Opioid Use Disorder Treatment

South Dakota Resource Hotline 1-800-920-4343

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:

Methadone
  • 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

Source: samhsa.gov

Buprenorphine
  • Works similarly to methadone
  • Only partially activates opioid receptors
  • Often reduces drug use and protects patients from overdose

How to prescribe:

  • Obtain a waiver from the Substance Abuse & Mental Health Services Administration (SAMHSA)
  • Review the SAMSHA qualifications and apply for a practitioner waiver
  • Receive an additional registration number by the U.S. Drug Enforcement Administration (DEA)

Source: samhsa.gov

Naltrexone
  • 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

Source: samhsa.gov

Obtaining a MAT Waiver

The Drug Addiction Treatment Act of 2000 Waiver  helps improve access to treatment for Opioid Use Disorder (OUD) and Substance Use Disorder (SUD) by allowing clinicians to dispense or prescribe narcotic medications in settings other than an opioid treatment program. To increase the number of Waiver-certified clinicians in high-need communities, the National Health Service Corps is partnering with SAMSHA. SAMHSA’s Provider Clinical Support System provides Waiver training and offers the most effective, evidence-based clinical practices in preventing, identifying, and treating OUD and SUD.

As a provider, you are eligible for free, discipline-specific MAT Waiver Training if you meet both of the following criteria:

  • You are a physician (MD or DO), nurse practitioner (NP), certified nurse midwife (CNM), or physician assistant (PA).
  • You have an active Drug Enforcement Administration (DEA) number to dispense controlled substances.

The MD/DO training is 8 hours. NP, CNM, and PA training courses are 24 hours. Register for the in-person or online courses.

How to refer patients to a MAT clinic

Does your clinic not offer MAT? Refer patients to a MAT clinic.

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.

For additional questions on financial assistance, encourage patients to call the Resource Hotline or the Division of Behavioral Health at 605-367-5236.

Additional questions about MAT

Contact the Division of Behavioral Health at 605-367-5236 or email questions to DSSbh@state.sd.us.

Refer patients to the Resource Hotline (1-800-920-4343)

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.

Alternative ways manage pain while recovering from OUD

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
  • Acupuncture
  • 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.