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Medication-assisted Treatment for Opioid Use Disorder PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Medication-assisted treatment for opioid use disorder" by John e lopes jr., dhsc, pa-c Associate Professor, Physician Assistant Program Central Michigan University and Project Director Medication-assisted Treatment Waiver Training Initiative Physician Assistant Education Association, to learn about the extent of the opioid use disorder crisis, the nature of addiction as a chronic disease, the evidence for medication-assisted treatment (MAT), and the use of the three FDA approved medications for MAT.

Tags : Medication-assisted treatment, opioid use disorder, addiction as a chronic disease, medication

Published on : Mar 14, 2023 | Views : 987 | Downloads : 0

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Medication-assisted treatment for opioid use disorderJohn e lopes jr., dhsc, pa-cAssociate Professor, Physician Assistant ProgramCentral Michigan Universityand Project DirectorMedication-assisted Treatment Waiver Training InitiativePhysician Assistant Education Association
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Objectives Describe the extent of the opioid use disorder crisis Explain the nature of addiction as a chronic disease Describe the evidence for medication-assisted treatment (MAT) Explain the use of the three FDA approved medications for MAT 2
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Data source: NCHS Vital Statistics System for numbers of deaths. Bureau of Census for population estimates. Age Range: 0 – 85 Accidental Deaths in the US 3
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In 2016, the age-adjusted rate of drug overdose in the US was more than three times the rate in 1999 4
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Among persons aged 15 and over, adults aged 25-34, 35-44, and 45-54 had the highest rates of drug overdose deaths in 2016 5
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HHS Publication No. SMA 17-5044, NSDUH Series H-52 6
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HHS Publication No. SMA 17-5044, NSDUH Series H-52 7
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Addiction as chronic disease 8
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Diagnosis of Opiate Use Disorder 9
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Screening, Brief Intervention, Referral to Treatment (SBIRT) A set of services designed to identify an individual’s level of risk from alcohol or other substance use and provide an appropriate follow-up service Demonstrated benefit for hazardous alcohol users; less robust evidence of benefit for illicit drug users . 10
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SBIRT Three main components Screening Assess the risk for or presence of a substance use or mental health disorder Brief Intervention Raising awareness of behavioral change that supports overall health Referral to treatment A clear pathway for follow-up with individuals identified as having a substance use or mental health disorder 11
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Single-Item Drug Screener How many times in the past year have you used an illegal drug or a prescription medication for nonmedical reasons? (A positive screen is 1 or more days.) Two-item Drug Use Disorder Screener for Primary Care Clinics Serving US Veterans Question 1: How many days in the past 12 months have you used drugs other than alcohol? (A positive screen is 7 or more days. If < 7, proceed with Question 2.) Question 2: How many days in the past 12 months have you used drugs more than you meant to? (A positive screen is 2 or more days.) Smith, P. C., Schmidt, S. M., Allensworth-Davies, D., & Saitz, R. (2010). A single-question screening test for drug use in primary care. Archives of Internal Medicine, 170(13), 1155–1160. Tiet, Q. Q., Leyva, Y. E., Moos, R. H., Frayne, S. M., Osterberg, L., & Smith, B. (2015). Screen of drug use: Diagnostic accuracy of a new brief tool for primary care. JAMA Internal Medicine, 175(8), 1371–1377. 12
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13 Lanier D, Ko S. Screening in Primary Care Settings for Illicit Drug Use: Assessment of Screening Instruments — A Supplemental Evidence Update for the U.S. Preventive Services Task Force. Evidence Synthesis No. 58, Part 2. AHRQ Publication No. 08-05108-EF-2. Rockville, Maryland: Agency for Healthcare Research and Quality. January 2008.
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Medication-assisted Treatment of Opioid Use Disorder 15
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Methadone Full opioid receptor agonist Dispensed only in accredited/licensed treatment programs Medical director must meet regulatory requirements Stabilization of patient in state of normal function by blockade treatment. From Arch Intern Med, 1966, 118: 304 16
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Buprenorphine Partial opioid receptor agonist/antagonist Available through treatment programs and in outpatient settings Requires special training to prescribe 17
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Naltrexone Full opioid receptor antagonist Available from treatment programs and outpatient offices No special training to prescribe or administer 18
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Reimbursement Treatment of OUD in the outpatient setting is just like treating any other chronic disorder Medicaid, Medicare, and commercial insurance companies should pay for any care considered reasonable and necessary https://elearning-asam.org/NavigatingPaymentPathways 19
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Diagnoses Codes – ICD-10 F11 Opioid related disorders F11.1 Opioid abuse F11.10 Opioid abuse uncomplicated F11.11 Opioid abuse in remission F11.12 Opioid abuse with intoxication F11.2 Opioid dependence F11.20 Opioid dependence uncomplicated F11.21 Opioid dependence in remission F11.23 Opioid dependence with withdrawal 20
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DATA 2000 Waiver Training MAT using buprenorphine is authorized under the Drug Addiction Treatment Act of 2000 Requires physicians without certain qualifications to take additional training and obtain a DEA certificate to prescribe buprenorphine for MAT The Comprehensive Addiction Recovery Act of 2016 provides a time-limited window for PAs and NPs to obtain a waiver to prescribe buprenorphine 21
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Resources DATA waiver training for physicians, PAs, NPs American Society of Addiction Medicine www.elearning-asam.org/buprenorphine-waiver-course Provider Clinical Support System www.pcssnow.org/education-training/mat-training/ American Academy of Addiction Psychiatry www.aaap.org/clinicians/education-training/mat-waiver-training/ American Psychiatry Association www.psychiatry.org/psychiatrists/education/signature-initiatives/buprenorphine-prescriber-training American Osteopathic Academy of Addiction Medicine www.aoaam.org/PCSSMAT 22
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QUESTIONS 23