INDEX

Opiates & Chronic Pain

Table of Contents:

• Opiate Use Disorder (OUD) Pathway

• OUD Care Pathway

• SAMHSA Project

• Naloxone Take-Home Kits

• UAB Addiction Recovery Program

• PEER Navigators

• Chronic Pain Resources (Printable)

• Lecture Videos

Cross References:

• Psych Patients

• ePrescribing

• PowerPlan Name:  "UED Opiate Use Disorder"

• Discharge Instructions:  "ED - Opiate Use Disorder"

• OUD Diagnostic Criteria

• COWS Scale Calculator

The EMBED study is over, however the care pathway is still available for use. See below.

For patients enrolled in the SAMHSA project, the MAT treatment pathway will be slightly different than the flowchart above.

• For UED: Contact the RA team via the Vocera group “Emergency Medicine Research”.

• For HED:

  • Monday through Friday, 8am to 4pm, contact Delissa @ 205-910-5853

  • Thursday, Friday, Saturday 2pm-7pm, Sanika @ 313-221-6116

• For GED:

  • Monday 11a-7p, Wednesday 1p- 7p, Thursday 2:30p-7p,

  • Saturday 11a-4p, Jolanda @ 205.243.7774

• You will be approached by a linkage coordinator requesting 2 separate prescriptions for Suboxone, for 10-days and 14-days.

• Both prescriptions are in the “UED Opiate Use Disorder” PowerPlan, however you may need to direct the prescriptions to two different printers to ensure they are not printed on the same page.

• The 7-day prescription will be held by the linkage coordinator in the event that the patient cannot get an MAT appointment in 10 days. The patient is instructed to contact the coordinator if this occurs.

• The second prescription will otherwise be torn up.

• Please note that you may see a pop-up in FirstNet when writing for the second prescription. This is intended for subsequent visits and it is OK to override and proceed with the prescription under these circumstances.

• You may also document a billable procedure for this. You can find the template under the Procedure section of the ED Physician Note called “OUD MAT”.

• Order name is "UED naloxone intranasal (take home supply)"

• In efforts to curb a rising number of opioid overdose deaths in Central Alabama, we now have Take Home Naloxone (THN) kits available in the UED Omnicells free for distribution to patients or families at risk of an opioid overdose. This was made possible through partnership with the Jefferson County Health Department and UAB to cover the costs.

• Eligibility to receive a kit includes anyone at risk of an opioid overdose, especially overdose and addiction presentations.

• Kits include: 2 intranasal naloxone delivery devices, simple instrucitons on use, protective film for rescue breathing.

• UAB Outpatient Addiction Services: 205-975-7350

• UAB Medicine Addiction Recovery Resources

Peer Support Specialists are available at UED in-person, often (but not always) 7 days a week, typically 8am to midnight via Vocera ('ED Peers'). They can also be utilized by HED or GED via phone, as needed, and post-midnight (also by phone) via the on call ED Care Transitions Social Worker who has access to the Peer contact information.

KEYWORDS: chronic pain, opiates, OUD, overdose, heroine, IVDU, PEER