Pregnancy and Substance Abuse: A Harm Reduction Toolkit

This toolkit was designed to help community providers care for pregnant and parenting people who use drugs in a holistic manner. The kit includes information about stigma reduction, trauma-informed care, and legal services. While the guide was developed IN NY, there are engagement and other information that is useful regardless of location.
Telehealth in a Post-Pandemic Era Sustainable Approaches to Support Integrated Care – Part 2

Telehealth in a Post-Pandemic Era Sustainable Approaches to Support Integrated Care – Part 2

This interactive virtual workshop is part two of a two-part series to support providers ongoing efforts to implement and sustain innovative models of telehealth following the COVID-19 public health emergency. Topics include best practices to support behavioral health care delivery through telehealth; improving patient engagement through telehealth and DC telehealth policy and priority updates.

TEAMcare An Integrated Multicondition Collaborative Care Program for Chronic Illnesses and Depression

Patients with poorly controlled diabetes, coronary heart disease, and depression have an increased risk of adverse outcomes. In a randomized, controlled trial, we tested an intervention designed to improve disease control outcomes for diabetes and/or heart disease and coexisting depression. Patients with one or more parameters of poor medical disease control (ie, HbA1c ≥8.5, or SBP >140, or LDL >130) and a Patient Health Questionnaire-9 (PHQ-9) ≥10 were randomized to the TEAMcare intervention or usual care (N = 214). This article will describe the TEAMcare health services model that has been shown to improve quality of care and medical and psychiatric outcomes.

Using Disease Registries to Improve Your Practice Population’s Health

This webinar focuses on effective strategies for engaging justice-involved populations and ways to support individuals transitioning to communities. The speakers shared case studies to illustrate the ways that providers have managed transitions of care and supported people. This session is approved by the American Academy of Family Physicians for up to 1 AMA Level 1 CME credit.

Physician Burnout

The health care environment—with its packed workdays, demanding pace, time pressures, and emotional intensity—can put physicians and other clinicians at high risk for burnout. Burnout is a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment. In recent years, the rising prevalence of burnout among clinicians (over 50 percent in some studies) has led to questions on how it affects access to care, patient safety, and care quality. Burned-out doctors are more likely to leave practice, which reduces patients’ access to and continuity of care. Burnout can also threaten patient safety and care quality when depersonalization leads to poor interactions with patients and when burned-out physicians suffer from impaired attention, memory, and executive function.

Correlates of Patient-Centered Care Practices at U.S. Substance Use Disorder Clinics

Substance use disorder treatment professionals are paying increased attention to implementing patient-centered care. Understanding environmental and organizational factors associated with clinicians’ efforts to engage patients in clinical decision-making processes is essential for bringing patient-centered care to the addictions field. This study examined factors associated with patient-centered care practices in substance use disorder treatment.

Cannabis Use May be Associated with Suicidality in Young Adults

NIH study suggests a link between cannabis use and higher levels of suicidal ideation, plan, and attempt. An analysis of survey data from more than 280,000 young adults ages 18-35 showed that cannabis (marijuana) use was associated with increased risks of thoughts of...
Telehealth Tips: Managing Suicidal Clients During the COVID-19 Pandemic

Telehealth Tips: Managing Suicidal Clients During the COVID-19 Pandemic

The current need for social distancing and isolation related to the COVID-19 pandemic has necessitated a quick expansion of the provision of mental health services via remote platforms. This tip sheet provides some tips for evaluating and treating suicidal individuals remotely via telehealth.

ASHP Guidelines on Preventing Diversion of Controlled Substances

Controlled substances (CS) diversion in health systems can lead to serious patient safety issues, harm to the diverter, and significant liability risk to the organization. Diversion driven by addiction puts patients at risk of harm, including inadequate relief of pain, inaccurate documentation of their care in the medical record, exposure to infectious diseases from contaminated needles and drugs, and impaired healthcare worker (HCW) performance. In addition to patient harm, there are regulatory and legal risks to the organization, including fraudulent billing and liability for resulting damages, and decreased community confidence in the healthcare system. These guidelines provide a detailed and comprehensive framework to support organizations in developing their CS diversion prevention program (CSDPP) in order to protect patients, employees, the organization, and the community-at-large. Ultimately, each organization is responsible for developing a CSDPP that complies with applicable federal and state laws and regulations but also one that applies technology and diligent surveillance to routinely review process compliance and effectiveness, strengthen controls, and seek to proactively prevent diversion.

How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations

Many randomized controlled trials in which motivational interviewing (MI) is a key intervention make no provision for the assessment of treatment fidelity. This methodological shortcoming makes it impossible to distinguish between high- and low-quality MI interventions, and, consequently, to know whether MI provision has contributed to any intervention effects. This article makes some practical recommendations for the collection, selection, coding and reporting of MI fidelity data, as measured using the Motivational Interviewing Treatment Integrity Code. We hope that researchers will consider these recommendations and include MI fidelity measures in future studies.

Telehealth for the Treatment of Serious Mental Illness & Substance Use Disorders

This guide contains a foreword and five chapters. The chapters stand alone and do not need to be read in order. Each chapter is designed to be brief and accessible to healthcare providers, healthcare system administrators, community members, policymakers, and others working to meet the needs of people at risk for, experiencing, or recovering from SMI and/or SUD. The goal of this guide is to review the literature on the effectiveness of telehealth modalities for the treatment of SMI and SUD, distill the research into recommendations for practice, and provide examples of how practitioners use these practices in their programs.

Use of the Family CAGE in Screening for Alcohol Problems in Primary Care

To establish the reliability and validity of the Family CAGE (an acronym indicating Cut down on drinking; Annoyed by complaints about drinking; Guilty about drinking; had an Eye-opener first thing in the morning), a four-item instrument intended to assess family alcohol-related problems.
Counseling Patients in Primary Care: Evidence-Based Strategies

Counseling Patients in Primary Care: Evidence-Based Strategies

Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling...
Implementing Telemedicine in Primary Care: Learning Lessons From Electronic Health Records

Implementing Telemedicine in Primary Care: Learning Lessons From Electronic Health Records

The common narrative is coronavirus disease 2019 happened, payment and policy barriers were quickly lowered, and voila, telemedicine, a technology for which adoption had been slow over the past decade, is, within a matter of months, in widespread and successful use. Fait accompli. On to this narrative has been grafted the hopes that telemedicine will solve other persistent problems, particularly in primary care.

Implementing Care for Alcohol & Other Drug Use in Medical Settings An Extension of SBIRT

This change guide is designed to assist primary care clinicians and leaders to integrate care for patients with unhealthy alcohol and/or other drug use into routine medical care. As behavioral health care is increasingly integrated into medical settings, especially primary care, the focus is often on depression and anxiety. Care for alcohol and/or other drugs is often omitted or minimized, likely reflecting: stigma, lack of workforce training/education, and the traditional separation of care for alcohol and other drugs from traditional health care (e.g., primary care, emergency care, and behavioral health, etc.). This guide expands on and updates the widely recognized model of Screening, Brief Intervention, and Referral to Treatment (SBIRT).

IBHA Recommended Measures to Assess Behavioral Health Integration in Primary Care

IBHA recommends that health systems, insurance plans, and others looking to measure progress toward integrating behavioral health in primary care use the 2017 PCPCH Standard 3.C.3 as the integration metric of choice. At the system level, IBHA concurs that measuring practice-level progress toward adopting excellent integrated care delivery models in the most meaningful way to affect system change.

Fighting Back Against the Stigma of Addiction

Untreated drug and alcohol use contributes to tens of thousands of deaths every year and affects the lives of many more people. We have effective treatments, including medications for opioid and alcohol use disorders, that could prevent a significant number of these deaths, but they are not being utilized widely enough, and people who could benefit often do not even seek them out. One important reason is the stigma around those with addiction.

Common Comorbidities with Substance Use Disorders Research Report

When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid. Comorbidity also implies that the illnesses interact, affecting the course and prognosis of both.1,2 This research report provides information on the state of the science in the comorbidity of substance use disorders with mental illness and physical health conditions.

Words Matter: Terms to Use and Avoid When Talking About Addiction

This handout offers background information and tips for providers to keep in mind while using person-first language, as well as terms to avoid to reduce stigma and negative bias when discussing addiction. Although some language that may be considered stigmatizing is commonly used within social communities of people who struggle with substance use disorder (SUD), clinicians can show leadership in how language can destigmatize the disease of addiction.

Advancing Integrated Mental Health Solutions – Collaborative Care Resources

Collaborative Care (CoCM) is a specific type of integrated care developed at the University of Washington that treats common mental health conditions such as depression and anxiety that require systematic follow-up due to their persistent nature. Based on principles of effective chronic illness care, Collaborative Care focuses on defined patient populations tracked in a registry, measurement-based practice, and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who are not improving as expected.

Addressing Burnout and Resilience

Burnout is common in healthcare and has increased during the Covid 19 pandemic. This brief presentation defines burnout and it's consequences. Building resilience is a strategy to reduce and prevent burnout. The presentation defines resilience and provides tips in increase personal resilience and organizational resilience.

Adolescent Screening for Substance Use Disorders

Adolescents are at the highest risk for experiencing health problems related to substance use. This resource provides an overview of screening adolescents for substance use disorders including assessments and tips.
Fentanyl Strip Testing

Fentanyl Strip Testing

This brief video provides an overview of fentanyl strip testing to identify the presence of fentanyl in unregulated drugs for people who use drugs (PWUD). It also includes a brief demo of how to use fentanyl test strip testing to detect the presence of fentanyl in their drug supply. Testing for fentanyl test strips can identify the presence of fentanyl in unregulated drugs. They can be used to test injectable drugs, powders, and pills. Being aware if fentanyl is present allows people to implement appropriate harm reduction strategies to reduce the risk of an overdose. Presented by Sari Frankel, DC Department of Behavioral Health.

Using Registries for Population Health

Registries are important population health tools that allow organizations to collect, organize, aggregate, and utilize the information for a variety of purposes. Maintaining registries for certain disease states such as depression or diabetes provides easy access to results, identification of care gaps, and level of improvement and can lead to adjustments in care as needed. This Short Take video provides an introduction to registries and how to use them.

Mother & Baby Substance Exposure Toolkit

An online resource to provide broad access to resources to clarify best practices to support and improve the care for substance-exposed mothers and newborns. The toolkit includes resources to support screening, assessment, and level of care determination; treatment; transitions of care; and education.

Addiction Free California

The California Department of Health Care Services (DHCS) has implemented the California Medications for Addiction Treatment (MAT) Expansion Project to address the opioid epidemic throughout the state. This website serves as a separate yet complementary resource to the DHCS MAT Expansion Website and provides resources and information related to the four MAT Expansion Project initiatives operated by Health Management Associates. The California MAT Expansion Project aims to increase access to MAT, reduce unmet treatment need, and reduce opioid overdose-related deaths through the provision of prevention, treatment, and recovery activities. The project focuses on individuals experiencing homelessness, youth, rural, and tribal populations with limited MAT access. The California MAT Expansion Project, composed of nearly 30 initiatives, is funded by grants from the Substance Abuse and Mental Health Services Administration (SAMHSA).

HMAedu – A Learning Management System for Treatment Teams

HMAedu.com is an educational resource specifically designed for training treatment teams about addiction, pain, and behavioral health. With over 25 hours of education through the lens of patient-centered care, users can explore topics of interest or follow the suggested curriculum path. Once a user signs in, the learning management system automatically loads modules that are pertinent to the user’s level of training. This automation allows for consistency in messaging to all providers without delivering information beyond the scope of practice. Each course starts with a TED Talks-style overview that is followed by patient-focused modules of 3-10 minutes each. Each module is traced for completion and can be reported back to the client and individual for tracking purposes.

Effective Strategies to Enhance Transitions of Care for Justice Involved Populations

This webinar focuses on effective strategies for engaging justice-involved populations and ways to support individuals transitioning to communities. The speakers shared case studies to illustrate the ways that providers have managed transitions of care and supported people. This session is approved by the American Academy of Family Physicians for up to 1 AMA Level 1 CME credit.

Motivational Interviewing In Primary Care

Healthcare systems are in the process of reforming themselves to better meet the needs of people with, or at risk of developing, chronic diseases and long-term conditions. One goal of these efforts is the coproduction of activated, informed, engaged, and motivated patients and citizens.