The ALTO or Alternative to Opiates initiative is a an emergency department (ED) based program intended to utilize non-opioid approaches as a first-line therapy for certain pain conditions commonly treated in the ED. These slides briefly describe the ALTO protocols and the results of a pilot study of the program.
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COVID-19
UPDATED November 15, 2020: The COVID-19 public health emergency is particularly challenging for people in treatment for substance use disorder, people in recovery, and people who use drugs. This collection features educational resources that can be adapted for local settings, specific guidance on harm reduction, recovery housing and providing peer support services during the pandemic, and links to websites that provide high-quality information, data, and/or examples for local communities to adopt.
Montefiore Health System COVID-19 Toolkit for Opioid Use Disorder Treatment
Montefiore Health System created this toolkit for its prescribers and staff to manage access to opioid use disorder (OUD) treatment including medications during the COVID-19 pandemic. This toolkit includes the following materials that may serve as templates for other hospital systems or clinician practices during this national emergency:
Tips for Talking about Opioids and Pain with Patients
Health care providers often request guidance on how to have conversations with patients about opioids, pain treatment, addiction and other topics that may be challenging. In this collection, we have gathered materials that provide support to providers as they have these difficult conversations.
Medication Assisted Treatment – Hospitals and Emergency Departments
Hospital inpatient care programs and emergency departments are increasingly developing policies and programs to provide medication assisted treatment (MAT) to their patients. This collection features guidelines from the Massachusetts Health & Hospital Association, resources and tools from the California American College of Emergency Physicians, and links to the Public Health Institute’s California Bridge Program and the California Health Care Foundation’s Support for Hospital Opioid Use Treatment (SHOUT) initiative. Also included is a link to Massachusetts General Hospital’s “Get Waivered” campaign which provides free buprenorpine waiver training and support for creating emergency department programs.
Opioid Safety for Hospital Clinicians
Source: UMASS-TOX
This website from the University of Massachusetts’s Division of Medical Toxicology contains several training videos on opioid safety for hospital providers. The 5 instructional videos are intended to educate providers on common pitfalls and evidence-based strategies for safe administration of opioids in the inpatient, hospital setting.
Approaches to Treating Serious Infection in People Who Inject Drugs: Evidence and Policies
Source: Center for Evidence-based Policy
This review looks at evidence and program models for alternatives to hospitalization to treat serious infections in people who inject drugs.
Resources to Treat Substance Use Disorder in the Acute Care Setting
Source: California Bridge Project
This toolkit contains clinical materials targeting treatment of substance use disorder in the acute care setting. It includes resources for hospital clinicians to adopt including clinical protocols, information about medication assisted treatment and induction protocols, treating patients with justice involvement,
How Community Health Centers are Addressing the Opioid Epidemic
Source: Milbank Memorial Fund
This case study profiles how a federally qualified health center (FQHC) in New York provides integrated medical and behavioral health care services for individuals with opioid addiction.
EPIC Template: Telemedicine Documentation in Progress Notes
Source: Montifiore Health System
This document provides a template for an EPIC electronic health record note for documenting that the service was provided via telemedicine due to the COVID-19 pandemic.