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Arizona’s MOUD Expansion – Evidence-Based Strategies for Opioid Recovery | Nirvana Recovery

2023 OPIOID-OVERDOSE REDUCTION CONTINUUM OF CARE APPROACH ORCCA PRACTICE GUIDE

The Critical Role of MOUD in Addressing the Opioid Crisis

The U.S. Food and Drug Administration (FDA) has approved three drugs to treat opioid addiction: methadone, buprenorphine (available in different forms), and extended-release naltrexone. These drugs work in different ways to help manage opioid addiction. Expanding access to these treatments is a key part of the country’s plan to combat the opioid crisis.

Medication for opioid use disorder (MOUD) is a vital evidence-based intervention for treating opioid use disorder (OUD) and reducing opioid overdose deaths. MOUD has been shown to reduce opioid use, decrease overdose risk, and improve overall health outcomes for individuals with OUD.

However, despite its proven effectiveness, access to MOUD remains limited in many communities across the United States, including in Arizona.

The Opioid Crisis in Arizona: The Need for Expanded MOUD Access

Arizona has been hit hard by the opioid epidemic, with verified non-fatal opioid overdose events increasing from 3,428 in 2022 to 4,066 in 2023, an 18.6% increase. Sadly more than 5 Arizonans every single day lost their lives to opioid overdoses in 2023. 

To reverse this alarming trend, expanding access to MOUD is critical.  Many counties in Arizona, particularly in rural areas, have limited or no MOUD providers. Before understanding the Strategies for Arizona Treatment Centers to Expand MOUD access, First understand the Opioid-Overdose reduction continuum.

The Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) Guide

The Opioid-Overdose Reduction Continuum of Care Approach, or ORCCA for short, is a plan to help communities reduce the number of people dying from opioid overdoses. It was created by a group of experts from four different research sites working on the HEALing Communities Study.

The ORCCA has three main parts:

  1. Teaching people about preventing overdoses and giving out naloxone (a medicine that can reverse an overdose) to people who are at high risk of overdosing.
  2. Making sure people can get medicines that treat opioid addiction, like methadone or buprenorphine. This includes reaching out to people at high risk and making it easier for them to get treatment.
  3. Helping doctors prescribe opioid pain medicines more safely and making sure pharmacies give them out safely too.

The idea is that by doing these three things, communities can reduce the number of people who overdose and die from opioids. The ORCCA is based on practices that have been proven to work through research.

So in simple terms, it’s a plan that brings together different strategies to prevent overdoses, treat addiction, and make opioid use safer, all with the goal of saving lives in communities that are struggling with the opioid crisis. This approach could be used in cities and towns across Arizona to help address the opioid problem.

The HEALing Communities Study Opioid-Overdose Reduction Continuum of Care Approach with Sample Strategies 1

The image above “The HEALing Communities Study Opioid-Overdose Reduction Continuum of Care Approach with Sample Strategies” outlines a multi-pronged approach across different stages, from primary prevention to sustained recovery, for reducing opioid overdoses in communities in Arizona.

This diagram shows a plan for communities in Arizona to reduce opioid overdoses. It has different strategies that can be used at each stage, from preventing overdoses in the first place to helping people recover in the long-term.

The main parts of the plan are:

  1. OEND (Overdose Education and Naloxone Distribution): Teaching people about overdoses and giving them naloxone, a medication that can reverse an overdose. This involves reaching out to people at risk of overdose in different ways and making sure naloxone is available where overdoses might happen.
  2. Effective Delivery of MOUD (Medication for Opioid Use Disorder): Making sure people can get medications that treat opioid addiction, like methadone or buprenorphine. This means offering these treatments in more places, like regular doctor’s offices, addiction treatment centers, jails, and through telemedicine. It also means connecting people to other services they might need.
  3. Safer Opioid Prescribing/Dispensing: Making opioid prescribing and dispensing safer. This includes things like teaching doctors how to safely prescribe opioids for pain, both for short-term and long-term use. It also means making sure pharmacies dispense opioids safely and having programs where people can drop off or mail back unused prescription opioids.

The diagram shows how these strategies fit into different stages:

  • Preventing overdoses before they happen
  • Reducing the risk of overdose
  • Treating overdoses when they occur
  • Getting people into long-term treatment
  • Helping people stay in recovery

By using a combination of these approaches at each stage, the goal is to save lives and help people with opioid addiction get better in a lasting way. The plan recognizes that there are different points where we can make a difference, from before an overdose ever happens to supporting someone’s long-term recovery.

Strategies for Arizona Treatment Centers to Expand MOUD Access

Applying the ORCCA model in Arizona can help expand access to life-saving MOUD services. By partnering with health systems, payers, and community organizations, the state can build a more robust continuum of care for those struggling with opioid use disorder. This aligns with the goals outlined in Arizona’s opioid settlement Funds, which aims to strengthen prevention, treatment, and recovery services

Drug treatment centers in Arizona can play a crucial role in expanding MOUD access by implementing strategies outlined in the SAMHSA new ORCCA practice guide 2023. The ORCCA guide provides a comprehensive framework for expanding MOUD treatment across various settings, including healthcare, criminal justice, and other community settings. Let’s understand these in detail.

The ORCCA guide highlights several key strategies for expanding MOUD access:

  1. Partnering with Healthcare Organizations
    • Collaborate with primary care clinics, hospitals, and other healthcare settings to integrate MOUD
    • Provide training and education on MOUD prescribing and management to healthcare providers
    • Offer ongoing consultation and support from addiction specialists to healthcare partners

  2. Utilizing Telemedicine to Reach Underserved Areas
    • Implement telemedicine-based MOUD initiation and maintenance programs
    • Partner with rural healthcare clinics and community organizations to promote telemedicine-based MOUD
    • Advocate for policies that support reimbursement and regulatory flexibility for telemedicine-based MOUD

  3. Collaborating with Criminal Justice Partners
    • Work with jails and prisons to implement MOUD programs for incarcerated individuals
    • Establish linkage protocols to connect individuals to community-based MOUD upon release
    • Provide education and training to probation and parole officers on supporting MOUD continuation

These strategies build upon the insights gained from community assessments, as discussed in “How Community Assessments Can Strengthen Arizona’s Response to the Opioid Crisis“. By tailoring services to local needs and reducing barriers to care, treatment centers can make a meaningful difference in the lives of Arizonans affected by opioid use disorder.

A Call to Action for Arizona Treatment Centers

Expanding access to MOUD is a critical component of addressing the opioid crisis in Arizona. By working collaboratively with healthcare organizations, leveraging telemedicine, and partnering with criminal justice agencies, Arizona treatment centers can significantly increase the availability of this life-saving, evidence-based treatment. The ORCCA practice guide serves as a valuable roadmap for these efforts. For more information and support in implementing MOUD expansion strategies, treatment centers can contact [Arizona state agency/department contacts].

By embracing the strategies and resources outlined in the ORCCA guide, Arizona treatment centers can play a pivotal role in reducing opioid overdose deaths and improving the lives of individuals with OUD across the state.

Disclaimer

The information provided in this article is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

The strategies and resources mentioned in this article are based on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Opioid-Overdose Reduction Continuum of Care Approach (ORCCA) Practice Guide 2023. While this guide provides evidence-based recommendations, it is essential to consult with local healthcare professionals, behavioral health specialists, and Arizona state agencies to ensure that the implementation of these strategies is appropriate and complies with Arizona’s specific laws, regulations, and guidelines.

The data presented in this article regarding opioid overdose deaths and the availability of MOUD providers in Arizona are based on the most recent information available at the time of publication. However, these numbers may have changed since then and should be verified with local and state health departments for the most up-to-date statistics.

The mention of specific organizations, agencies, or departments in this article is for informational purposes only and does not constitute an endorsement or recommendation by the author or Nirvana Recovery Arizona.

It is crucial to approach the expansion of MOUD access with care, sensitivity, and respect for individuals with opioid use disorder and their families. Stigma and discrimination can be significant barriers to seeking and receiving treatment, and it is essential to create a supportive and inclusive environment that promotes recovery and well-being.

Expanding access to MOUD is just one aspect of addressing the opioid crisis in Arizona. A comprehensive approach that includes prevention, harm reduction, treatment, and recovery support services is necessary to effectively combat this public health emergency.

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