Substance Use Disorder Treatment Settings
Overdose is an ever-present issue in substance use disorder treatment, yet it is rarely directly addressed. While engagement in substance use disorder treatment can help individuals eliminate or reduce drug use, which can decrease overdose risk, it is also a tolerance changing event that can actually increase risk for overdose death.
In March 2015, SAMHSA updated Opioid Treatment Program guidelines, including new guidance on discussing overdose:
“Overdose prevention, including prescribing or dispensing naloxone, is an essential complement to both detoxification services as well as medically supervised withdrawal. Patients should be advised of the risks of relapse following detoxification and offered a relapse prevention program that includes counseling, naloxone and opioid antagonist therapy.”
Similarly, in June 2015, the American Society of Addiction Medicine (ASAM) developed National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use, including guidance on discussing overdose:
“The Guideline Committee, based on consensus opinion, recommends that patients who are being treated for opioid use disorder and their family members/significant others be given prescriptions for naloxone. Patients and family members/significant others should be trained in the use of naloxone in overdose.”
Opportunities to address overdose and distribute take-home naloxone kits in substance use disorder treatment:
- Waitlists
- Intake assessment
- Trauma screening
- Induction or orientation phase
- Individual or group counseling
- Routinely upon positive drug screen results
- At discharge
- When client overdoses
- International Overdose Awareness Day (August 31- the day before Recovery Month)
- Family support groups
- Consider developing an on-site emergency overdose response policy and provide staff training
If a non-profit substance abuse treatment provider in Florida is interested in implementing a naloxone distribution program to provide free take-home naloxone kits to the people they serve at risk of overdose and their friends and family, you may be eligible to receive free naloxone from DCF for this program. Please review DCF’s Overdose Prevention Program information and/or contact DCF’s Overdose Prevention Coordinator at Amanda.Muller@myFLfamilies.com