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Slide 1: Title Slide

Module 4: Prescription Opioid Use Disorder - Community Resources

Slide 2: Meet the Developers

The following Montana State University faculty and staff helped create the content of this toolkit:

  • Michelle U. Grocke-Dewey, Ph.D. Principal Investigator, Assistant Professor, Health & Human Development, MSU Extension FCS Health & Wellness Specialist
  • Alison Brennan, Ph.D. Principal Investigator, Assistant Professor, Health & Human Development, MSU Extension FCS Mental Health Specialist
  • Barbara Allen, M.S. Program Director, MSU Extension Associate Specialist
  • Jennifer Munter, Program Manager, MSU Extension
  • Barbara Watson, Program Coordinator, MSU Extension
  • Lori Mayr, FCS Administrative Assistant, MSU Extension

Slide 3: Learning Objectives

At the conclusion of module four, participants will be able to:

  • Locate agencies/organizations that provide Community Resources pertinent to the identified need.
  • Better understand the types of State/Community level resources for the prevention, treatment, and recovery of Opioid Use Disorder (OUD) and Mental Health Disorders
    • In-patient vs. out-patient treatment programs
    • Opioid Treatment Programs vs. Office-Based Opioid Treatment
  • Learn about the different community resource categories such as SAMHSA-Affiliated and Licensed, Tribal and culturally-relevant, and those specific to Montana.

Slide 4: Prevention Resources

The following slides will provide prevention education and information on the existing resources on the topics of :

  • Opioid Misuse (non-medical use)
  • Opioid overdose deaths
  • Substance Use Disorder (SUDs) including Opioid Use Disorder (OUD)
  • Suicide

Slide 5: State Level Resources To Prevent The Non-Medical Use of Prescription Opioids

According to the 2019 National Survey on Drug Use and Health, 9.7 million people misused prescription pain relievers, in 2019 alone.  This survey also showed most misused prescription drugs were obtained from family and friends, often from the home medicine cabinet (DEA.gov).

Slide 6: State Level Resources To Prevent Opioid Overdose Deaths

Naloxone: the opioid antagonist that reverses the effects of an opioid overdose.

There are 3 FDA-approved formulations available to Montanans:

  1. Injectable: professional training required
  2. Auto-injectable: prefilled auto-injection device for families or emergency personnel to inject quickly into outer thigh. The device provides verbal instruction to the user describing how to deliver the medication.
  3. Nasal Spray: prefilled, sprayed into one nostril while patients lay on their back.    *No professional training required

By familiarizing yourself with naloxone, you can help save lives!

Slide 7: Substance Use Disorder Prevention Resources

Slide 8: Indian Health Services (IHS) Agency

  • Agency within the Department of Health and Human Services.
  • Provides federal health services to members of federally-recognized American Indian and Alaska Native tribes.
  • Goal: Raise health status to the highest possible level.
  • Indian Health Services Office Of Urban Indian Health Programs in Billings.  For more information about the services provided visit:   http://billingsurbanindianhealth.org/services-page/#1574367397058-b23bb3b8-0e6c

Slide 9: IHS Opioid Misuse Prevention Services

IHS Resources:

https://www.ihs.gov/opioids/prevention/

Slide 10: IHS Technical Assistance Training Information

The IHS recognizes the complexity of implementing and sustaining evidence-based strategies to improve substance use prevention, treatment, and recovery outcomes in tribal communities.

https://www.ihs.gov/opioids/opioidresponse/techassistance/

Slide 11:  State Suicide Prevention Resources

Suicide Prevention resources are available at

https://dphhs.mt.gov/suicideprevention

If you are in crisis and want help,
call the Montana Suicide Prevention Lifeline, 24/7, at
1-800-273-TALK
(1-800-273-8255)
Or text “MT” to 741 741

Slide 12: Tribal Suicide Prevention Resources

Indian Health Services suicide prevention resources are available at:

https://www.ihs.gov/forpatients/healthtopics/suicideprevention/

If you are in crisis and want help, call the confidential support 24 hours a day, 7 days a week:

CALL:  1-800-273-8255 (TALK),

VISIT:  the National Suicide Prevention Lifeline CrisisChat webpage,

TEXT:  the Crisis Text Line (text START to 741741 from anywhere in the U.S., and a trained Crisis Counselor will respond quickly).

Slide 13: Treatment & Recovery Resources

The following slides will provide treatment and recovery resources for:

  • Opioid Use Disorder (OUD)
  • Substance Use Disorders (SUDs)
  • Mental Health Services

*COVID 19 Pandemic Resources

Slide 14: State Resources To Treat Opioid Use Disorder (OUD)

Medication-Assisted Treatment Services Locators

Buprenorphine Practitioner Locator

Slide 15: Tribal Resources to Treat Substance Use Disorder

Alcohol and Substance Abuse Program (ASAP):

The objective of ASAP is to reduce the incidence and prevalence of alcohol and substance abuse among American Indians and Alaska Natives (AI/AN) to a level at or below the general U.S. population.

Provide alcohol and substance abuse programs within Tribal communities, including emergency treatment, inpatient and outpatient treatment, and rehabilitation services, in rural and urban settings.

Improve access to behavioral health services (tele-behavioral health methods)

More information available at https://www.ihs.gov/asap/

Slide 16: Tribal Resources To Prevent Opioid Use Disorder & Overdose Deaths

https://www.ihs.gov/opioids/

  • Opioid Use Disorder and Pain Overview
  • Training opportunities
  • Opioids & COVID-19
  • Heroin, Opioids, and Pain Efforts (HOPE) Committee
  • Maternal & Child Health & Wellness
  • Medication-assisted recovery
  • Harm reduction
  • Naloxone
  • Prevention

2-Minute video: Preventing and Treating Opioid Use Disorder

Slide 17: Tribal Resources to Treat Opioid Use Disorder

https://www.ihs.gov/opioids/

Training Opportunities   

  • Essential Training on Pain and Addiction
  • ECHO and DATA Waiver Training
  • Screening, Brief Intervention, and Referral to Treatment (SBIRT)
  • CDC Training

Opioids and the COVID-19 Pandemic

  • Telehealth and remote services resources

The Indian Health Service National Committee on Heroin, Opioids and Pain Efforts (HOPE) Committee

  • 7 workgroups working directly with Stakeholders to foster tribal relationships

Opioid Response at IHS

  • Assessment, screening, treatment planning, monitoring, safe storage of medications, medication disposal, and legal considerations for prescribers
  • Opioid Crisis Data
  • Funding opportunities
  • Best and promising practices

Slide 18: Tribal Resources To Treat Opioid Use Disorder

https://www.ihs.gov/opioids/

Maternal and Child Health and Wellness

  • Helping babies and supporting moms
  • Screening, prenatal care, and treatment
  • Maternal health
  • Delivery and postpartum care
  • Information for parents and families

Medication Assisted Recovery

  • Tribal Healing Wellness Courts
  • Tele-MAT
  • Pharmacological Treatment
  • Office-Based Opioid Treatment
  • Provider considerations/Warmline
  • Supportive services/Holistic Care
  • Trauma Informed Care
  • Opioid withdrawal support/clinical considerations

Slide 19: IHS Substance Use Warmline for Clinicians

The Substance Use Warmline (1-855-300-3595)

  • Answered by trained clinical support specialists with diverse experience and substantial training in substance use disorder interventions.
  • Highly accessible, free, and confidential resource available to all health care providers in IHS federal, tribal, and urban facilities.
  • Providing support, sharing knowledge and information about evidence-based clinical interventions.

Goal: maximize clinical services offered to patients, families, and communities facing substance use disorders.

Slide 20: Montana DPHHS Addictive and Mental Disorders Division (AMDD)

Substance Use Disorder resource information available at: https://dphhs.mt.gov/amdd/substanceabuse

Slide 21: State COVID-19 Resources For Mental Health and Substance Use Disorders

COVID-19 resources for Individuals, Families, and Providers available at:  https://dphhs.mt.gov/amdd/covid19.

Individuals:

  • Behavioral Health
  • Stress
  • Treatment and Recovery
  • Recovery Support Groups

Families:

  • Parenting
  • Developing children
  • Trauma
  • Grandparents
  • Kids
  • Teens
  • Self-care

Providers: 

  • Financial support options
  • Tele-health
  • Behavioral Health
  • People with disabilities
  • Opioid treatment

Slide 22: Montana Substance Use Disorder Treatment Providers by Level of Care

The following slides will provide more information about:

  • State Approved Treatment Providers
  • Inpatient Providers
  • Outpatient Providers
  • Opioid Federally-Funded Providers

Slide 23: Substance Use Disorder Treatment Providers by Level of Care: State Approved Providers

https://dphhs.mt.gov/amdd/SubstanceAbuse/TreatmentProviderInformation:
(Interactive Map)

Treatment Providers – In-patient Providers

Treatment Providers – Out-patient Providers

Treatment Providers – Federally-funded

Slide 24: Indian Heath Services (IHS)-OUD Treatment & Recovery Resources

Opioid use disorder is a chronic disease and is treatable. The goals are to support recovery and prevent relapse with medication and psychosocial therapy. Medication in support of recovery is one part of a comprehensive approach toward achieving long-term recovery (IHS).

Medication Assisted Recovery using Medication Assisted Treatment (MAT)

https://www.ihs.gov/opioids/recovery/

Tribal Healing to Wellness Courts, as part of a tribal justice system, integrate the wellness concept to meet a tribal community's substance abuse needs. 
https://www.ihs.gov/opioids/recovery/wellnesscourts/

Tele-MAT expands access to a needed service to address OUD in areas and communities where this service has been difficult to establish or maintain. https://www.ihs.gov/opioids/recovery/telemat/

Pharmacological treatment to support recovery from Opioid Use Disorder includes opioid agonist therapy or antagonist therapy. https://www.ihs.gov/opioids/recovery/pharmatreatment/

Treatment of substance use disorders can occur in specialized opioid treatment programs or through general health care practice in an office based opioid treatment program model.

https://www.ihs.gov/opioids/recovery/obot/

Slide 25: Indian Heath Services (IHS)-OUD Treatment & Recovery Resources

The Substance Use Warmline (1-855-300-3595) offers on-demand Clinician-To-Clinician support for IHS providers managing alcohol and substance use disorders.  https://www.ihs.gov/opioids/recovery/providers/

Holistic care refers to healing and wellness for the mind, body and spirit. It is important to consider cultural spiritual beliefs and offer resources within the community to meet these needs. https://www.ihs.gov/opioids/recovery/supportiveservices/

Many American Indian/Alaska Native (AI/AN) communities experience, cope with, and attempt to recover from the effects of trauma. Data shows that AI/AN people in the U.S. are at greater risk compared to other groups of experiencing physical, psychological, cultural and emotional traumas that may result in negative health outcomes. 

https://www.ihs.gov/opioids/recovery/tic/

Opioid withdrawal may cause a patient great discomfort and dysphoria and generally will lead the patient to continued use of opioids. https://www.ihs.gov/opioids/recovery/withdrawal/

Slide 26: Mental Health Services

Montana Mental Health Centers list available at  https://dphhs.mt.gov/amdd/substanceabuse

Medicaid and Public Mental Health Services
for Adults available at
https://dphhs.mt.gov/amdd/mentalhealthservices

Children's Mental Health Bureau available at                          https://dphhs.mt.gov/dsd/cmb              https://dphhs.mt.gov/dsd/cmb/childrensmentalhealthservices

   *According to the 2019 Montana Youth Risk Behavior Survey, 37% of students felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing usual activities.

Slide 27: Mental Health Services (cont'd)

County Mental Health Resource Guides available at:                      https://namimt.org/montana-county-mental-health-resource-guides/

Mental Health Services Bureau Programs and Contacts available at: https://dphhs.mt.gov/amdd/substanceabuse

Pdf. List available at: https://dphhs.mt.gov/Portals/85/amdd/MSHBProgramContacts.pdf

Montana Chapter of the National Alliance on Mental Illness (NAMI) available at: http://www.namimt.org/

MSU Extension Health and Wellness available at:          http://www.msuextension.org/wellness

Tribal Indian Health Services Mental Health Services and resources available at: https://www.ihs.gov/mentalhealth/                         https://www.ihs.gov/mentalhealth/resources/

Slilde 28: Conclusion

Please visit our website:

http://health.msuextension.org/opioid_misuse.html

  • Access to all five modules and PowerPoints
  • Access to the Native American Toolkit
  • Access to informational and recovery story videos
  • Print/download educational resources
  • Order a medication disposal pouch (while supplies last)

If you have any questions, please email our program director   Barbara Allen  [email protected]

Montana Department of Health and Human Services website:

https://dphhs.mt.gov/opioid/

Slide 29: References

MT DPHHS. (n.d.). Montana State Health Improvement Plan . A Healthier Montana. https://dphhs.mt.gov/ahealthiermontana/.

Prevention of substance use and mental disorders. SAMHSA. (n.d.). https://www.samhsa.gov/find-help/prevention.

Substance Abuse and Mental Health Services Administration. (1970, January 1). Substance use and suicide: A nexus requiring a public health approach.Substance use and suicide: a nexus requiring a public health approach. -Drugs and Alcohol. https://www.drugsandalcohol.ie/28961/