Step 2: Treatment & Intervention
“We get the best outcomes when we have the full interdisciplinary team aware of what is happening with each resident. It is important to document signs/symptoms in the chart so the whole team can access notes,” said Russell.
She added, “Robust documentation is key to getting everyone in the know, but it also is important to notify the prescriber so they can assess the resident and make appropriate changes to medications or non-pharmacologic interventions.”
It may be possible to treat OUD onsite in the long-term care setting. This may involve the use of medications such as methadone and programs such as Narcotics Anonymous. It is important to be familiar with state laws regarding methadone use in long-term care facilities as it is not allowed in all states. Bose noted, “There also are partial opioid agonist/antagonist products available, such as buprenorphine/naloxone, to help safely and effectively wean residents.”
There has been a recent push to increase access to OUD healthcare providers and treatments. For example, the elimination of the DATA-Waiver (X-Waiver) Program requirement to prescribe buprenorphine products for OUD. Since the elimination of this requirement, prescribers with a standard DEA registration number that includes Schedule III authority may now help manage OUD with these buprenorphine products. Bose stressed, “This increased access is a boon to overall public health, but we should also leverage practitioners’ expertise when needed and engage experts like addictionologists for difficult cases.”