This toolkit is designed to help individuals and organizations providing methadone treatment reduce the risk of adverse incidents among their clients.

For Practitioners

TIP 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs This training manual provides counselors and other clinical staff with scripted modules and handouts to use in trainings for Treatment Improvement Protocol (TIP) 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, published by SAMHSA’s Center for Substance Abuse Treatment. The 12 training modules will assist program staff in discussing, understanding, and implementing the evidence-based practices described in TIP 43.

Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) The CIWA is a common measure used in North American hospitals to assess and treat alcohol withdrawal syndrome and for alcohol detoxification. This clinical tool assess 10 common withdrawal signs and symptoms.

Standardized Field Sobriety Test The Standardized Field Sobriety Test (SFST) is a battery of three tests administered and evaluated in a standardized manner to obtain validated indicators of impairment and establish probable cause for arrest.

Clinical Opiate Withdrawal Scale The clinical opiate withdrawal scale (COWS) is a clinician-administered, pen and paper instrument that rates eleven common opiate withdrawal signs or symptoms. The summed score of the eleven items can be used to assess a patient’s level of opiate withdrawal and to make inferences about their level of physical dependence on opioids.

Clinical Sobriety Checklist This documentation tool for nurses can be used in the assessment of clients who may be under the influence of drugs or alcohol.

Community Substance Abuse Centers’ Impairment Assessment Tool This impairment assessment tool is for nurses working in community substance abuse centers.

Opioid Risk Tool This tool can be used to quantify a patient’s risk for opioid addiction.

Benzodiazepines & Medication-Assisted Treatment A one-pager for patients on immediate consequences, long-term effects, and threats to recovery.  Print out and distribute or post on the wall.

For Organizations

Effective Risk Management Strategies in Outpatient Methadone Treatment – Trainer’s Manual, Webinar Series, and PowerPoint Slides The one-day training “Effective Risk Management Strategies in Outpatient Methadone Treatment” is designed to increase opioid treatment providers’ (both clinical and administrative staff) knowledge and skills on the most effective ways to conduct risk management strategies for opioid treatment centers.

SAMHSA’s Guidelines for the Accreditation of Opioid Treatment Programs These guidelines were established to serve as a guide to accreditation organizations in developing accreditation standards, which conform with the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Federal Opioid Treatment Standards

Exception Request and Record of Justification. Form SMA-168 This form was created to assist in the interagency review of patient exceptions in opioid treatment programs.

SAMHSA’s “Guidelines for the Accreditation of Opioid Treatment Programs” and “Dear Colleague Letter” (take-home medication) The purpose of this letter is to restate the Substance Abuse and Mental Health Services Administration’s (SAMHSA) policy for unsupervised medication take-home doses when the opioid treatment program (OTP) is closed for business, including Sundays and Federal and State holidays.

“CSAT Dear Colleague Letter (Sept. 4, 2007)” (standing orders) The purpose of this letter is to advise all opioid treatment programs (OTPs) of concerns the Center for Substance Abuse Treatment (CSAT) has relative to methadone admission, dosing and induction practices.

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