Central California Alliance For Health

 

Pain Management Resources

Opioid Stewardship at the Alliance


While opioid overuse has emerged as one of the fastest growing and most serious public health issues in recent history, restoring and repairing our communities is within reach. The Central California Alliance for Health (Alliance) is committed to working with community partners, supporting our providers and members, and jointly developing effective, resourceful and innovative strategies to change the course of this crisis.


As complex problems require complex solutions, we are coordinating our efforts toward four key evidence-based areas:


Prevention. Limiting the number of new members starting the path of chronic
   opioid use.

Management. Promoting safer prescribing practices by evolving our focus
   toward safety, helping identify members on high-risk regimens,
   and working with providers and members to develop
   successful tapering plans.

Treatment. Fostering medication assisted treatment for substance use
   and streamlining access to these multimodal, essential services.

Stopping overdose deaths. Educating providers, pharmacies, members,
   and their families on the life-saving importance of naloxone for anyone
   prescribed opioids.

The helpful resources below provide clinicians and members with evidence-based information, tools, and best practices for safe, compassionate, and effective care.


Additional Resources

State, National and Federal Organizations

•  California Department of Public Health Prescription Drug Overdose
    Prevention Initiative

•  California Health Care Foundation, California Improvement
    Network, Opioid Safety

•  California Opioid Surveillance Dashboard

•  American Society of Addiction Medicine

•  Providers’ Clinical Support System

•  Providers’ Clinical Support System for Opioid Therapies (PCSS-O)

•  National Center for Complementary and Integrative Heath
    (NCCIH)

•  National Institute on Drug Abuse (NIDA)

•  SAMHSA-HRSA Center for Integrated Health Solutions

•  Substance Abuse and Mental Health Services Administration
    (SAMHSA)


Complementary and Alternative Medicine

•  Complementary Health Approaches for Chronic Pain

•  Pain Care on a New Track: Complementary Therapies in the
    Safety Net (CHCF)(PDF)

•  Free or Low Cost Community Resources (Coming Soon)

•  Member Online Health and Wellness Calendar

•  Mindfulness and Guided Meditation

•  Evidence Based Evaluation of Complementary Health Approaches
    for Pain Management in the U.S. (PDF)


Tools and Toolkits

CDC Clinician Tools (complete toolkit)

•  Clinical Tools for Pain Management (comprehensive list of useful,
    downloadable, PDF tools and forms)(OPG)

•  Nonopioid Treatments for Chronic Pain (CDC)(PDF)

•  Tapering Toolkit Provider Resource (MPS/PHC)(PDF)

•  Buprenorphine Dosing Algorithms

•  American Osteopathic Academy of Addiction Medicine (AOAAM)
    Buprenorphine Clinical Tools (includes multiple, useful
    tools and forms)

•  Safe Pain Prescribing in Emergency Departments and Urgent Care
    Centers (SafeMedLA)

•  Emergency Department Medication Assisted Treatment of Opioid
    Addiction (PDF)

•  Opioid Tapering Flow Sheet (OPG)

•  Primary Care Guidelines Flowchart (SC SafeRx)(PDF)

•  Opioid Overdose Prevention Toolkit (SAMHSA)

•  Buprenorphine Dosing Algorithms


Behavioral Health and Psychiatric Support

•  Beacon Health Options

•  Encompass

•  Janus

•  Monterey County Behavioral Health

•  Santa Cruz County Behavioral Health

•  Merced County Behavioral Health

•  Central Coast Recovery Options

•  Sun Street Center Monterey

•  Member Online Health and Wellness Calendar

•  Motivational Interviewing Network of Trainers (MINT)

•  Difficult Conversations (OPG)

•  SAMHSA-HRSA Center for Integrated Health Solutions

•  Substance Abuse and Mental Health Services Administration
   (SAMHSA)


Clinical Guidelines

•  CDC Guideline Checklist (PDF)

•  CDC Guideline for Prescribing Opioids for Chronic Pain, 2016

•  CDC Guideline Resources

•  Medical Board of California, Guidelines for Prescribing Controlled
   Substances for Pain (PDF)

•  Complementary Health Approaches for Chronic Pain

•  Guidelines for Prescribing Controlled Substances for Pain
   (Medical Board of CA)(PDF)

•  Interagency Guideline on Opioid Dosing for Chronic Non-Cancer
   Pain (includes opioid tapering guideline)(PDF)

•  Noninvasive Treatments for Acute, Subacute, and Chronic Low
   Back Pain: A Clinical Practice Guideline (ACP)(PDF)

•  VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic
   Pain 2017 (includes provider summary and pocket card)


Medication Assisted Treatment

•  ASAM National Practice Guideline for the Use of Medications in
   the Treatment of Addiction Involving Opioid Use (PDF)

•  VA/DoD Practice Guideline for the Management of Substance Use
   Disorders (includes provider summary and pocket card)

•  Clinical Guidelines for the Use of Buprenorphine in the Treatment
   of Opioid Addiction (SAMHSA)(PDF)


Community Coalitions

•  Alameda County Safety Net Working Group on Opioid Prescribing

•  NoRxAbuse

•  SafeMed LA

•  RxSafe Marin

•  Prescribe Safe Monterey County

•  Prescribe Safe Santa Cruz/HiP


Evidence Based and Best Practices

•  Managing Chronic Pain in Adults With or In Recovery from
    Substance Use Disorders (SAMHSA)(PDF)

•  Tapering Long-term Opioid Therapy in Chronic Noncancer Pain:
    Evidence and Recommendations for Everyday Practice (PDF)

•  Difficult Conversations (OPG)

•  Naloxone for Opioid Safety (SFDPH)(PDF)

•  Opioid Failure

•  DSM-5 Opioid Use Disorder Diagnostic Criteria and
    Educational Guide (PDF)

•  Recommendations for the Care of Homeless Adults with Chronic
    Non-Malignant Pain (PDF)

•  SAMHSA-HRSA Center for Integrated Health Solutions Treatment
    for Chronic Pain: Our Approach

•  Six Building Blocks: A Team-Based Approach to Improving
    Opioid Management in Primary Care


Medication Assisted Treatment

•  Recovery Within Reach: Medication Assisted Treatment of Opioid
    Addiction Comes to Primary Care (CHCF)(PDF)

•  Webinar Series: Implementing Medication Assisted Treatment in
    Primary Care (CHCF)

•  MAT in Specific Populations (PCSS)

•  Procedures for Medication Assisted Treatment of Alcohol or Opioid
    Dependence in Primary Care (RAND)(PDF)


Medication Assisted Treatment (MAT) Peer Support and Services

MAT Advisory Group

The SafeRx Santa Cruz and Prescribe Safe Monterey MAT Advisory Group is a peer support and resource group of physicians, advanced practice clinicians, and behavioral health providers focused on improving opioid use disorder recovery capacity and quality


The Advisory Group convenes periodic in-person gatherings in addition to other forms of support: local mentors willing to guide providers that already have or are interested in obtaining a buprenorphine waiver; a Google Group for case discussions, questions, and answers; as well as a Google Drive folder with training and prescribing resources.


We invite all providers interested in acting as mentors or mentees to join the MAT Advisory Group. If you are interested in learning more, please contact admin@hipscc.org.


PCP MAT Program

The Alliance’s Enhanced Primary Care Pain Management Program seeks to strengthen the network of primary care providers (PCPs) through provision of Medication Assisted Treatment (MAT) services to their linked members. PCPs with X-licenses offering MAT for linked members will be paid fee-for-service rates for qualifying services.
To learn more, please reference Section 3 of the Alliance Provider Manual, contact a Provider Services Representative at (800) 700-3874 ext. 5504, or contact Dr. Julio Porro, Alliance Medical Director, at (831) 430-5551.


MAT Training for Providers (PDF)


Peer Support and Consultation

Clinician Consultation Center (UCSF)

Providers’ Clinical Support System Mentoring Program (PCSS)

List of local mentors with contact information


Member Benefits

•  Acupuncture

•  Chiropractic Care

•  Physical Therapy

•  Member Online Health and Wellness Calendar

•  Case Management


Patient Education and Handouts

•  CDC Guideline Resources: Patient and Partner Tools

•  Opioid Addiction Treatment: A Guide for Patients, Families and
    Friends (ASAM)

•  Feeling Better Brochure (SafeRx) (PDF)

•  Learning About Pain (SafeRx)(PDF)

•  Mindfulness and Guided Meditation

•  Pregnancy and Opioid Pain Medications (CDC)(PDF)

•  El Embarazo Y Los Medicamentos Opioides (CDC)(PDF)

•  Prescriptions Opioids: What You Need to Know (CDC)(PDF)

•  Recovery is Possible (Video)


Safe Medication Disposal

•  Safe Medication Disposal Santa Cruz

•  Safe Medication Disposal Monterey (PDF)

•  Disposal of Unused Medicines (FDA)

•  Safe Medication Disposal Merced

•  DEA Drug Disposal Locator


Helpful Websites for Patients

•  American Academy of Pain Medicine

•  CDC Guideline Information for Patients

•  Greater Good in Action: The Science of a Meaningful Life
    (UC Berkeley)

•  Mindful.org

•  Pain - National Center for Complementary and Integrative Health

•  SAMHSA

•  SAM's Guide to Monterey County Family Resources


Naloxone

•  Prescribe to Prevent (information for providers, pharmacists and
    patient education)

•  Opioid Safety and How to Use Naloxone (SFDPH)(PDF)

•  How to Use Narcan® Nasal Spray (video)


Pharmacy Resources

•  Alliance Pharmacy Department

•  CURES 2.0 Patient Safety Alerts

•  Online MME Calculator

•  Opioid Calculator (PPM)

•  Buprenorphine Dosing Algorithms

•  Prescribe to Prevent


Pocket Guides and Apps

•  ASAM National Practice Guideline Pocket Guide and Mobile App

•  CDC Mobile App (PDF)

•  Medication Assisted Treatment of Opioid Use Disorder Pocket
   Guide(SAMHSA)(PDF)

•  Online MME Calculator

•  MATx Mobile App

•  Calculating Total Daily Dose of Opioids for Safer Dosage
   (CDC)(PDF)

•  Opioid Calculator (PPM)


Training and CMEs/CEs

Local

•  Local CMEs/CEs/events (Coming Soon)


Online

•  Project ECHO
UC Davis ECHO - Pain Management is a peer-to-peer video conference mentoring program designed to support community primary care clinicians in their mission to provide high quality, safe and effective pain care. Through weekly videoconference learning and support sessions, the program provides primary care providers with the opportunity to increase their specialized knowledge as well as transition their clinical site into a primary care Center of Excellence in pain management. For more information about this program, please contact Dr. Julio Porro, Alliance Medical Director, at (831) 430-5551.
•  American Academy of Addiction Psychiatry Buprenorphine Waiver Training
•  American Society of Addiction Medicine (includes Waiver Qualifying Training)
•  Pathways to Safer Opioid Use
•  Providers Clinical Support System (includes Waiver training for providers, NPs and PAs)
•  Health Improvement Partnership CME Video Series
•  SCOPE of Pain
•  Webinar Series: Implementing Medication-Assisted Treatment in Primary Care (CSAM/CHCF)
•  California Hub and Spoke System: MAT Expansion Project




 

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