Opioid Use Disorder Treatment
Providers play a critical role in a patient's recovery from Opioid Use Disorder (OUD).
Similar to other chronic conditions, OUD patients are at a high risk for relapse, related complications, and death. Medical treatment and monitoring is necessary to ensure a patient’s well-being throughout recovery.
Treatment is composed of several different but intertwined components. Each aspect is important. However, providers are uniquely positioned to aid in the recovery process by prescribing medication to limit a patient’s cravings and withdrawal symptoms. Providers can reference this page as a starting point to better understand treatment options.
Additionally, encourage patients, families, and friends to explore the American Society of Addiction Medicine Patient Guide. Fill out a quick form to order free printed copies for your healthcare facility.
Prescribing Medication-Assisted Treatment
To treat those with Opioid Use Disorder, it is crucial to expand access to evidence-based treatment. Medication-assisted treatment (MAT) is considered the best treatment option for OUD as part of a comprehensive treatment plan.
- MAT combines FDA-approved medication and behavioral therapy
- Medication works to relieve physical symptoms and cravings associated with withdrawal
- Patients can focus on making positive lifestyle changes that support long-term recovery
There are three FDA-approved medications used for OUD MAT. Each have specific protocol providers must follow in order to prescribe:
- Opioid agonist medication that has been used for decades
- Blunts or blocks the effects of opioids to reduce craving and withdrawal
How to prescribe:
- Prescribed or dispensed through SAMHSA-certified Opioid Treatment Programs (OTP) for daily administration either on site or, for stable patients, at home
- Works similarly to methadone
- Only partially activates opioid receptors
- Often reduces drug use and protects patients from overdose
How to prescribe:
- For treating up to 30 patients: Obtain a waiver from the Substance Abuse & Mental Health Services Administration (SAMHSA) and submit a Notice of Intent
- For treating more than 30 patients: After the first year of certification, complete waiver training and resubmit a Notice of Intent
- Completely blocks opioid receptors and is used after detoxification to prevent relapse
- No abuse and diversion potential or overdose risk
How to prescribe:
- Prescribed by any health care provider who is licensed to prescribe medications
- Special training is not required
On April 28, 2021, the Department of Health and Human Services (HHS) released new Buprenorphine Practice Guidelines that expand access to OUD treatment by removing a longtime training requirement.
Under the new guidelines, providers can prescribe medication for up to 30 patients at a time without training.
Before the initial dispensing or prescribing of Buprenorphine, providers must:
- Apply to the Drug Enforcement Administration for a Waiver
- Submit a Notification of Intent (NOI) to SAMHSA
Refer to SAMHSA’s Frequently Asked Questions for more information about the new practice guidelines.
For those still interested in completing training and for providers who wish to treat more than 30 patients after their first year of certification, the Providers’ Clinical Support System (PCSS) (funded by SAMHSA) offers waiver training at no cost for:
After completing the training, providers who wish to prescribe above the 30-patient limit are required to submit documentation with a new Notice of Intent.
SAMHSA offers tools, training, and technical assistance, including printable guides for providers seeking to prescribe buprenorphine:
Does your clinic not offer MAT? Refer patients to a MAT clinic.
- Currently, there are three state-supported clinics in South Dakota that offer MAT: Lewis & Clark Behavioral Health Services in Yankton, Project Recovery in Rapid City, and Center for Family Medicine in Sioux Falls. Contact these facilities for more information.
- Explore an up-to-date list of MAT waived providers in South Dakota.
- Search substance abuse treatment centers near you.
Patient insurance for MAT
Many people avoid treatment for their Substance Use Disorder (SUD) due to the cost. Insurance companies are required to cover behavioral health conditions in the way that they cover other medical conditions. If a patient has insurance, check with the provider to see what they cover.
Individuals who meet financial eligibility guidelines or who have considerable personal circumstances may qualify for state-funded services. The Indigent Medication Program through the SD Department of Social Services provides temporary financial support for those seeking MAT. Patients can call the Resource Hotline to learn what options best fit their needs.
Some Employee Assistance Programs (EAP) may also cover the cost of the initial assessment or a few counseling sessions. Legal spouses and children under the age of 26 often fall under the employee’s benefit.
Providers should refer their patients to call the Resource Hotline at 1-800-920-4343. The hotline is available 24/7 for FREE—offering confidential support and for connection to resources. If providers have patients who are expressing concerns that could create barriers to their success in MAT, they should assure them that the Resource Hotline is available for an abundance of services, referrals and support.
The Resource Hotline can help with:
- Listening and providing support for those struggling with Substance Use Disorder, including Care Coordination if an individual would like follow-up support and assistance
- Accessing treatment and recovery support services
- Finding resources such as housing, transportation, employment, financial, and food assistance
Explore a full list of support services for patients and their families.
Recovery may be distinctively challenging for patients who need to manage their chronic pain. Providers can help their patients by providing them with alternative methods of pain management.
Treatments for OUD patients with chronic pain may include:
- Physical therapy
- Osteopathic or chiropractic manipulative treatment
- Cognitive behavioral therapy
- Proper use of medications from several drug classes
- Nerve blocks
- Steroid injections
Additional resources for recommending treatment:
Better Choices, Better Health SD®
Better Choices, Better Health® SD offers free educational workshops for caregivers and adults living with chronic pain. In a supportive group environment, participants learn skills to safely manage pain and balance life with ongoing physical and/or mental health conditions. Encourage patients to learn more about online or local workshop options.