Screening for Substance Use Disorders/Opioid Use Disorder

The purpose of this manual is to introduce the ASSIST and to describe how to use it in health care settings – particularly community based primary health care settings – to identify people who are using substances, so that a brief intervention (or referral) can be provided, as appropriate.

The Decision Support Tool empowers providers to estimate Medicare and Medicaid revenue across prominent integrated care services to finance these services more effectively in community mental health care, substance use treatment and primary care provider organizations. It includes a list of specific billing codes, service types, professional discipline coverage, documentation and time requirements.

Provides examples of patient behaviors that may indicate prescription medication abuse or addiction and behaviors that may appear aberrant but are likely to be part of the normal process of stabilizing a patient's pain condition.

Provides guidance on the use of buprenorphine among a number of topics, including physiology and pharmacology of opioids, opioid addiction, and buprenorphine treatment; screening and assessment of OUDs; protocols for buprenorphine treatment; management of special populations; and policies and procedures related to DATA 2000.

Helps clinicians better identify the presence of opioid abuse or dependence in patients with chronic pain.

Uses a 20-item instrument administered in an interview format to track behaviors characteristic of addiction related to prescription opioid medications in chronic pain populations. The instrument is scored based on participant responses, interviewer observations of displayed behaviors, and information gathered from medical chart review.

Provides a score indicating the severity of dependence on opioids using a 5-item questionnaire.

Uses a 17-item self-assessment to identify patients with chronic pain taking opioids who have indicators of current aberrant drug-related behaviors.

Assesses the risk of opioid abuse and suitability of candidates for long-term opioid therapy in primary care.

Guides physicians to incorporate screening, brief interventions, and referrals to treatment for use of alcohol, tobacco, marijuana, and other drugs among adolescent patients.