We are asking physicians, physician assistants, nurse practitioners AND OTHER SUD HEALTH TEAM MEMBERS to complete an online survey, Ability to Treat Opioid Use Disorder in West Virginia, designed to assess providers’ availability and willingness to prescribe medication-assisted treatment (MAT) to patients with Opioid Use Disorder (OUD). The resulting data will be used to help improve public policy to better address the opioid epidemic in West Virginia. This research project is a joint effort of the WV Department of Health and Human Resources (WVDHHR), Marshall Health, WV School of Osteopathic Medicine, and West Virginia University (WVU) under the direction of Garrett Moran, PhD, at WVU and Lyn O’Connell, PhD, at Marshall Health.
This survey link will be e-mailed directly from the WV DHHR to WV Medicare and Medicaid service providers. The survey may be accessed directly through the following link: https://bit.ly/2VokOBZ
Additionally, the survey is also available on the WV Rural Health Association’s blog page at https://bit.ly/2LJEwIZ. Voluntarily completing this survey should take no more than 7 to 10 minutes of your time and requires no examination of records. Your answers will remain completely confidential. Before completing the survey, or at any time, you may ask questions of the individuals administering it by contacting Brianna Sheppard, PhD, at 304-293-1444 or firstname.lastname@example.org. WVU IRB acknowledgment of this protocol is on file.
As you may know, State Bill 273, the Opioid Reduction Act, was signed into law and will take effect on June 7, 2018, and may have an impact on your daily practice.
It is important to note that current legislation allows for the following exemptions to the new prescribing regulations:
- Patient undergoing active cancer treatment
- Patients under hospice care
- Patients residing in long-term care facilities
- Patients undergoing active addiction treatment
- Patients receiving chronic opioids prior to January 1, 2018. (Chronic is defined as longer than three continuous months)
Areas of potential impact include:
- Emergency Department and Urgent Care practitioners are limited to writing a 4 day supply of opioids
- Pediatricians, Dentists, and Optometrists are limited to writing a 3 day supply of opioids
- All other practitioners, including surgeons post-operatively, are limited to writing a 7 day supply of the lowest effective dose of opioids. Documentation for these prescriptions must include:
- A thorough history of non-opioid medication, non-pharmacologic treatment, and substance abuse history
- Physical exam pertinent to the problem requiring the prescription
- Treatment plan
- Documentation of a review of the Controlled Substance Monitoring Program (CSMP)
- These prescriptions can be refilled in 6 days. For the first refill:
- Must document discussion of risk of opioid addiction with the patient
- Must document the risk of use of sedatives and alcohol
- For the second refill:
- Referral to a pain specialist and/or alternative treatments must always be considered. Patient acceptance or refusal of such must be documented prior to refill.
- Must assess the patient’s addiction/dependence
- For practitioners who choose to continue prescribing chronic opioids:
- Must assess medication therapy at least every 90 days
- Must attempt to decrease dosage, stop medication, or use other modalities every 90 days
- Practitioners are required to enter into a narcotics contract with the patient whenever a Schedule II opioid is prescribed
As you may know, the U.S. Senate and House of Representatives have overwhelmingly passed the First Step Act. The passage of this seminal criminal justice legislation is highly significant because it represents that first major bi-partisan criminal justice reform bill that has been approved in a generation. Not only was the First Step Act have unprecedented support in Congress, it was also fully endorsed by President Trump – with the leadership of Jared Kushner. The President is expected to sign the bill on Friday, December 21st.
It is important to mention that a great deal of credit for reaching this milestone in criminal justice reform should was go the national criminal justice reform advocacy community- which includes NASW. For more than 10 years, we all have actively advocated for comprehensive criminal justice reform. Therefore, NASW along with our coalition partners are thrilled by the passage of this legislation.
The First Step Act prioritizes much needed reforms in sentencing within the federal criminal justice system. The bill includes the following important items:
- It will reduce mandatory minimum sentences for certain crimes;
- It includes programing funds that improve reentry services and planning;
- The act includes special funding targeting opioid prevention and treatment;
- The bill revises federal sentencing laws, including reducing the “three strikes” penalty for drug felonies from life behind bars to 25 years and retroactively limiting the disparity in sentencing guidelines between crack and powder cocaine offenses;
- The legislation eliminates solitary confinement for juveniles who are incarcerated in federal facilities.
- It requires the Justice Department to develop an evidence-based prisoner risk and needs assessment system to evaluate prisoners’ recidivism risk;
- Improves opportunities for inmates to earn “good time” for early release from prison;
- The First Step Act prohibits placing pregnant prisoners in restraints and shackles, and
- It expands the information required to be collected by the National Prisoner Statistics Program.
While the First Step Act is not perfect, it is certainly a critical “first step” toward reaching comprehensive criminal justice reforms at the federal, state and local levels. NASW should be proud of being a part of this advocacy and social action. It is an incentive for us to continue to be active on criminal justice reforms both at the national and chapter levels.
Each September, SAMHSA sponsors National Recovery Month to increase awareness and understanding of mental and substance use disorders, and to celebrate individuals living in recovery. The Toolkit and PSAs can be used to organize events, issue proclamations, and increase public awareness. Learn more about Recovery Month 2018 and how you can get involved.
SAMHSA is accepting applications for $930 Million to combat the opioid crisis through State Opioid Response Grants (Short Title: SOR). The program aims to address the opioid crisis by increasing access to medication-assisted treatment, reducing unmet treatment need, and reducing opioid overdose related deaths. The application due date is August 13, 2018 by 11:59 p.m. (ET).
SAMHSA is accepting applications for up to $50 million in Tribal Opioid Response Grants. The grants, which will go to tribes and tribal organizations, will fund prevention, treatment, and recovery activities in response to the opioid crisis. The grants will reduce unmet treatment needs and opioid overdose-related deaths. The application due date is August 20, 2018 by 11:59 p.m. (ET).
SAMHSA has published an update to this brochure that offers emergency department providers tips for enhancing treatment for people who have attempted suicide. It also offers information about communicating with families, HIPAA, patient discharge, and resources for medical professionals, patients, and their families.