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Opioid Use Disorder

Opioid use disorder is characterized by a pattern of opioid use that causes clinically significant impairment or distress. This medical condition often includes a strong desire to use opioids, increased tolerance to opioids, and withdrawal syndrome when opioids are abruptly discontinued. Addiction and dependence are components of a substance use disorder and addiction represents the most severe form of the disorder. Opioid dependence can manifest as physical dependence, psychological dependence, or both.

Opioid dependence is a complex disease involving physiological, psychological, genetic, behavioral and environmental factors. It shares features of other drug dependencies but often requires unique treatment strategies. No single treatment approach is effective in all cases. While abstinence is generally accepted as the primary goal of treatment, it is not feasible as an exclusive goal for all opioid dependent persons.

Preventing Prescription Drug Misuse and Abuse

Preventing prescription drug misuse, abuse, opioid use disorder and addiction requires a public health approach that includes prevention, early intervention, treatment, and recovery support services. Appropriate opioid use is an important step in preventing opioid use disorder and addiction.  National guidelines support shared decision-making for appropriate use and misuse.


 


I-STOP: Internet System for Tracking Over-Prescribing

Because of possible danger and misuse, opioids are closely controlled by medical providers and by the law. Patients who use opioids should have their prescriptions written and monitored by one physician and have the prescriptions filled at the same pharmacy.

Physicians in New York have a duty to consult the NYSDOH’s Prescription Monitoring Program (PMP) since August 27, 2013.  To access the PMP, physicians need a Health Commerce System (HCS) account.  Physicians can apply for an HCS account on the NYSDOH here.



Bureau of Narcotic Enforcement

The Bureau of Narcotic Enforcement (BNE) is responsible for protecting the public health by combating the illegal use and trafficking of prescription controlled substances. The Bureau also prevents prescription drug abuse through educational materials and presentations for parents, educators, and healthcare professionals.




Medication-Assisted Treatment

Buprenorphine may be used for the treatment of substance abuse disorder by qualified prescribers.

Medication Assisted Therapy (e.g., Buprenorphine, LAAM, Methadone Maintenance Treatment, Ultra-rapid Detoxification), Opioid treatment (PDF) Policy 3.01.04 (posted 9/13/17)

SAMHSA’s MATx Mobile App empowers health care practitioners to provide effective, evidence-based care for opioid use disorders. This free app supports practitioners who currently provide medication-assisted treatment (MAT), as well as those who plan to do so in the future. Features include:

Medication-Assisted Treatment (MAT) Training is available.




Appropriate Use of Naloxone

CDC guidelines suggest clinicians should offer naloxone when factors that increase the risk for overdose are present, such as a history of overdose, history of substance use disorder, higher opioid doses (>50 mg oral morphine equivalents/day) or concurrent benzodiazepine use.




Special Considerations: Teens

Families dealing with addiction are often devastated by medical, financial and psychological ordeals, car accidents, lost jobs, derailed college experiences, incarceration and sometimes death by accident, homicide, overdose or suicide.




Additional Resources

Below is a list of resources providing information to help with addiction.


Help with Addiction 

StopAddiction.US

OASIS.ny.gov serves as a guide to services, educational information and source to locate available treatment programs and beds in New York.

Urine Drug Testing, immunoassay, presumptive testing, confirmatory testing (PDF) Policy 2.02.50 (posted 1/17/17)



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