Opioid Crisis Management is an area of increasing importance as the need to access and use information for clinical problem solving and health system management grows. Balancing the interests of key stakeholders including patients, providers, vendors, and legislators can be challenging. This Community is a space to share resources & connect with others interested in improvements within the realm of opioid crisis management in healthcare settings. (Note that since this is a public space, posting confidential information is not recommended). Browse our resources to see case studies, tools, and articles that might help generate some ideas for implementation within your organization. Share your thoughts and expertise, and ask questions to join the conversation – you can also upload additional resources here.

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The Opioid Crisis: What is it?

 Introduction to the Opioid CrisisAccording to the U.S....

Know More: Stigma, Why Words Matter

This fact sheet provides information on stigma, why our words matter and how stigma can affect people who use opioids.

Opioid Use Disorders: A Guide for Patients

This guide for patients outlines key characteristics of opioid use disorder, including biological, social, and psychological risk factors, strategies for bringing up one's diagnosis with one's family,...

Words Matter: How Language Choice Can Reduce Stigma

This document is about the stigma that people who use opioids or have opioid use disorder face, including the harms of clinicians using stigmatizing and discriminatory language....

Using the Prescription Opioid Misuse Index (POMI): Information for Physicians

This document provides a brief introdution to the POMI screening tool for opioid use disorder, outlines the threshold for a positive screen, and presents the screening tool. 

CEP - Management of Chronic Non-Cancer Pain Tool

Through a multidisciplinary and multidimensional approach, the Management of Chronic Non-Cancer Pain Tool is designed to assist family physicians and primary care nurse practitioners develop and imple...

Opioid Tapering Template

This tool is to be used when a decision is to be made to reduce or discontinue and opioid in chronic non-cancer pain (CNCP). For more information: Opioid Crisis Management: Foundation Roadmap

Pharmacy Syringe Exchange Program for Injection Drug Users

The opioid crisis is an issue around the world....

Alcohol Abuse Amongst the Elderly: A Complete Guide

Alcohol abuse is a danger amongst to the elderly. In 2014, more than 15 million Americans over the age of 18 reported having Alcohol Use Disorder (AUD)....

Summary Recommendations from the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain

 Recommendation 1: When considering therapy for patients with chronic non-cancer painWe recommend optimization of non-opioid pharmacotherapy and non-pharmacological therapy, rather than a trial o...

Putting Quality Standards into Practice

 To make the most out of the quality standards:Assess current practice against the evidence-based care described in the quality statements to identify where current practice does not align with t...

Checklist for Prescribing Opioids for Chronic Pain

This tool will provide a checklist for primary care providers to be used when prescribing opioids as well as information on the importance of guidelines for primary care providers. For more infor...

The Opioid Crisis: Data and Demographics

Opioid-Related DeathsAccording to the U.S....

The Essentials of …Series: Trauma-informed Care

Key Questions: What is Trauma-informed Care? Why is it important to understand and treat trauma properly?...

Medication-Assisted Treatment for Opioid Dependence and Addiction

MAT appears to be the most cost-effective treatment for opioid dependence....

Clinical Opiate Withdrawal Scale

Key Questions: How can the severity of opiate physical dependence and withdrawal be assessed?...

United States Opioid Treatment Program Directory

Key Question: Where in the United States can Opioid users find treatment?This tool is intended to find treatment facilities and programs in the United States or U.S....

Boston Medical Center: The State Technical Assistance Treatment Expansion Office-Based Opioid Treatment Program

In the United States, more than 129 people a day die from accidental overdoes related to prescription drugs. In 2015, 20.8 million Americans had a substance abuse disorder....

Holistic Approach to the Addiction Recovery Process

There are many healing modalities that offer specific benefits related to withdrawal and relapse prevention....

Umbrella Project - Knowledge Exchange: Canada’s Opioid Crisis

Key Questions: What are some harm reduction tips to help reduce the problematic effects of alcohol and other drugs?...

Evidence Brief: Drug checking services as a harm reduction intervention

Key Questions: What is the effectiveness of drug checking services for adults who use drugs on drug use behaviours or serious adverse health outcomes related to drug use? This paper provides an o...

Patient Reference Guide - Opioid Prescribing for Acute Pain Care for People 15 Years of Age and Older

Key Questions: How do I know I am receiving the care I need regarding my acute pain?...

Opioid Risk Tool

Key Questions: How can patients at high risk of opioid addiction be identified?...

Knowledge Translation Planning Tools for Addiction and Mental Health Researchers

The Canadian Institutes of Health Research (CIHR) defines knowledge translation (KT) as “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound...

Substance Use Disorders: A Guide to the Use of Language

Key Question: How should language surrounding substance use disorders be curated to reduce associated negative stigmas? This guide draws attention to the terminology that currently...

Blue Shield of California's Narcotic Safety Initiative

Blue Shield of California launched its three-year Narcotics Safety Initiative in 2015 in response to the rate of overuse and overprescription of opioids....

Brigham & Women's Hospital Opioid Adherence Digital Pill Pilot

Opioid pain reliever prescribing in the ED setting has increased over the past decade....

Managing Pain Safely: Reducing Opioid Over-prescription at Partnership HealthPlan of California

Due to the level of independence that prescribers had, some counties, like Lake County, were prescribing opioids as much as five times the state average. The program targeted the issue by fo...

CDC Guideline for Prescribing Opioids for Chronic Pain

Key Questions: How are current opioid prescribing guidelines shaped?...

Manitoba Training Manual: Overdose Prevention, Recognition and Response

Key Questions: How can opioid overdose be addressed effectively?...

SAMHSA Opioid Overdose Prevention Toolkit

Key Question: How can my organization help prevent opioid-related deaths?...

Licensing Open Data: A Practical Guide

Key Questions: How can organizations obtain open data licenses?...

The CAGE Questionnaire Adapted to Include Drugs (CAGE-AID)

Key Questions: How can patients at high risk of opioid addiction be identified?...

A Public Health Approach to Drug Control in Canada

Key Questions: How does the harm caused by illegal drugs compare to the harm caused by tobacco and alcohol?...

Best Practices for Preventing Substance Use Problems in Nova Scotia

Key Questions: What factors are linked to substance use problems? What is the prevalence of substance use and substance use problems in Nova Scotia?...

National consultation on the Section 56 exemption requirement for methadone prescribing

Key Questions: What are barriers posed by the section 56 exemption requirement?  What are the benefits of removing the section 56 exemption?...

Stronger Together: Canadian Standards for Community-Based Youth Substance Abuse Prevention

Key Questions: What guiding principles should be applied in community-based substance abuse prevention work?...

Drug Facts: Treatment Approaches for Drug Addiction

Key Questions: What is drug addiction and how can it be treated? What are the principles of effective treatment? This fact sheet discusses research findings on effective treatment approaches...

Models of Addiction

Key Questions: What are the main theoretical approaches to understand addiction? What is an overarching model that can be used as a framework for capturing concepts and evidence?...

Lower Risk Cannabis Use Guidelines

Key Questions: What are major recommendations for low-risk use of cannabis?...

Mental Health and Addiction: Learning Resources, Archived Webinars, and Videos

Key Questions: How can I engage clients who use substances?  What are some motivational intervention approaches?The RNAO Mental Health and Addictions Initiative offers continuing educational...

Dalla Lana School of Public Health Leadership Series: Tue, 1 May 2018 5:30 PM – 8:30 PM EDT

Supervised injection services are critical, evidence-based public health interventions that save lives daily, but are Toronto's four sites enough? Should Canada join countries like Portugal in decriminalizing drug use to help overcome the stigma associated with addiction and improve community health? Registration Information for this free event: https://www.eventbrite.ca/e/decriminalizing-opioids-and-other-drugs-in-canada-tickets-44647411610

How Can Harm from High Risk Medications be Prevented?

 Prevent HarmDevelop order sets, preprinted order forms, and clinical pathways or protocols to establish a standardized approach to treating patients with similar problems, disease states, or nee...

Quality Standards Opioid Prescribing for Acute Pain - Measurement Guide

Key Questions: How do I adopt quality standards for opioid prescription?...

Opioid Prescribing for Acute Pain Care for People 15 Years of Age and Older

Key Questions: What are the quality standards for opioid prescription for acute pain?...

Current situation... I am in a working group looking to properly treat addiction and withdrawal from opioids among this patient population.
Where I want to go... How do I address treating opioid addiction and withdrawal among patients admitted to our mental health department?
Help I'm looking for... I am looking for more information regarding the various treatment options available.

WEBINAR: Workplace Safety and Prescribed Medications in Chronic Pain Patients

Thu, Mar 8, 2018 2:00 PM - 3:00 PM EST Employers are obliged to provide a safe work environment for employees. Unions are concerned for the safety of their members while at work. Assisting workers in achieving a safe and sustainable return to work after illness or injury has always been an appropriate goal of treatment. However, North American workplaces are increasingly challenged with how to address prescription and over-the-counter medication use by employees, while ensuring a safe working environment, given the dramatic increase in the number of prescriptions written by physicians in recent years. Link to register: https://www.wwdpi.org/Webinars/Pages/Webinar.aspx?wbID=172

Course in Understanding Stigma

https://moodle9.camhx.ca/moodle/?lang=en Courtesy the Mental Health Commission of Canada and CAMH.



The Opioid Crisis: Harm Reduction Strategies

Detecting Opioid OverdoseTo reduce harms related to opioid use, it is important to first recognize the signs of an opioid overdose....

Trauma-Informed Practice Guide

Key Questions: What is trauma? What is trauma-informed care?...

Joan Polzin shared a post


How To Help College Kids Avoid Abusing Substances

Why College Kids Are At RiskAre your kids really at risk for abusing substances while away at college? Unfortunately, that is true....


Planning health promotion programs: Introductory workbook

Key Questions: Which steps should be taken to design an effective health promotion program?...

CCSA - Prescription Monitoring Programs in Canada: Best Practice and Program Review

Key Questions: How should Prescription Monitoring Programs (PMP) be implemented? How can they be best effective?...

Oregon's strategy to confront prescription opioid misuse: a case study

Key Questions: How can prescription opioid misuse be reduced?...

Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence

Key Questions: How should psychosocially assisted pharmacological treatment of opioid dependence be administered?...

Current situation... I'm a physician from Toronto, that is looking for ways to integrate opioid crisis combative efforts into my practice.
Where I want to go... I'm interested in prescribing practices for patients with non-cancer pain.
Help I'm looking for... What kind of guidelines are available for prescribing to these patients?

Thanks Robert for the great post!

Here's a tool worth checking out:


Knowledge Translation Planning Tools for Addiction and Mental Health Researchers

The Canadian Institutes of Health Research (CIHR) defines knowledge translation (KT) as “a dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound...

How is the opioid crisis changing the role of policing?

How can front-line officers be better equipped to deal with this crisis?

Opioid Precribing Practices

I’m looking for more information regarding prescribing practices to get an idea of how these policies contribute to the opioid crisis.

Current situation... I am conducting research on the accessibility of substance abuse treatment.
Where I want to go... With my results, I want to suggest treatment search tips.
Help I'm looking for... How can I find treatment programs in different parts of the world?

Current situation... My clinic is re-evaluating our assessment/diagnostic procedures used before administering opioid treatment
Where I want to go... n/a
Help I'm looking for... What are some commonly used assessment tools?

Know More: Talking to Your Health Care Provider About Opioids

This fact sheet provides information that can help when talking to a health care provider about opioids.

CDC Module 3: Communicating with Patients

This module script for physicians reviews the CDC recommended strategies for communicating effectively with patients about pain management and opioid use.

Confronting Inadvertent Stigma and Pejorative Language in Addiction Scholarship: A Recognition and Response

This article makes an appeal for the use of language about substance use disorder that respects the worth and dignity of all persons (“people-first language”); focuses on the medical nature of substan...

DSM-5 Clinical Diagnostic Criteria for Opioid Use Disorder

This document presents the DSM-5 criteria for opioid use disorder. At least 2 of 11 criteria must be met for a diagnosis of opioid use disorder.

CEP - Opioid Manager

Opioids can be an effective way to treat pain but it is important for providers to know how to balance the risks and side effects of opioid therapy with the desired benefits....

The Emerging Role of meditation in Addressing Psychiatric Illness, with a Focus on Substance Use Disorders

Over the past 30 years, the practice of meditation has become increasingly popular in clinical settings. In addition to evidence-based medical uses, meditation may have psychiatric benefits. 

Holistic Nurses: Pain Relief Tools for Patients & Self-Care

This tool provides information about pain relief tools for patients and self-care....

Syringe Services Programs (SSPs) Developing, Implementing, and Monitoring Programs

This document provides example resources for health departments and local partners that may be helpful in planning, designing, and implementing SSPs in their jurisdictions as part of a comprehensive, ...

Emerging Idea: Fighting the Opioid Epidemic with Award-Winning App

There are a number of people that die each year from opioid overdoses.1 Furthermore, two-thirds of opioid overdoses happen while the victim is alone. Naloxone can be used for reversal o...

Opioid-related Morbidity and Mortality in Ontario Interactive Tool

Key Questions: How many cases of opioid-related morbidity and mortality were recorded from 2003 to 2017?...

The NYC RxStat Initiative

The opioid epidemic is taking the lives of 62, 070 people in 2016 as reported by the CDC, and continues to increase. RxStat program was implemented with the goal of reducing overdose deaths. 

Responding to the Opioids Epidemic

The opioids crisis is continuing to worsen, despite some amazing work over the last few years by police departments, public health agencies, drug treatment programs, hospitals, and many other organiza...

10 Opioid Crisis Actions for Law Enforcement

Use of Naloxone kits (grant opportunity for kits)Data collection (example of using data to track and predict opioid overdose)Implement early warning systems (example of the Centers for Disease Control...

What is Naloxone?

Naloxone is a drug that can be used to counteract the effects of a drug overdose....

Ohio Police Change Approach On Addiction: People Need Help, Not Jail

In July 2014 Sheriff John Tharp from the Lucas County Sheriff’s Office, in Toledo, Ohio, started the Drug Abuse Response Team or DART program when he noticed that opioid addiction was affecting ...

AHIMA Opioid Addiction-Documentation Tip Sheet

Key Questions: What role does proper addiction-documentation play in the Opioid Crisis?...

St. Joseph's Regional Medical Center's Alternatives to Opiates Program (ALTO)

St. Joseph's Regional Medical Center was concerned over the rate of overprescription of opiates and opiate-related deaths....

Assertive Community Treatment (ACT) Evidence-Based Practices (EBP) KIT

Key Questions: How can my organization develop a community-based service delivery model for people with mental illness? This toolkit offers tools to implement the evidence-based practice of Asser...

The Opioid Crisis: Treating Addiction

Opioid use disorder or opioid addiction occurs when individuals who use prescribed or recreational opioids have a hard time controlling their opioid use, resulting in significant health or social...

Applying situational assessment skills to address opioid-related harms: Workshop report

Key Questions: What is the importance of involving people with lived experience?...

Concurrent Disorders: Substance Abuse in Canada

Key Questions: Which populations are the most vulnerable to substance use?...

The Safe and Appropriate Opioid Prescribing Program at Kaiser Permanente Southern California

The Safe and Appropriate Opioid Prescribing program was launched in 2010 after OxyContin became the most prescribed nonformulary medication to Kaiser Permanente Southern California's members. 1

Open Data Repository: the Opioid Crisis

Benefits of Open Data include:Support for innovationAdvancing government's accountability and democratic reformLeveraging public sector information to develop consumer and commercial productsBetter us...

The Opioid Crisis: Police Interdiction

Overdose Risk Factors: Fentanyl and CarfentanilA spike in fatal drug overdoses can be attributed to the increasing phenomenon of dealers “boosting” relatively weak heroin with much stronger and cheape...

Together, we can do this: Strategies to Address British Columbia's Prescription Opioid Crisis

Key Questions: What is the provincial pharmaceutical opioid problem?...

The Opioid Resource Hub

Key Questions: How can health care providers build capacity in the area of opioid use and addiction?...

Intermountain Healthcare's Efforts to Reduce Opioid Prescriptions & Improve Awareness

Intermountain Healthcare currently prescribes more than 5 million opioid tablets each year across its 22 hospitals and 180 clinics....

Opioid Manager

Key Questions: How do I manage chronic non-cancer pain among my primary care patients?...

Overdose Prevention Information for First Nations

Key Questions: What are some resources that can be used by healthcare professionals to prevent overdose? What are the signs of an overdose?...

Legal Interventions to Reduce Overdose Mortality: Naloxone Access and Overdose Good Samaritan Laws

Key Questions: How can increasing naloxone access and distribution assist in combatting the opioid crisis? What are the policies on naloxone distribution in the United States?...

Mental Illness and Addiction Index

This tool provides clear, reliable information about mental illness and addiction, including treatment and recovery....

Vancouver Police Department Recommendations for Combatting the Opioid Crisis

1. Expand federal and provincial government support and accountability.This support is required to enact an emergency response that is in keeping with the scale of the problem....

Mental and Substance Use Disorders in Canada

Key Questions: How do the rates of mood disorders and generalized anxiety disorder differ between females and males?...

Substance Abuse Treatment For Persons With Co-Occurring Disorders

Key Questions: What is a TIP?...

Substance Use and Addiction

 How common is substance use and addiction? Almost 5% of the world's population has used an illicit substance at one point....

National Framework for Action to Reduce the Harm Associated with Alcohol and Other Drugs and Substances in Canada

Key Questions: What key principles should be applied to address the harms associated with alcohol and other drugs and substances?...

Seeking Drug Abuse Treatment: Know What to Ask

Key Questions: How do I find the right treatment program for drug abuse? What are some examples of behavioural therapies?...

World Drug Report

Key Questions: What is the magnitude of the world drug problem?...

Reducing Harms: Recognizing and Responding to Opioid Overdoses in Your Organization

Key Questions: How can an opioid-related emergency be identified? How can Naloxone be administered?...

CRISM National Guideline for the Clinical Management of Opioid Use Disorder

...

The Kids Aren’t All Right: Teenagers in the Opioid Epidemic

The Opioid CrisisThe roots of the opioid epidemic date back to at least the 1990s, when pharmaceutical companies launched marketing campaigns touting the benefits of opioids....

Opioid Manager -- Addressing the Opioid Epidemic

April 18, 2018 - 12:00 - 1:30 PM ET The opioid epidemic is reaching crisis proportions. As many as 40% of patients treated with opioids are on a high dose that puts them at increased risk of an overdose. Yet, tapering patients off opioids is risky, difficult and time-consuming. Learn how a new Opioid Manager app makes it easier, faster and safer to taper patients on high dose opioids. Registration Information: https://www.regonline.ca/registration/Checkin.aspx?EventID=2162920

March 29, 2018 | 12:00 – 1:30pm ET - Strategies for Strengthening Opioid Stewardship: A Conversation with the NQP™ Opioid Stewardship Action Team

Registration Information: http://nqf.commpartners.com/se/Rd/Rg.aspx?807529

Recommendations for Adoption: Opioid Prescribing for Acute Pain

Key Questions: What are the quality standards for opioid prescription for acute pain?...

Implementing Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care: Environmental Scans

Key Questions: How do I prevent opioid misuse in rural communities? What are some initiatives taking place in rural communities?...

Profiling Innovative Networks in Chronic Pain & Youth Mental Health

 ACCESS Open MindsACCESS Open Minds is a national research and evaluation network in Canadian innovation in regards to youth mental health service design, delivery, evaluation, and research....

Current situation... We have some complex patients on our hospital unit who require pain management but we are concerned about risk of dependency associated with opioid use.
Where I want to go... Are there CPGs for pain management?
Help I'm looking for... Specifically for managing non-cancer related chronic pain

The Opioid Crisis: Preventing Overdose

Addressing Opioid Overdose Risk FactorsEffective prevention of opioid-related overdoses requires addressing and supporting overdose risk factors....

B.C. expands street-drug fentanyl testing program

Fatal overdoses have soared in B.C. owing to the local drug supply being poisoned with highly toxic adulterants....

Tapering Toolkit: Provider Resource

Key Questions: How can I set up an opioid tapering plan for my patients?...

Leadership panel discussion Addressing Opioid use in Ontario: Reducing harm, and improving care

Quality Rounds Ontario Thursday, January 18, 2018 - Noon to 1:00 p.m. (EST) http://healthqualityontario.cmail20.com/t/ViewEmail/i/F25A4189707729352540EF23F30FEDED/757812B6C1D0D3449A8E73400EDACAB4

BCCSU Guidance for Injectable Opioid Agonist Treatment for Opioid Use Disorder

Key Questions: How should injectable Opioid Agonist Treatment programs be administered and shaped?...

ANKORS 2015 Shambhala Music Festival Drug Checking Report

Key Question: Can providing drug checking booths reduce harm with drugs commonly used at music festivals? This report is a summary of 2015 data collected by ANKORS at the Drug Checking booth at S...

Best Practice Recommendations for Canadian Harm Reduction Programs that Provide Service to People Who Use Drugs and are at Risk for HIV, HCV, and Other Harms: Part 1 & 2

Key Questions: How can we improve the effectiveness of harm reduction programs among drug users?...

Current situation... I'm a project manager at a medical clinic in New York.
Where I want to go... The clinic is re-evaluating our assessment/diagnostic procedures to identify patients at high-risk of addiction.
Help I'm looking for... What kind of tools are available for optimizing this process?

Current situation... I'm a police officer in the Vancouver, B.C. area.
Where I want to go... Due to spikes in local opioid overdoses, I'm investigating how the opioid crisis is changing the role of policing.
Help I'm looking for... How can how front-line officers be better equipped to deal with the opioid crisis?

Current situation... I partake in running a methadone clinic and heard that fentanyl checking services can be effective.
Where I want to go... My clinic is considering implementing new harm reduction strategies.
Help I'm looking for... Is this true? Dose anyone know anything about the efficacy of these services?

Current situation... I'm a physician looking at prescribing practices for patients with non-cancer pain.
Where I want to go... n/a
Help I'm looking for... I want to find guidelines and evidence of programs previously implemented that have demonstrated effective results.

Sandra Ochwat shared a post


Great article about the reducing the risk associated with potentially harmful medications

https://www.colleaga.org/article/how-can-harm-high-risk-medications-be-prevented


Vincent Fernandez shared a post


Thanks Michiko for the post! Something to think about regarding risk factors for rebellious behaviour.

Is your home an accomplice for your rebellious teen?

Found some interesting information to highlight and think about for any educators, and others: https://www.homeadvisor.com/r/home-safeguards/


Current situation... Looking for advice on implementing this service.
Where I want to go... My clinic is thinking of implementing a fentanyl checking service.
Help I'm looking for... Does anyone know anything about the ethicacy of these services?