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Substance Use Disorders "SUD"

Definitions

In this section:
  • CA DMC-ODS (Medi-Cal Organized Delivery System)
  • MAT (Medically Assisted Treatment)
  • SBIRT (Screening, Brief Intervention and Referral to Treatment)

​CA Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver (8-14-15)  "The waiver gives the state flexibility to establish a continuum of care to help ensure that services and treatment are delivered in the right place at the right time in the right setting for the individual's needs... “Medi-Cal Moves Addiction Treatment into the Mainstream: Early Lessons from the DMC-ODS Pilots.” 2018, CA Health Care Foundation / “How Medi-Cal Expanded Substance Use Treatment and Access to Care” is a follow up to the 2018 paper and includes perspectives from additional counties representing various population sizes and geographic areas throughout the state. 2020, CA Health Care Foundation​​

Medication Assisted Treatment (MAT) means utilizing U.S. Food and Drug Administration (FDA)-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Medications commonly used include methadone, buprenorphine, and naltrexone, which reduce or prevent cravings and withdrawal symptoms, and reduce the risk of overdose. MAT is primarily used for the treatment of addiction to opioids (heroin and prescription pain relievers that contain opiates). Additionally, acamprosate may be used to reduce cravings for individuals with alcohol use disorder, and disulfiram deters drinking because combining it with alcohol causes physical illness. Naltrexone is also used for alcohol use disorder since it blocks the euphoric effects and feelings of intoxication. 
  • Behavioral Health Action Blueprint 2021, page 21
  • Medications for Opioid Use Disorder Executive Summary    Full Document SAMHSA, 2021

SBIRT (Screening, Brief Intervention and Referral to Treatment) is an integrated, comprehensive, evidence-based approach to identify, reduce and prevent risky or unhealthy substance use and can be utilized in a variety of different settings.  SBIRT & SBIRT for Youth, National Council for Mental Wellbeing, 2021

Resources

Naloxone Vending Machine Dispenser, San Diego County, See Page 26

Overdose Prevention & Response for community corrections, Course Series (free), National Council for Mental Wellbeing, 2023

​CA Youth Peer Mentor Program 2021 Annual Report

​Overdose Prevention Initiative, CA Department of Public Health

Sobering Centers Explained, CA Health Care Foundation, 2021

Best Practices in Managing Patients with Kratom Addiction,  Recording - Providers Clinical Support System, November 2020

Fatal Opioid Overdose, HIV, and Hepatitis C Virus (HCV) Vulnerability Assessment, CA Department of Public Health, November 2020
​
Integrating SUD Services - Sustaining Progress in Challenging Times, National Council for Behavioral Health, October 2020

Nat'l Practice Guideline: Opioid Use Disorder Treatment (ASAM)​

Recommendations: Care of Homeless Patients with OUD

Drug and Alcohol Screening Tools (SAMHSA)
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Treatments for Substance Use Disorders (SAMHSA)

Reports

DMC‑ODS waiver evaluation reports External Quality Review Organization (EQRO) review of Drug Medi-Cal Organized Delivery System (DMC-ODS) in counties regarding access, timely access, and quality of care.

Optimal Utilization of psychosocial supports in medication-assisted treatment for opioid use disorder disorder, US Dept of Health & Human Services, July 2019

The MH and Substance Use Workforce for Older Adults... Institute of Medicine (2012)

1.5 Million Adults Have Serious Mental Illness & Misused Opioids: ​SAMHSA (1-25-17)
​
Temporal Patterns of ER Visits Related to Underage Drinking:  SAMHSA (1-20-17)


Facing Addiction in America, Surgeon General's Report, Surgeon General, 2016





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MAT & Drug Court Opportunity December 2022
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Legislation

AB 638 (2021) Revises the Mental Health Services Act (MHSA) by authorizing the use of Prevention and Early Intervention (PEI) funds for prevention and early intervention strategies that address mental health needs, substance misuse or substance use disorders (SUDs), or needs relating to cooccurring mental health substance use.

​AB 2265 (2020) Authorizes the services for adults, older adults, and children, as well as innovative programs and prevention and early intervention programs that are provided by counties as part of the MHSA to include substance use disorder treatment for children, adults, and older adults with cooccurring mental health and substance use disorders who are eligible to receive mental health services pursuant to those programs. 

Policy Papers

Stanford-Lancet report calls for sweeping reforms to mitigate opioid crisis, Stanford Medicine, 2022

​The Overdose Crisis in California: 2017-2021, DHCS, HMA and CA Health Policy Strategies, 2022

Peers Speak Out: Priority Outcomes for Substance Use Treatment and Services, American Society of Addiction Medicine+, 2021
​
​​​​CA Assoc. of Alcohol & Drug Program Executives (CAADPE) Policy Papers
  • SUD Workforce
  • Recovery Housing
  • Improving Parolee SUD Treatment through Medi-Cal (Response to Legislative Analyst's Office (LAO) report)
​​
Blueprint for Behavioral Health, Behavioral Health Action Coalition, 2020

Papers / Webinars/Articles

Governor’s “Master Plan for Tackling the Fentanyl and Opioid Crisis”, 2023

Xylazine: A Drug that Naloxone Can’t Combat, U.S. Drug Enforcement Administration (DEA)

​Education on fentanyl, other drugs often optional in California schools, if offered at all. // EdSource

When It’s Time To Come Down, Weaning Opioids With Compassion, Providers Clinical Support System, 2022

Drug-Related Emergency Department Visits Analysis, SAMHSA, 2021

Sobering Centers Offer Clients Pathway to Stable Lives, CA Health Care Foundation, September 2021

In Their Own Words: How Fragmented Care Harms People with Both Mental Illness and Substance Use Disorder​, CA Health Care Foundation, August 2021​

Addiction & Mental Health As The Nation Moves Toward Recovery from COVID-19, The Kennedy Forum Recording

​The Implications of COVID-19 for Mental Health and Substance Use, Kaiser Family Foundation

Medication Assisted Treatment (MAT) coverage for services and drugs is now required through state Medicaid programs, October 2020

Community Care in Reach: Mobilizing Harm Reduction and Addiction Treatment Services for Vulnerable Populations, Frontiers in Public Health

Federal Court Ruling:  Jails must give inmates addiction treatment, NPR May 2019

Attorney General Becerra Urges Insurance Providers to Improve Access to Care for Individuals to help Combat the Opioid Epidemic

CA Medication Assisted Treatment (MAT) Project, CA Dept of Health Care Services

Effectiveness of Vermont's... Opioid Addiction Treatment, Vermont Dept of Health

Drug Medical Organized Delivery System, CA BH Planning Council

The MH and Substance Use Workforce for Older Adults. Institute of Medicine (2012)

1.5 Million Adults Have Serious Mental Illness & Misused Opioids: ​SAMHSA (1-25-17)

Temporal Patterns of ER Visits Related to Underage Drinking:  SAMHSA (1-20-17)

Facing Addiction in America, Surgeon General's Report, Surgeon General, 2016

TAU study links cannabis use in adolescence to schizophrenia, Tel Aviv University, August, 2017

Aging and Addicted:  The Opioid Epidemic Affects Older Adults, CA Healthline, 12-16

CA Expands Substance Abuse Treatment For Low-Income Residents, NPR 12-15

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mission

cALBHB/C supports the work of california's 59 local mental/ behavioral health boards and commissions by providing resources, training, and opportunities for communication and statewide advocacy.

Local boards are responsible for reviewing community mental health needs, services, facilities and special problems, and serve in an advisory capacity to local governing bodies and local mental/behavioral health directors per CA Welfare and Institutions Code 5604.2.
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