CaroNova’s Online Library for Opioid Stewardship is a compilation of best practice tools and resources that have been assembled by a team of subject matter experts from across North and South Carolina.
It is intended to be used by healthcare professionals for the prevention, intervention, and treatment of opioid use disorder. These resources may not be duplicated, sold, or used for profit in any way without direct permission from the author.
Stigma reduction strategies include:
National Academies of Science, Engineering, and Medicine; Guiding Principles for Addressing the Stigma on Opioid Addiction; The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review
According to the CDC’s 2022 Clinical Practice Guideline for Prescribing Opioids for Pain:
Individuals with opioid use disorder need connections to ongoing SUD treatments that support their recovery. Practices that can contribute to success include engaging peer support specialists; working with family and friends; prescribing naloxone; health system/community collaboration; and leveraging telehealth. Although care coordination models vary widely, common elements include an individualized plan of care with a lead provider, discharge planning from a hospital visit, continual data-sharing, and education for both providers and patients.
CDC Care Coordination in Treatment of Substance Use Disorders
Care Coordination Strategies for Patients Can Improve Substance Use Disorder Outcomes
Harm reduction strategies include overdose education, counseling and referrals to treatment for infectious disease and SUD; naloxone; syringe services programs; testing drugs with fentanyl test strips; and stigma reduction.
Harm reduction strategies include:
To help reduce disparities and improve equity, SAMHSA recommends the following community-informed strategies (in addition to standard treatments such as MAT/MOUD and naloxone):
Source: The Opioid Crisis and the Black/African American Population: An Urgent Issue
Access to MOUD can be improved by initiating it in hospitals and other settings, such as primary care and outpatient settings. The removal of the federal X-Waiver requirement means that all practitioners who have a current DEA registration that includes Schedule III authority may now prescribe buprenorphine for Opioid Use Disorder in their practice if permitted by applicable state law.
Gaps in NC addiction treatment disproportionately hit rural residents of color; Evidence-Based Strategies for Preventing Overdose
State-specific opioid settlement strategies are provided at the links below. Additionally, throughout this Online Library for Opioid Stewardship, resources and tools that are related to or support NC or SC opioid settlement fund strategies are flagged with a special icon at the bottom of the resource description page.
The toolkits and implementation guides in this section can help health systems and communities integrate peer support specialists into opioid use disorder treatment.
The following resources offer education for health care providers on identifying when a patient has taken xylazine or fentanyl and understanding treatment options.
Overall, SC DPH has issued the following recommendations to monitor and treat individuals exposed to xylazine. These strategies can also be useful more broadly for polysubstance use:
Sources: Increase in Overdose Deaths and Health Hazards Associated with Xylazine in South Carolina (SC DPH Advisory); Polysubstance Use Facts
These resources can be incorporated into health system trainings to help any clinician better understand and treat substance use disorder.
Safe prescribing strategies include:
Multiple validated screening and assessment tools exist for use in various contexts. A useful summary table of evidence-based screening tools and assessments can be found here.
These resources contain best practices for treating specific populations.
CaroNova’s opioid resource library is designed to be used by health systems in North Carolina and South Carolina to accelerate adoption of best practices for opioid use disorder prevention, treatment, and recovery. The links provided by CaroNova are to publicly available resources. Although these resources are in the public domain, they should be used for educational purposes, and not for any commercial purposes. Please review the source’s restrictions, if any, on using, redistributing or reproducing their documents, toolkits and other information. CaroNova is not a healthcare provider, and the information and resource links available on this website are not intended as a substitute for individual professional medical advice, diagnosis, or treatment. I understand and accept these terms and conditions.