Gaston Controlled Substances Coalition 2017-2020 Strategic Plan
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Gaston Controlled Substances Coalition 2017-2020 Strategic Plan Coalition Principles The following attributes describe how the Coalition will conduct its meetings, programs, and activities. · Engaging, by actively seeking the opinions, suggestions, and criticisms of professional and community stakeholders. · Transparent, by doing our work openly to avoid actual and perceived conflicts of interest. · Comprehensive, by engaging leaders from the professional and community sectors that influence and are influenced by the crisis of drug dependence, and by assuring they engage in strong collaboration and communication. · Evaluative, by continually determining if our work is successful and by using our findings to improve our processes and programs. · Prevention oriented, by addressing the root causes of drug-dependence to develop effective avoidance programs. · Harm Reducing, by preventing the migration of drug-dependent individuals to street drugs. · Neutral, by encouraging prescribers to employ our policies and protocols with fidelity, without regard to their hospital affiliations. · Non-punitive, by helping prescribers adopt our policies and protocols, without regard to their previous prescribing practices. · Non-judgmental, by encouraging prescribers to accept the status of their drug-dependent patients as they help them become drug free. Coalition Mission The mission of the Gaston Controlled Substances Coalition is to engage professional and lay leaders from across the county to collaboratively develop and conduct programs that will: (1) prevent the onset of addiction to controlled substances, (2) assure the adoption of safe opioid prescribing practices, (3) deliver comprehensive drug treatment and mental health services for all persons in need, and (4) deliver professional and community education in support of these outcomes. Coalition Functions The Gaston Controlled Substances Coalition will: · Promote collaboration among its member organizations; · Receive and discuss reports from Coalition committees to assure we are comprehensive consideration to problems, analyses, and recommended actions; · Avoid unintended consequences by testing activities, analyzing and deliberating the results, securing additional insights, and developing successful programs; · Raise community expectations for the Coalition and continually engage new stakeholders to achieve our mission; and, · Hold Coalition members and organizations accountable for full engagement and follow-up. Coalition Membership Organizations and individuals committed to preventing and solving the problems caused by drug dependence in Gaston County are invited to join the Coalition. Coalition Priorities: March 1, 2017 to February 28, 2018 1. Raise community awareness of opioid problems in Gaston County 2. Raise community awareness of new policies/protocols that restrict opioid prescribing 3. Reduce stigma about chronic opioid addiction 4. Reduce community demand for opioids 5. Reduce diversion of prescribed opioids to unintended users. 6. Community trained and prepared to prevent opioid overdoses 7. Prepare prescribers to meet CDC- and State-required opioid policies and procedures 8. Prepare prescribers to manage patient resistance to new opioid policies/procedures 9. Document activity in Gaston County for preventing and treating opioid dependence 10. Identify and plan activities to expand treatment and linkage needs Controlled Substances Policy Adoption Committee Role The Controlled Substances Policy Adoption Committee develops and implements programs to facilitate the full adoption of our controlled substance policies and protocols by all prescribers in Gaston County. Objectives All Gaston County prescribers and clinical practices: 1. Manage patient pain as effectively and humanely as possible; 2. Begin treating pain with non-pharmacologic and non-opioid therapies; 3. Use opioid therapy, and lower-than-customary doses, only when the benefits outweigh risks to patients; 4. Combine opioid therapy with non-pharmacologic and non-opioid drug therapy; 5. Routinely wean patients from opioid dependency; 6. Refer opioid-dependent patients to behavioral health and drug treatment programs; 7. Consistently use the NC Controlled Substances Reporting System; 8. Provide prescriptions for narcan, or recommend its use, to patients at-risk of opioid overdosing; and, 9. Adopt and consistently follow CDC opioid policies. Programs Program 1. Conduct annual CME programs Description · Potential topics: Behavioral approaches to managing opioids in your practice. · Options for pain management. · Using cognitive behavioral therapy. · Using anti-inflammatory medications. · Setting patient expectations for opioid prescriptions. · Setting patient expectations for their safe use of opioid prescriptions. · Working with chronic pain patients who refuse/resist changing opioid prescriptions · Managing difficult patient conversations about their opioid prescriptions. · Working with patients who are misusing and abusing opioids. · Managing opioid-using patients who require behavioral health services. · Weaning resistant patients from opioid-dependency. · Exploring the benefits and limitations of needle and syringe exchange programs. · Building collaboration between prescribers and pharmacists. Estimated Cost · Salary of program staff and time of loaned staff · ~$5,000 for facility rental, snacks, and meeting materials. Evaluation · Track number of attendees by profession. · Administer Training Survey from the Governor’s Institute · Administer the Training Evaluation developed by GCSC. · Review results to improve program content and process. Program 2. Conduct ongoing education and information programs Description · Sustain continuing awareness of opioid issues and practices by: using the speed-dating model for CME programs at CaroMont Regional Medical Center; listing CME programs offered in NC and fee- based and free online CME resources on our website; offering classes that do not provide CME credits; and, disseminating oioid information at local professional meetings. · Potential topics: · Tips for strengthening opioid management in your practice · Sending letters to patients whom receive opioid prescriptions on the consequences of opioid abuse and misuse and the practice’s opioid policies and protocols. · Having appointment-setting staff tell all individuals who call for initial visits that their providers will not issue prescriptions for narcotics at the first visit. · Telling all patients about the practice’s opioid policy. · Managing difficult conversations with patients. · Managing patients who obtain opioids and illegally and illicitly. · Prescribing or recommending naloxone to patients at risk of overdose. · Overcoming challenges with using the NC Controlled Substance Reporting System. · Overcoming challenges with using pain agreements. · Overcoming challenges with using urine drug screening. · Overcoming challenges with using risk assessment tools. · Describing the benefits of signing up for buprenorphine waivers. · When not to abandon opioid-dependent patients · Alternative healing modalities, indications and contraindications. · Acupuncture · Chiropractic · Physical Therapy · Pain Management · Massage Therapy · Reflexology · Yoga · Addressing Social Isolation · Weight Management / Nutrition Management · Low Impact Aerobic Activity Estimated Cost · Cost: to be determined Evaluation · Track number of attendees by profession. · Administer Training Survey from the Governor’s Institute · Administer the Training Evaluation developed by GCSC. · Review results to improve program content and process. Program 3. Visit practices with high opioid prescribing rates Description · Identify practices with high opioid prescribing rates using data from · Prepare physicians and dentists to visit high-prescribing practices. · Meet with physicians and mid-level practitioners in each practice to discuss: · The number of opioids they prescribe; · Adopting CDC recommendations for opioid prescribing; · Using non-opioidal medications for acute pain; · Weaning patients from opioid dependence; · Using education, patient contracts, urine drug screening, and the NC Controlled Substances Reporting System to manage their opioid prescribing; · Referring high-need opioid-using patients for behavioral health services; · Participating in CME programs offered by GCSC; · That GCSC will never report outliers to drug oversight and enforcement bodies. Estimated Cost · Time of individuals making site visits. Evaluation · Number of practices visited. · Number and name of participants at each site visit. · Results from the conversation, including questions and concerns. · This data will be de-identified and summarized for improving program content and process. Program 4. Review/update opioid-related documents for prescribers Description · At six-month intervals, review and update documents developed for prescribers and on the GCSC website: · General Considerations when Prescribing Opioids · Our New Path to Managing Your Pan, A Local Solution · Pain Management Agreement · Pain Management Notification · Commonly Prescribed Opioids and MME Considerations · Comparative Pain Scale · Quick Reference Guide to Community Behavioral Health Services, Gaston and Lincoln Counties · Gaston County: Alternative Pain Management Resources, October 1, 2016 · Others to follow Estimated Cost · Committee and staff time. Evaluation · Changes made, all earlier documents are archived. Program 5. Maintain Gaston County Opioid Dashboard Description · Secure monthly