Substance Use Disorder Clinical Resources

Below are up-to-date resources for clinicians and clinical administrators on preventing, treating, and recovering from substance use disorders.

Clinical Care

Treatment Improvement Protocol #59 – Improving Cultural Competence (SAMHSA)
Best practices for developing culturally responsive behavioral health services.

TIP 35: Enhancing Motivation for Change in Substance Use Disorder Treatment (SAMHSA)
Includes the latest evidence on motivation-enhancing approaches and strategies. It describes how SUD treatment providers can use these approaches and strategies to increase participation and retention in SUD treatment.

Provider Care Coordination Agreement – Pain Clinical Pharmacy Specialist – Template (VA)
Template created by the PBM Clinical Pharmacy Practice Office with standard components that foster clinical pharmacy practice standardization. Specific components are editable and may be modified by the facility depending on the role of the Pain CPS and practice setting, how patients are prioritized for Pain CPS services, and administrative oversight responsibilities

Harm Reduction

Taking Care of Each Other: Indigenous Perspectives on Harm Reduction (FNHA)
Recorded webinar by the First Nations Health Authority that includes information on decolonizing addiction and Indigenous harm reduction.

Indigenous Harm Reduction Video Series (FNHA and VCH)
Video series about Indigenous harm reduction to help start discussions in Indigenous communities about harm reduction, substance use, and stigma, all from Indigenous perspectives.

Innovative Frameworks to Expanding Harm Reduction: Strategies to Build Relationships with Law Enforcement on HIV Prevention (HIV-PJA)
PowerPoint presentation on harm reduction and law enforcement; includes strategies for engaging law enforcement in harm reduction efforts.

Harm Reduction Coalition (HRC)
A national advocacy and capacity-building organization in the U.S. that promotes the health and dignity of individuals and communities impacted by drug use.

North Carolina Harm Reduction Coalition (NCHRC)
A comprehensive harm reduction program engaged in grassroots advocacy, resource development, coalition building, and direct services for people impacted by drug use, sex work, overdose, gender, STIs, HIV, and hepatitis.

Medication-Assisted Treatment (MAT)

TIP 63: Medications for Opioid Use Disorder (SAMHSA)
This Treatment Improvement Protocol (TIP) reviews the use of the three medications used to treat opioid use disorder (OUD)—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support recovery.

Business Plan for Medication-Assisted Treatment (PCSS)
Medications that treat opioid use disorder are safe, effective, and can be prescribed and/or administered at community health centers, with a sustainable business plan.

Ensuring MAT Benefits the Individual & the Community (didgʷálič)
Ever wondered how to offer medication-assisted treatment safely? Learn how the didgʷálič Wellness Center- owned and operated by the Swinomish Indian Tribal Community- ensures that the medications they offer are beneficial.

Statutes, Regulations, and Guidelines (SAMHSA)
Learn about the federal statutes, regulations, and guidelines that apply to opioid treatment programs (OTPs) and medication-assisted treatment (MAT).

Tribal MAT Policies and Procedures Template (NPAIHB)
Adapted from tribal medication-assisted treatment policies and procedures by the Northwest Portland Area Indian Health Board.

Role of the Clinical Pharmacy Specialist in Medication Assisted Treatment for Opioid Use Disorder (VA)
Handout about the role of Clinical Pharmacy Specialists as integral providers in the provision of comprehensive medication management services for patients with opioid use disorder.

Naloxone

Tribal Naloxone Policy
Sample naloxone policy shared by a tribe located in Washington state.

Naloxone Overview (IHS)
Information and training videos about this prescription medication that can temporarily reverse opioid overdose and can save lives.

Overdose Prevention

Overdose Prevention and Naloxone Training – Outline (Indian Country ECHO)
Sample outline for an overdose prevention and naloxone training; provided by a tribal partner in the Pacific Northwest.

The Overdose Safety Plan: A Quick Guide for Clinicians (ODSP)
Step-by-step instructions for developing an overdose safety plan.

Patient Education

Patient Education Resources for I/T/U Providers (Indian Country ECHO)
A variety of patient education tools on SUDs; for providers serving American Indian and Alaska Native populations.

Rx Pain Medications, Know the Options, Get the Facts (SAMSHA)
Simple fact sheet on the appropriate use of opioids and the dangers of opioid use disorder and overdose.

Public Messages (SAMSHA)
Useful information and videos to help reduce the impact of substance use disorders and mental illness.

Words Matter When We Talk About Addiction (NPAIHB)
Fact sheet for AI/AN community members on the importance of using non-stigmatizing, supportive language when talking about substance use disorders.

Using Nasal Spray to Reverse an Opioid Overdose (NPAIHB)
Fact sheet for AI/AN community members that described the signs of an opioid overdose and how to respond; includes step-by-step instructions for administering Naloxone nasal spray.

Supporting Someone with Opioid Addiction (NPAIHB)
Fact sheet for AI/AN community members on how support a friend or loved one with opioid use disorder.

Getting Help for an Opioid Use Disorder (NPAIHB)
Fact sheet for AI/AN community members on recognizing the signs of opioid use disorder, how to get help, and potential treatments, including MAT.

The Truth About Opioids (NPAIHB)
Fact sheet for AI/AN community members describing opioids, the process of addiction, how to recognize the signs of opioid use disorder, and how to get help.

A Trickster Tale – Outsmarting Opioids through Education and Action (NPAIHB)
A booklet for tribal community members on preventing, treating, and recovering from opioid use disorder.

Text Message Campaign Card (NPAIHB)
Post card, perfect for clinic settings, to encourage your patients to text ‘opioids’ to 97779 to learn more about opioid misuse prevention, treatment, and recovery.

Healing Ourselves and Our Communities (NPAIHB)
For tribal community members who want to learn more about preventing, treating, and recovering from opioid use disorder.

What People with Opioid Addiction Want You to Know (NPAIHB)
Words of wisdom from tribal community members about what you should know about opioids.

Recovering from Opioid Addiction is Possible (NPAIHB)
We can heal from opioid use disorder. See how others have walked the road to recovery.

Supporting Someone with Opioid Addiction (NPAIHB)
Support can be lifesaving. Hear the stories of tribal community members who have helped their friends and relatives through tough times.

Medication-Assisted Treatment Myths (NPAIHB)
MAT helps many people with opioid use disorder recover. It is more than twice as effective as counseling alone. Learn the facts here.

Provider Education

Words Matter When Providers Talk About Addiction (NPAIHB)
Fact sheet for clinicians on using non-stigmatizing language when talking about substance use disorders.

Healing Our Patients with Opioid Use Disorder (NPAIHB)
Clinical insights for healthcare providers on effective strategies for treating opioid use disorder and supporting Native patients as they walk the road to recovery.

didgʷálič Wellness Center (didgʷálič)
In one year, didgʷálič Wellness Center cut tribal opioid overdose deaths in half. Learn about their unique treatment model from the perspective of staff and clients.

Identifying and Addressing Barriers to Care (didgʷálič)
Removing barriers to care is vital for tackling the opioid epidemic. See how the didgʷálič Wellness Center- owned and operated by the Swinomish Indian Tribal Community- eliminates barriers to create positive patient outcomes.

A Culture of Respect: Providing Clients with Compassionate Care (didgʷálič)
Learn about how the didgʷálič Wellness Center incorporates harm reduction into their successful approach for treating individuals with opioid use disorder.

Ensuring MAT Benefits the Individual & the Community (didgʷálič)
Ever wondered how to offer medication-assisted therapy safely? Learn how the didgʷálič Wellness Center ensures that the medications they offer are beneficial.

Screening and Assessment Tools

Screening and Assessment Tools Chart (NIDA)
Chart to assist clinicians in choosing evidence-based screening tools and assessment materials for substance use disorders.

Clinical Opiate Withdrawal Scale (COWS)
11-item scale designed to be administered by a clinician to rate common signs and symptoms of opiate withdrawal; objective and subjective in nature.

Objective Opioid Withdrawal Scale (OOWS)
Scale for measuring opioid withdrawal that relies on clinical observation; useful in measuring objectively measurable symptoms of opioid withdrawal.

The Subjective Opioid Withdrawal Scale (SOWS)
Scale for measuring opioid withdrawal that records the patient’s rating of withdrawal on a 16-item scale.

Syringe Services

Guide to Developing and Managing Syringe Access Programs (HRC)
Comprehensive manual for starting and managing syringe access programs; guidance offered in several areas including: Planning and Design, Operational Issues, Organizational Issues, External Issues and Population-Specific Considerations.

Compassion, Action, and Healing: Working with Injection Drug Users in Native Communities (NNAAPC)
Important information relevant to people who inject drugs and those who work with this population.

Syringe Access in the Native American Community (HRC Podcast)
Kris Fourstar of Fort Peck Tribal Health and harm reduction pioneer Pawnee Brown discuss developing and implementing syringe exchange programs on reservations.

Getting off Right: A Safety Manual for Injection Drug Users (HRC)
Easy-to-read survival guide for people who inject drugs (PWID); a compilation of medical facts, injection techniques, and strategies to keep PWID healthier and safer.

Participant Orientation Agreement and Screening (Project NICE)
Sample participant orientation agreement and screening form from Project NICE Syringe Services Program.

The Syringe Access Fund (AU)
A national grantmaking collaborative that supports service providers and policy projects that reduce use of shared syringes and ensure their safe disposal.

North American Syringe Exchange Network (NASEN)
Organization that offers useful information about starting and supplying syringe exchange programs.

Pregnant and Parenting

Tapping Tribal Wisdom: Providing Collaborative Care for Native Pregnant Women With Substance Use Disorders and Their Infants (NCSACW)
Clinical care recommendations for pregnant women with SUDs and their infants; based on lessons learned from listening sessions with five tribes in Minnesota conducted in 2018.

Prescription Drug Monitoring Programs (PDMPs)

Rx Pain Medications, Know the Options, Get the Facts – Prescription Drug Monitoring Programs (SAMHSA)
Fact sheet that focuses on how Prescription Drug Monitoring Programs (PDMPs) help health providers better serve their patients’ needs and promote safety.

Technical Assistance and Capacity Building

Technical Assistance and Capacity Building (Indian Country ECHO)
Free service designed to optimize IHS, tribal, and urban clinic policies, enhance care delivery for patients, and build community capacity to prevent and treat complex medical conditions, including substance use disorders.

Substance Use Warmline
Free confidential service that provides on-demand clinical recommendations from experts on effectively treating patients with substance use disorders; designed for providers practicing at IHS, tribal, and urban facilities.

Training

Indian Country ECHO
Free service for I/T/U clinicians and programs to enhance care delivery for patients with complex conditions, including substance use disorders; offers a variety of online clinics, trainings, technical assistance, and capacity building.

didgʷálič Immersion Trainings (Coming soon!)
Free 2-day in-person training to enhance your capacity to effectively treat patients with opioid use disorder (OUD); trainings are designed for health care teams practicing at I/T/U clinics.

Practitioner Training (SAMHSA)
SAMHSA’s practitioner training resource that offers tools, training, and technical assistance to practitioners in the fields of mental health and substance use disorders.

Steps to Obtain your MAT Waiver (PCSS)
Physicians require 8 hours of training to apply to the Drug Enforcement Agency for a waiver to prescribe buprenorphine, one of three medications approved by the FDA for the treatment of opioid use disorder. Learn more on this website.

Treatment

Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants (SAMHSA)
Comprehensive, national guidance for optimal management of pregnant and parenting women with opioid use disorder and their infants.

Guide for Appropriate Tapering or Discontinuation of Long-Term Opioid Use (HHS)
Compiled from published guidelines and practices endorsed in the peer-reviewed literature, the Guide covers important issues to consider when changing a patient’s chronic pain therapy.

Tribal Resources

Growing Your Tribal Community’s Capacity to Address Opioid Use Disorder: Advice for Tribal Leaders, Policymakers, and Program Staff Based on Lessons Learned from the Swinomish Indian Tribal Community (Coming soon!)
In one year, the Swinomish Indian Tribal Community cut tribal opioid overdose deaths in half. This document describes how they developed their successful treatment approach, as well as important lessons learned along the way.

Tribal Opioid Response National Strategic Agenda (NPAIHB)
To assist tribes in successfully addressing the opioid epidemic, the Northwest Portland Area Indian Health Board, along with partners, developed this strategic agenda. Recommendations are based on input from tribal policymakers, service providers, and individuals with opioid use disorder (OUD).

Withdrawal

Clinical Opiate Withdrawal Scale (COWS)
11-item scale designed to be administered by a clinician to rate common signs and symptoms of opiate withdrawal; objective and subjective in nature.

Objective Opioid Withdrawal Scale (OOWS)
Scale for measuring opioid withdrawal that relies on clinical observation; useful in measuring objectively measurable symptoms of opioid withdrawal.

The Subjective Opioid Withdrawal Scale (SOWS)
Scale for measuring opioid withdrawal that records the patient’s rating of withdrawal on a 16-item scale.