MAT Resources

AUDIT (Alcohol Use Disorders Identification Test)
The AUDIT is a simple way to screen and identify people at risk of alcohol problems. 

Drug Abuse Screening Test (DAST-10)
The DAST-10 is a 10-item brief screening tool that assesses drug use, not including alcohol use, over the past 12 months. 

Criteria for Diagnosis of Opioid Use Disorder (DSM-5)
Identifying problematic pattern of opioid use leading to clinically significant impairment or distress over the past 12 months.

Drug Screening Treatment Referral Form
This form can be used to outline patient referrals, and substance involvement. 

ASAM Urine Testing Resources
American Association of Addiction Medicine (ASAM) links for webinars and electronic pocket guides for additional information on drug testing. 

Buprenorphine Initiation Checklist for Clinics
This checklist, to be completed by a clinical staff member, is a sample of what the clinical process can look like for intake of an OUD patient that is ready to begin MAT.

Patient Consent Form
Sample MAT consent form, including purpose, practice policies/procedures, and reasons for dismissal from suboxone treatment program.

Buprenorphine Treatment Agreement (Sample 1)
Sample treatment agreement form that can be used for patients who are beginning long-term MAT. This agreement outlines risks associated with suboxone, voluntary consent for treatment, patient and prescriber responsibilities, etc.

Buprenorphine Treatment Agreement (Sample 2)
Sample treatment agreement form that can be used for patients who are beginning long-term MAT. This agreement outlines risks associated with suboxone, voluntary consent for treatment, patient and prescriber responsibilities, etc.  

MAT Program Overview

Sample handout for OUD patients that includes an overview of MAT, benefits of buprenorphine, and what to expect during MAT visits.

Buprenorphine Information Sheet 

Informational handout for patients about buprenorphine.

Clinical Opiate Withdrawal Scale (COWS) 

The COWS is an 11-item scale designed to be administered by a clinician to identify and monitor signs and symptoms of opioid withdrawal. 

Subjective Opiate Withdrawal Scale (SOWS) 

The SOWS is a 16-item scale designed to be completed by a patient to rate intensity of withdrawal on a 5-point scale.

Office Induction Protocol for Practices 

A sample of what the first 3 days of an induction might look like for the patient and the practice.  Includes when to administer the COWS, withdrawal observation guidelines, and maximum day doses.  

Unobserved Home Induction Clinic Protocol

A guide for the clinic to follow when doing unobserved (home) inductions for patients.

Observed Phone or Video (Telehealth) Induction Clinic Protocol

A guide for the clinic to follow when doing an observed telehealth induction (by phone or video) for patients.

Unobserved Home Induction Patient Guide

A guide for the patient to use for an unobserved (home) buprenorphine induction.

Induction Day Care Plan

Sample form to be completed by the patient that outlines supports, goals, and self-care during induction period.

Maintenance Care Plan

Sample form to be completed by the patient that outlines supports, triggers, emotional/physical relapse, self-care, goals, and coping skills during the maintenance period.

Side Effect Management Protocol

A resource for managing side effects of opioids.

Relapse Flowchart

Sample practice flowchart for delivering MAT care to patients that relapse. 

History of Present Illness (HPI) Assessment and Plan Template

Includes templates for induction and follow-up appointments for MAT in OUD, and suboxone script writing. Can be saved electronically to cut/paste into EHR.

Billing & Coding for MAT

MAT billing and coding background, information, considerations, and procedures for patient visits.

Billing and Coding considerations for MAT & OUD

PowerPoint presentation created by an IT MATTTRs expert consultant about billing and coding considerations for OUD and MAT.

MAT and C-Sections
Managing pain for patients that will deliver by c-sections and sample MAT for c-sections.

OpiSafe Sales Sheet

OpiSafe is a comprehensive online support system for opioid prescribers that meets regulatory requirements for managing opioid prescribing and MAT.

OpiSafe Teamwork Flyer
OpiSafe Teamwork is an engagement tool for patients during office visits without compromising patient privacy.

SBIRT in Colorado (Screening, Brief Intervention, Referral to Treatment)
Screening, Brief Intervention, and Referral to Treatment is an evidence-based early intervention to prevent alcohol and drug use problems in adults and adolescents.  No-cost training and technical assistance can be accessed using this handout.

SBIRT Reimbursement
List of commonly used CPT codes for screening and brief intervention services that can be used for reimbursement.

Cycle of Addiction

Taken from the IT MATTTRs primary care practice team curriculum, this handout provides a visual of the Cycle of Addiction.

The words we use matter (NAABT) 
Information about reducing stigma of opioid use disorder through language. 

Opioid names: Brand, Generis, Street, and Combination
List of various names associated with opioids, combination prescriptions, and street names. 

Alternatives to Buprenorphine

Alternatives to buprenorphine with descriptions of benefits, limitations, and potential candidates. 

Urine Drug Screening Article (ASAM)

Information about drug screening from the American Society of Addiction Medicine (ASAM). 

Rethinking JCAHO Pain Standards (JAMA)

Information about lessons learned to help inform efforts to address the prescription opioid crisis. 

MAT Implementation Checklist

Practice checklist to evaluate and consider level of MAT implementation within clinic.

Buprenorphine Patient Limits

History and overview of patient limits.

Blank Local Resources Logs (BHPs, MAT prescribers, Community resources)

Use these sections to track community resources for referrals, support, or additional sources of information in your region.

 

Law Enforcement Treatment Partnership
Information about learning the language, accepting the differences, and embracing the goals between law enforcement and treatment programs.

 

Administering Naloxone

Guidance for first responders administering Naloxone.

Take Meds Seriously (Colorado-only)

Information to access resources about safe use, safe storage, safe disposal (Take Back Program location finder), and resources.

Colorado Opioid Legislation Summary for 2019

Description of Colorado opioid-related legislation passed in 2019.

Recent Colorado Opioid Legislation Summary

CAGE Questionnaire Adapted to Include Drugs (CAGE-AID) 

Version of the CAGE alcohol screening questionnaire, adapted to include drug use. Target population for this tool includes both adults and adolescents. 

NIDA Quick Screen 

Assist clinicians serving adult patients in screening for drug use.

NIDA Quick-Screen: Lifetime & Substance Involvement (SI) Score

Assesses lifetime & Substance Involvement (SI) Score.

NIDA Screening for Drug Use in General Medical Settings

Quick Reference Guide for identifying drug users, providing education, and referral to resources for quitting.

Two-Item Conjoint Screen (TICS) 

Two question screening tool on alcohol/drug use in the past year, and the need to cut down on use.

Current Opioid Misuse Measure (COMM)

Brief patient self-assessment to monitor chronic pain patients on opioid therapy.

CRAFFT Screening Interview
6-question behavioral health screening tool for children under the age of 21.

 

Columbia-Suicide Severity Rating Scale (C-SSRS) Risk Assessment

Questionnaire used for suicide assessment.

Columbia-Suicide Severity Rating Scale

Questionnaire used for suicide assessment.

Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES v8)
Assesses readiness for change in alcohol misuse.

 

SOCRATES 8D: Personal Drug Use Questionnaire

Assesses readiness for change in alcohol abusers.

Brief Situational Confidence Questionnaire (BSCQ)

Assesses self-confidence to resist the urge to drink heavily or use drugs in situations.

Alcohol (and Illegal Drugs) Decisional Balance Scale

20-item self-report measure to assess an individual’s pros and cons of health behaviors. 

42 CFR Part 2 – Comparison Chart

Comparison between 42CFR Part 2 (1987 Rule) and 42 CFR Part 2 (Updated Final Rule).