharge. Part of the Addiction Policy Forum’s Spotlight series which highlights innovative programs to address the opioid crisis.

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Spotlight: Yale Emergency Department Treatment Initiation

Evidence Ranking: Promising

Source: Addiction Policy Forum

A brief overview of the emergency department (ED) based induction to buprenorphine program initiated at Yale New Haven Hospital. This report describes a randomized controlled trial that provided patients with opioid use disorder seen in the emergency room with either a substance use disorder screening and referral to treatment, a screening and brief intervention with facilitated referral to treatment, or induction to buprenorphine medicated assisted treatment and a referral to follow up treatment. Those patients offered buprenorphine were significantly more likely to be engaged in treatment 30 days later than the other patients. This model has subsequently been adopted in EDs across the country. This report is part of the Addiction Policy Forum’s Spotlight series which highlights innovative programs to address the opioid crisis.

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Opioid Initiative Wave 1: Starting an ALTO Program – Presentation Slides

Evidence Ranking: Promising

Source: Emergency Quality Network

The ALTO program, or alternatives to opioids, is a comprehensive program focused on providing non-opioid treatments for some common conditions treated in hospital emergency departments. These presentation slides provide guidance to providers or administrators who may want to start an ALTO program in their emergency department.

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