Harbor:BUP: Difference between revisions

Latest revision as of 23:11, 25 April 2022

Opioid Withdrawal MAT/Bup

Please refer all DHS patients with substance use disorder (SUD) started on medication assisted treatment (MAT) to PVCC/CCC – Har for enrollment in Dr. Brown's addiction clinic
- In the "For referral, specify need" box: "MAT for opiate/alcohol dependency"

Qualifying patients

Active withdrawal or post-overdose: start buprenorphine in ED via buprenorphine protocol
Not in active withdrawal but with opioid use disorder: Rx for home start using home initiation protocol
Patients with chronic pain and opioid dependence with PMD at Harbor: message PMD AND Christopher Brown AND Gloria Sanchez to link patient to Harbor SUD clinics
For pregnant patients - once the primary complaint is addressed (or if primary complaint is pregnant and opiate use disorder/withdrawal), if patient has confirmed IUP please send to OB triage for initiation of Suboxone during pregnancy

Consult Social Work for ALL patients started on or prescribed buprenorphine in the ED

Narcan Distribution from ED

Available for any patient with SUD and would benefit from distribution in hand on discharge
- In Code White cabinet in purple doc box, next to the adult airway cabinet, requires key from either senior resident phones or either attending phones
- Please initial to log the distribution on the clipboard attached, no PHI required
All patients handed Narcan also need Rx sent to pharmacy for tracking
Please document as you otherwise would for prescribing Narcan, with the addition of .ednaloxonegiven in your note, which can soon be replaced by .naloxoneEDdistribution

FM MAT Inpatient Consult Service

For patients 16y/o and older
- Mon-Thur 8a-4p x64398
- Call (310) 697-6030
- Message Center: Yvettte Cerna
Flyer: FM MAT Consult Service.pdf

MAT Provider Consultation Line

DHS on-call providers available to help initiate MAT for patients with alcohol and/or opioid use disorder
- (213) 288-9090
- 8a-12a, 7 days per week
Flyer: MAT Consult Line.pdf

Patient MAT/Buprenorphine Follow Up Options

Insurance	Clinic	Hours
DHS Empaneled and DHS Eligible (not Harbor Family Medicine)	Primary Care & Diagnostic Center (PCDC) - Basement Clinic C 1000 W. Carson St Torrance, CA 90502 (424) 306-4546	Schedule as "HAR PC MAT New" or Walk-In: Monday AM or Thursday AM For questions, please message Chris O. Brown, MD via ORCHID/Outlook
DHS Empaneled and DHS Eligible	Lomita Clinic 1430 W Lomita Blvd, 2nd Floor Harbor City, CA 90710 (310) 602-2600 (424) 306-4193 - SUD Counselor	Walk-In: Tuesday AM or Friday AM For questions, please message Gloria Sanchez, MD via ORCHID/Outlook
DHS Empaneled, DHS Eligible, MyHealthLA, Uninsured (No OOP)	LAC+USC Urgent Care 2051 Marengo St, 2nd Floor Los Angeles, CA 90033 (323) 409-1000	Walk-In: Tuesday-Thursday & Saturday 8am-7pm
All Patients	Tarzana Treatment Center 5190 Atlantic Blvd Long Beach, CA 90805 (818) 654-3933	Walk-In: 24/7

All patients can call the Substance Abuse Service Hotline 24/7 for more help (844) 804-7500

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+===[[Harbor:Opiate Withdrawal/MAT/BUP|Opioid Withdrawal MAT/Bup]]===
+* Please refer all DHS patients with substance use disorder (SUD) started on medication assisted treatment (MAT) to PVCC/CCC – Har for enrollment in Dr. Brown's addiction clinic
+** In the "For referral, specify need" box: "MAT for opiate/alcohol dependency"
+'''Qualifying patients'''
+* Active withdrawal or post-overdose: start buprenorphine in ED via buprenorphine protocol
+* Not in active withdrawal but with opioid use disorder: Rx for home start using home initiation protocol
+* Patients with chronic pain and opioid dependence with PMD at Harbor: message PMD AND Christopher Brown AND Gloria Sanchez to link patient to Harbor SUD clinics
+* For pregnant patients - once the primary complaint is addressed (or if primary complaint is pregnant and opiate use disorder/withdrawal), if patient has confirmed IUP please send to OB triage for initiation of Suboxone during pregnancy
+'''Consult [[Harbor:Social_work|Social Work]] for ALL patients started on or prescribed buprenorphine in the ED'''
+====Narcan Distribution from ED====
+*Available for any patient with SUD and would benefit from distribution in hand on discharge
+**In Code White cabinet in purple doc box, next to the adult airway cabinet, requires key from either senior resident phones or either attending phones
+**Please initial to log the distribution on the clipboard attached, no PHI required
+*All patients handed Narcan also need Rx sent to pharmacy for tracking
+*Please document as you otherwise would for prescribing Narcan, with the addition of .ednaloxonegiven in your note, which can soon be replaced by .naloxoneEDdistribution
+====FM MAT Inpatient Consult Service====
+*For patients 16y/o and older
+**Mon-Thur 8a-4p x64398
+**Call (310) 697-6030
+**Message Center: Yvettte Cerna
+*Flyer: [[:Media:FM MAT Consult Service.pdf|FM MAT Consult Service.pdf]]
+====MAT Provider Consultation Line====
+*DHS on-call providers available to help initiate MAT for patients with alcohol and/or opioid use disorder
+**(213) 288-9090
+**8a-12a, 7 days per week
+*Flyer: [[:Media:MAT Consultation Line.pdf|MAT Consult Line.pdf]]
+====BUP/MAT Treatment and Discharge Pathway====
+*[[:Media:Bup_Protocol_Harbor.pdf|Harbor Bup Protocol.pdf]]
+====Patient Discharge Handout====
+*[[:Media:Harbor_Bup_Start_Instructions.pdf|Harbor Bup Start.pdf]]
+====BUP Home Initiation====
+*[[:Media:Bup home Initiation.pdf|Bup Home Start.pdf]]
+====Patient MAT/Buprenorphine Follow Up Options====
+{| class="wikitable"
+|-
+! Insurance !! Clinic !! Hours
+|-
+| DHS Empaneled and DHS Eligible (not Harbor Family Medicine) || Primary Care & Diagnostic Center (PCDC) - Basement Clinic C
+W. Carson St<br/>
+Torrance, CA 90502<br/>
+(424) 306-4546<br/>
+ || '''Schedule as "HAR PC MAT New"''' or
+'''Walk-In: Monday AM or Thursday AM'''<br/>
+For questions, please message Chris O. Brown, MD via ORCHID/Outlook
+|-
+| DHS Empaneled and DHS Eligible || Lomita Clinic
+W Lomita Blvd, 2nd Floor<br/>
+Harbor City, CA 90710<br/>
+(310) 602-2600<br/>
+(424) 306-4193 - SUD Counselor<br/>
+ || '''Walk-In: Tuesday AM or Friday AM'''
+For questions, please message Gloria Sanchez, MD via ORCHID/Outlook
+|-
+| DHS Empaneled, DHS Eligible, MyHealthLA, Uninsured (No OOP) || LAC+USC Urgent Care
+Marengo St, 2nd Floor<br/>
+Los Angeles, CA 90033<br/>
+(323) 409-1000
+ || Walk-In:
+Tuesday-Thursday & Saturday<br/>
+am-7pm
+|-
+| All Patients || Tarzana Treatment Center
+Atlantic Blvd<br/>
+Long Beach, CA 90805<br/>
+(818) 654-3933
+ || Walk-In:
+/7
+|}
+All patients can call the Substance Abuse Service Hotline 24/7 for more help (844) 804-7500
 ==See Also==
-*[[Harbor:Operations Manual]]
+*[[Harbor:Main]]
+*[[Harbor:Opiate_Withdrawal/MAT/BUP|Harbor:Opiate Withdrawal/MAT/BUP]]
+*[[Harbor:Whole person care|Harbor:Whole Person Care]]
+[[Category:Admin]]