Referral

Description: 
This Clinical Practice Guideline is intended to provide primary care clinicians and other healthcare providers with a framework by which to evaluate, treat, and manage the individual needs and preferences of patients with substance use disorders (SUD), leading to improved clinical outcomes. (From the website.)
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Department of Veterans Affairs and Department of Defense
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Description: 
Find Opioid Treatment Programs by state.
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SAMHSA
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BrochuresPatients who have been referred for buprenorphine treatment may be anxious about what to expect. You can help ease patient concerns by providing some patient education materials about topics, such as:

Related Resources: 
Description: 
This web page provides educational materials on buprenorphine treatment including information on different stages of treatment, patient stories, educational essays, and a glossary.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Patient Handouts: 
Description: 
This printable patient brochure provides information about opioid dependence, buprenorphine, DATA 2000, and finding treatment.
Source: 
National Alliance of Advocates for Addiction Treatment (NAABT)
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Description: 
A comparison of cognitive performance outcomes of patients maintained on methadone versus those maintained on buprenorphine/naloxone during early opioid substitution treatment.
Source: 
Rapeli et al. BMC Clin Pharmacol.2007; 12;7:5.
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Physician stage in practice: 
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Description: 
A systematic review and economic evaluation of methadone and buprenorphine for the management of opioid dependence.
Source: 
Health Technology Assessment; Vol 11: number 9. Connock et al., 2007.
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Some patients will resist or flatly deny substance abuse. However, if you suspect substance abuse and referral to addiction treatment is warranted, then you must discuss the issues with the patient. Explain to patients and their significant others that:

Related Resources: 
Description: 
A guide for using non-stigmatizing language when working with patients who have substance use disorders.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Physician stage in practice: 
Description: 
Guide on using motivation to effect substance abuse treatment. Includes information on motivational interviewing, integrating motivational approaches into treatment, and measuring patient motivation.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Description: 
Provides physicians with information on how to work with a patient who has co-occurring disorders, including how to engage the patient in treatment and how to develop a successful therapeutic relationship.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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ReferralPhysicians who do not want to prescribe buprenorphine should maintain a list of local treatment providers where they can refer patients when opioid use disorder is identified or suspected.

Related Resources: 
Description: 
Guideline document discussing the psychosocial treatment buprenorphine patients should receive.
Source: 
Physician Clinical Support System (PCSS-MAT)
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Physician stage in practice: 
Description: 
A directory of treatment programs and physicians authorized to treat patients with buprenorphine.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Description: 
Search tool where a patient or physician can enter their zipcode and receive a listing of the closest buprenorphine counselors, pharmacies, treatment facilities, and support groups.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Description: 
This brochure provides information for patients on how to locate a physician certified to provide buprenorphine treatment.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Listing of State Agencies and Organizations

Description: 
A listing of websites and other contact information for state agencies that regulate substance dependence treatment. Many provide resources to assist patients or physicians in identifying treatment providers.

Description: 
This page provides a search form for regional branches of Narcotics Anonymous to locate meetings in a specific area.
Source: 
Narcotics Anonymous (NA)
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Primary care providers who do not prescribe buprenorphine should refer opioid-dependent patients to a specialist either another provider a substance abuse treatment center whenever:

Related Resources: 
Description: 
This chapter discusses the treatment approaches and models available to those working with patients with substance abuse disorders.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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CTI Referral Form for Substance Abuse Treatment

Description: 
Form3used for referral to substance abuse treatment or counseling.

This form is for use by a primary care provider to refer a patient for substance abuse treatment. It could also be used to refer the patient for counseling.


Description: 
Described on the ASAM website as, "the most widely used and comprehensive set of guidelines for placement, continued stay and transfer/discharge of patients with addiction and co-occurring conditions.
Source: 
ASAM
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Description: 
This study found that specialists and PCPs perceive the quality of their communications with each other differently regarding referral and consultations. Physicians who did not receive timely communications regarding referrals or consultation reported that it impacted their ability to provide high quality care. This highlights the importance of effective referral as a clinical skill, and the need to improve inter-profession communication between primary care physicians and specialists.
Source: 
Archives of Internal Medicine (Jan 10, 2011)
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Physician stage in practice: 

CTI Referral Form for Substance Abuse Treatment

Description: 
Form3used for referral to substance abuse treatment or counseling.

This form is for use by a primary care provider to refer a patient for substance abuse treatment. It could also be used to refer the patient for counseling.

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Stages of Change Model

Description: 
The Stages of Change Model can be used to assess the patient's readiness to change his/her addictive behavior; this should be determined before addiction treatment begins.

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