Harbor:Opiate Withdrawal/MAT/BUP: Difference between revisions
 
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===[[Harbor:Opiate Withdrawal/MAT/BUP|MAT/BUP/Opiate Withdrawal]]===
===[[Harbor:Opiate Withdrawal/MAT/BUP|MAT/BUP/Opiate Withdrawal]]===
* Please refer all '''DHS patients with substance use disorder''' (SUD) started on medication assisted treatment (MAT) to '''PVCC/CCC – Har for enrollment in Dr. Brown's addiction clinic'''
** In the "For referral, specify need" box: '''"MAT for opiate/alcohol dependency"'''
*** Qualifying patients
**** Active withdrawal or post-overdose: start buprenorphine in ED via buprenorphine protocol
**** Not in active withdrawal but with opioid use disorder: rx for home start using home initiation protocol
**** Patients with chronic pain and opioid dependence with PMD at Harbor: message PMD AND Christopher Brown AND Gloria Sanchez to link patient to Harbor SUD clinics
**** For pregnant patients - once the primary complaint is addressed (or if primary complaint is pregnant and opiate use disorder/withdrawal), if patient has confirmed IUP please send to OB triage for initiation of Suboxone during pregnancy
* Additional resources: 
** '''FM MAT Inpatient Consult Service'''
*** For patients 16y/o and older
**** Mon - Thurs 8a-4p x64398
**** call 31x-697-6030
**** Message Center:  Yvettte Cerna
** '''MAT Provider Consult Line'''
***DHS on-call providers available to help initiate MAT for patients with alcohol and/or opioid use disorder
****(213) 288-9090
****8a-MN, 7 days per week
****Flier: [[:File:MAT Consultation Line.pdf|Mat Consult Line.pdf]]
'''Consult [[Harbor:Whole person care|Whole Person Care]] for ALL patients started on or prescribed buprenorphine in the ED'''
'''Narcan Distribution from ED'''
*Available for any patients that meet criteria for Narcan distribution and would benefit from distribution
**In Code White cabinet in purple doc box, next to the adult airway cabinet, requires key from either senior resident phones or either attending phones
**Please initial to log the distribution on the clipboard attached, no PHI is required
*All patients distributed Narcan also need it prescribed to the pharmacy for tracking purposes
*Please document as you otherwise would for prescribing Narcan, with the addition of .ednaloxonegiven in your note, which can soon be replaced by .naloxoneEDdistribution
*Thank you for helping!
====BUP/MAT Treatment and Discharge Pathway====
*[[:File:Bup_Protocol_Harbor.pdf|Harbor Bup Protocol.pdf]]
====Patient Discharge Handout====
*[[:File:Harbor_Bup_Start_Instructions.pdf|Bup Start Instructions.pdf]]
====BUP Home Initiation====
*[[:File:Bup home Initiation.pdf|Bup Home Start.pdf]]
====Patient MAT/Buprenorphine Follow Up Options====  
====Patient MAT/Buprenorphine Follow Up Options====  
{| class="wikitable"
{| class="wikitable"
Line 47: Line 5:
! Insurance !! Clinic !! Hours
! Insurance !! Clinic !! Hours
|-
|-
| DHS Empaneled and DHS Eligible (not Harbor Family Medicine) || Primary Care & Diagnostic Center (PCDC) - Basement Clinic C
| DHS Empaneled to Internal Med or DHS Eligible || Primary Care & Diagnostic Center (PCDC) - Basement Clinic C
1000 W Carson St<br/>
1000 W Carson St<br/>
Torrance, CA 90502<br/>
Torrance, CA 90502<br/>
(424) 306-4546
(424) 306-4546
  || '''Schedule as "HAR PC MAT New"''' or
  || '''ED provider to submit PVCC/CCC form"'''
'''Walk-In: Monday AM or Thursday AM'''<br/>
'''Depart --> ED Post Visit Plan --> CCC-HAR --> free text in the "for Referral" box'''.  No longer taking walk-ins, clerk does NOT book appt.  For questions, please message Chris O. Brown, MD via ORCHID/Outlook
For questions, please message Chris O. Brown, MD via ORCHID/Outlook
|-
|-
| DHS Empaneled and DHS Eligible || Lomita Clinic  
| DHS Empaneled to Fam Med or DHS Eligible || Lomita Fam Med Clinic  
1430 W Lomita Blvd, 2nd Floor<br/>
1430 W Lomita Blvd, 2nd Floor<br/>
Harbor City, CA 90710<br/>
Harbor City, CA 90710<br/>
Line 80: Line 37:
|}
|}
All patients can call the Substance Abuse Service Hotline 24/7 for more help (844) 804-7500
All patients can call the Substance Abuse Service Hotline 24/7 for more help (844) 804-7500
* Please refer all '''DHS unempaneled patients with substance use disorder''' (SUD) started on medication assisted treatment (MAT) to '''PVCC/CCC – Har for enrollment in Dr. Brown's addiction clinic'''
** In the "For referral, specify need" box: '''"MAT for opiate dependency"'''
*** Qualifying patients
**** Active withdrawal or post-overdose: start buprenorphine in ED via buprenorphine protocol
**** Not in active withdrawal but with opioid use disorder: Rx for home start using home initiation protocol
* '''Empaneled patients:''' Patients with chronic pain and opioid dependence, message PCP to refer patients into a MAT clinic, AND CC Christopher Brown AND Gloria Sanchez to link patient to Harbor SUD clinics
* '''Empaneled to Lomita/Fam Med''', then message/consult FM MAT (see below) to get referral into FAM MAT clinic.
* For pregnant patients - once the primary complaint is addressed (or if primary complaint is pregnant and opiate use disorder/withdrawal), if patient has confirmed IUP please send to OB triage for initiation of Suboxone during pregnancy
* Additional resources: 
** '''FM MAT Inpatient Consult Service''' - opiate and meth use (excludes isolated EtOH use)
*** For patients 16y/o and older
**** Mon-Thur 8a-4p p0990 or call (310) 697-6030
**** Message Center:  Yvettte Cerna
****If afterhours, MAT team will call patient for follow up
****Flyer: [[:Media:FM MAT Consult Service.pdf|FM MAT Consult Service.pdf]]
** '''MAT Provider Consult Line'''
***DHS on-call providers available to help initiate MAT for patients with alcohol and/or opioid use disorder
****(213) 288-9090
****8a-MN, 7 days per week
****Flyer: [[:Media:MAT Consultation Line.pdf|Mat Consult Line.pdf]]
'''Narcan Distribution from ED'''
*Available for any patients that meet criteria for Narcan distribution and would benefit from distribution
**In Code White cabinet in purple doc box, next to the adult airway cabinet, requires key from either senior resident phones or either attending phones
**Please initial to log the distribution on the clipboard attached, no PHI is required
*All patients distributed Narcan also need it prescribed to the pharmacy for tracking purposes
*Please document as you otherwise would for prescribing Narcan, with the addition of .ednaloxonegiven in your note, which can soon be replaced by .naloxoneEDdistribution
* [https://www.bing.com/videos/search?q=Narcan+adapt+how+to+use&&view=detail&mid=3FE0F53C308009BA8ADF3FE0F53C308009BA8ADF&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3DNarcan%2Badapt%2Bhow%2Bto%2Buse%26FORM%3DHDRSC4 How to use intranasal narcan]
*Faculty/Resident Sponsors:  Wu/Golden (2021)
====BUP/MAT Treatment and Discharge Pathway====
*[[:Media:Bup_Protocol_Harbor.pdf|Harbor Bup Protocol.pdf]]
====Patient Discharge Handout====
*[[:Media:Harbor_Bup_Start_Instructions.pdf|Bup Start Instructions.pdf]]
====BUP Home Initiation====
*[[:Media:Bup home Initiation.pdf|Bup Home Start.pdf]]


==See Also==
==See Also==

Latest revision as of 19:22, 27 December 2022

MAT/BUP/Opiate Withdrawal

Patient MAT/Buprenorphine Follow Up Options

Insurance Clinic Hours
DHS Empaneled to Internal Med or DHS Eligible Primary Care & Diagnostic Center (PCDC) - Basement Clinic C

1000 W Carson St
Torrance, CA 90502
(424) 306-4546

ED provider to submit PVCC/CCC form"

Depart --> ED Post Visit Plan --> CCC-HAR --> free text in the "for Referral" box. No longer taking walk-ins, clerk does NOT book appt. For questions, please message Chris O. Brown, MD via ORCHID/Outlook

DHS Empaneled to Fam Med or DHS Eligible Lomita Fam Med Clinic

1430 W Lomita Blvd, 2nd Floor
Harbor City, CA 90710
(310) 602-2600
(424) 306-4193 - SUD Counselor

Walk-In: Tuesday AM or Friday AM

For questions, please message Gloria Sanchez, MD via ORCHID/Outlook

DHS Empaneled, DHS Eligible, MyHealthLA, Uninsured (No OOP) LAC+USC Urgent Care

2051 Marengo St, 2nd Floor
Los Angeles, CA 90033
(323) 409-1000

Walk-In:

Tuesday-Thursday & Saturday
8am-7pm

All Patients Tarzana Treatment Center

5190 Atlantic Blvd
Long Beach, CA 90805
(818) 654-3933

Walk-In:

24/7

All patients can call the Substance Abuse Service Hotline 24/7 for more help (844) 804-7500

  • Please refer all DHS unempaneled patients with substance use disorder (SUD) started on medication assisted treatment (MAT) to PVCC/CCC – Har for enrollment in Dr. Brown's addiction clinic
    • In the "For referral, specify need" box: "MAT for opiate dependency"
      • Qualifying patients
        • Active withdrawal or post-overdose: start buprenorphine in ED via buprenorphine protocol
        • Not in active withdrawal but with opioid use disorder: Rx for home start using home initiation protocol
  • Empaneled patients: Patients with chronic pain and opioid dependence, message PCP to refer patients into a MAT clinic, AND CC Christopher Brown AND Gloria Sanchez to link patient to Harbor SUD clinics
  • Empaneled to Lomita/Fam Med, then message/consult FM MAT (see below) to get referral into FAM MAT clinic.
  • For pregnant patients - once the primary complaint is addressed (or if primary complaint is pregnant and opiate use disorder/withdrawal), if patient has confirmed IUP please send to OB triage for initiation of Suboxone during pregnancy
  • Additional resources:
    • FM MAT Inpatient Consult Service - opiate and meth use (excludes isolated EtOH use)
      • For patients 16y/o and older
        • Mon-Thur 8a-4p p0990 or call (310) 697-6030
        • Message Center: Yvettte Cerna
        • If afterhours, MAT team will call patient for follow up
        • Flyer: FM MAT Consult Service.pdf
    • MAT Provider Consult Line
      • DHS on-call providers available to help initiate MAT for patients with alcohol and/or opioid use disorder


Narcan Distribution from ED

  • Available for any patients that meet criteria for Narcan distribution and would benefit from distribution
    • In Code White cabinet in purple doc box, next to the adult airway cabinet, requires key from either senior resident phones or either attending phones
    • Please initial to log the distribution on the clipboard attached, no PHI is required
  • All patients distributed Narcan also need it prescribed to the pharmacy for tracking purposes
  • Please document as you otherwise would for prescribing Narcan, with the addition of .ednaloxonegiven in your note, which can soon be replaced by .naloxoneEDdistribution
  • How to use intranasal narcan
  • Faculty/Resident Sponsors: Wu/Golden (2021)

BUP/MAT Treatment and Discharge Pathway

Patient Discharge Handout

BUP Home Initiation

See Also

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