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Best Practice: Opioid Use Disorder  


This section will focus on stakeholder best practices addressing the Pain-Opioid Epidemic challenge.


Developing and updating the evidence-based inventory of clinical, social, legal, and public policy materials and processes related to our vision.  We start with focusing on Opioid Use Disorders, overdose prevention, and addressing "the drug war" we follow with acute and chronic pain conditions.



Overall Approach:



  • Prevention

  • Supply reduction

  • Access to optimal treatment 

  • Treatment

  • Harm reduction 




Algorithm (Decision support/ based on evidence-based practice, patient's clinical status)

Patient education & information


Clinician education & information



  • Data analytics  

  • Point of care resources






EU Best Practice Portal 


Strategies to prevent diversion of opioid substitution treatment medications

The use of substitution drugs for the treatment of opioid dependence represents a key evidence-based response to heroin problems in Europe. However, the diversion of these medicines from their intended use in drug treatment to non-medical use and sale on illicit drug markets is a cause for concern. The use of diverted substances has been associated with fatal and non-fatal overdose and an increased incidence of opioid dependence. This analysis summarises the context of opioid substitution treatment in Europe, what diversion is and what current measures are being implemented to reduce it, and considers the implications for the future.

The Opioid Epidemic: Why Cops Are Sending People with Addiction to Treatment Instead of Jail

Published on Mar 17, 2016

Guest speakers: Leonard Campanello, Chief of Police, Gloucester, MA and Frederick Ryan, Chief of Police, Arlington, MA. Preceded by a presentation by Dr. Davida Schiff, BUMC

6 Thing Clinicians Can Do to Help Solve Maine's Opioid Crisis


A QC Lunch & Learn Video Webinar on practical steps primary care providers can take to reduce the proliferation of opioids in Maine and treat those suffering from substance use disorder. Recorded 2/2/16.

Managing a Multi-faceted Plan to Reduce Opioid Abuse in Your Community.

Oxford,  Maine 

Insightformation, Inc.

Project ECHO is a lifelong learning and guided practice model that revolutionizes medical education and exponentially increases workforce capacity to provide best-practice specialty care and reduce health disparities. The heart of the ECHO model™ is its hub-and-spoke knowledge-sharing networks, led by expert teams who use multi-point videoconferencing to conduct virtual clinics with community providers. In this way, primary care doctors, nurses, and other clinicians learn to provide excellent specialty care to patients in their own communities.

Pain Care As A Catalyst For Primary Care Transformation

Treatment Locator NH 

Use this locator to find agencies and individual practitioners offering substance use disorder services, including evaluation (this is a critical first step to determine level of treatment needed), withdrawal management (detox), outpatient counseling, residential treatment, recovery supports and other types of services for people experiencing problems with alcohol and other drug use, including addiction. Some agencies provide services on a sliding fee scale based on funding they receive from the NH Department of Health and Human Services (DHHS). Visit Resources to learn about support groups such as 12 step meetings for individuals and has information about ways to access naloxone, an opioid overdose reversal medication.

CDC Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain

The CDC aims to save lives and prevent opioid misuse, opioid use disorder, and overdose by equipping providers with the knowledge, tools, and guidance they need. With these goals in mind, CDC developed the Quality Improvement and Care Coordination: Implementing the CDC Guideline for Prescribing Opioids for Chronic Pain resource, which is intended to help healthcare systems integrate the Guideline and associated quality improvement (QI) measures into their clinical practice.


November 16, 2015


Public Health Leaders Urge Far-Reaching Reforms to Curb Prescription Opioid Epidemic



A group of experts, led by researchers at the Johns Hopkins Bloomberg School of Public Health, today issued recommendations aimed at stemming the prescription opioid epidemic, a crisis that kills an average of 44 people a day in the U.S.

The report calls for changes to the way medical students and physicians are trained, prescriptions are dispensed and monitored, first responders are equipped to treat overdoses, and those with addiction are identified and treated. The report grew out of discussions that began last year at a town hall co-hosted by the Bloomberg School and the Clinton Health Matters Initiative, an initiative of the Clinton Foundation. The recommendations were developed by professionals from medicine, pharmacy, injury prevention, and law. Patient representatives, insurers, and drug manufacturers also participated in developing the recommendations.

The call to action comes at a time of heightened awareness about the prescription opioid epidemic. More than 16,000 people died in the U.S. from overdoses related to opioid pain relievers in 2013, four times the number who died in 1999, according to the U.S. Centers for Disease Control and Prevention (CDC). Prescription opioid sales have increased 300 percent since 1999. The CDC estimates that two million Americans were dependent on opioid medications in 2013.


Franklin County and the North Quabbin Region of Massachusetts Opioid Task Force


Our mission is to ensure that Franklin County and the North Quabbin Region work together to help reduce opioid and heroin addiction, prevent overdose deaths and improve the quality of life in our community.

In September 2013, community leaders from across the region came together to form this Task Force in response to the growing problem of heroin and other opioids in our area. We started as a coalition of just a few people and have now grown to over 300 members. Together, we are doctors, judges, police officers, prevention experts, educators, and many others.


As a community, we can tackle the very serious problem of heroin and prescription drug abuse in our region. Our goals are to:


  • Prevent heroin and prescription drug misuse and addiction.

  • Prevent overdose from prescription drugs and heroin.

  • Help more people get treatment and recover from heroin and prescription drug addiction.


Go to Website 


Learn About Resources (Pdf)





Operation UNITE (Unlawful Narcotics Investigations, Treatment & Education) is a 501(c)(3) non-profit corporation created in 2003 by U.S. Congressman Harold “Hal” Rogers (KY-5th) to provide a regional, community-based antidrug response to the prescription drug epidemic sweeping across southern and eastern Kentucky. Serving a 32-county region, UNITE is engaged in numerous education, treatment and law enforcement initiatives – many with state and federal partners – designed to empower citizens groups and community leaders to no longer accept or tolerate the drug culture. This is achieved through expanding youth-focused anti-drug and education programs, community campaigns about the dangers of drugs, coordinating treatment and outreach programs for those struggling with addiction, providing support to families and friends of substance abusers, and conducting undercover narcotics investigations.


Collective Impact


Need system approach: 

Collective impact...not isolated programs..rather needs are complex working with collective effort.. 

Large-scale social change requires broad cross-sector coordination, yet the social sector remains focused on the isolated intervention of individual organizations.

- See more at:

"Managing a Multi-faceted Plan to Reduce Opioid Abuse in Your Community"

What can people manage in their minds / how do you manage the complexity...

No silver bullet: Get a coordinated effort ...more enduring .. 

Strategic alignment ... what is the community doing together... 

1. Regional vs. local

2. Getting volunteer support at the point of engagement to get people into treatment

3. Getting the Business community 

4. Prescription Opioids gateway...

5. Entire community needs to work together 

6. Narcan in cruisers 

7. Continuos communication



Project Lazarus

The rural North Carolina county renowned for its success in combating prescription drug abuse has a dirty little secret: Things are just as bad as they were before.

When activist and hospice chaplain Fred Brason appeared to dramatically slash Wilkes County's drug abuse rates with his well-known "Project Lazarus," he became a virtual celebrity among health advocates.



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