National Resource Center for Academic Detailing [NaRCAD]
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  • About
    • Why We Matter
    • Testimonials
    • Our Team
    • Contact Us
  • Tools & Resources
    • AD Core Toolkits >
      • Inclusivity Toolkit
      • Opioid Safety Toolkit
      • HIV Prevention Toolkit
      • E-Detailing Toolkit
      • Materials Toolkit
    • AD Literature Archives
  • Webinars
    • Webinar Series
    • E-Detailing Webinars
    • E-Detailing Roundtables
  • Blog & E-News
    • Best Practices Blog
    • E-Newsletter
  • Community
    • Discussion Forum
    • Peer Connection Program
    • Detailing Directory
  • EVENTS
    • Training Series
    • CONFERENCE SERIES
    • THE CONFERENCE HUB

Maryland | OPIOID SAFETY TOOLKIT

Topic-specific and site-specific resources for Academic Detailing on opioid safety in the state of Maryland
2-Day Training: Slide Decks for Review
  • The Case for Academic Detailing and Evidence-based Medicine
  • Using Educational Materials & Clinical Content Review (including talking points for reference articles)
  • Planning for Successful Visits
  • NaRCAD Technical Assistance & Customized Toolkit
CORE DETAILING KIT FOR PRINTING
Detailing Aid:
  • CDC 4-Pager Detailing Aid (Adapted by NaRCAD & used at Training Sessions)
  • 5 Key Messages PocketCards (CDC messaging, adapted by NaRCAD)

Printable Support:
  • How-To Get Your MAT Waiver:
    • MD Version  (Adapted from PCSS)
    • ​General Overview Link: Medication-Assisted Treatment (MAT) Training for NPs, PAs, & MDs (PCSS)
  • General Overview: Prescription Drug Monitoring Programs (PDMPs) (CDC)
  • Maryland's Controlled Substance Monitoring Database (CRISP): New Registration/Instructions​
Easy Print Copies of Referenced Studies: (includes highlighted text for quick reading)
  • SPACE Trial | ER Study 
Project Overviews & Tracking Tools
​Tracking Your Visits:
  • ​Individual Visit Notes Sheet | (Example Version Shown Here)​
  • Visit Targeting and Master Tracking Spreadsheet​
  • Form: Provider Evaluation of A Visit: Post-Detailing Session Evaluation Form

Additional Educational Tools & Materials

CDC: Guidelines & Additional tools
Guidelines for Prescribing Opioid for Chronic Pain
Infographic: Why Guidelines for Primary Care Providers?
Turn the Tide: Pocket Guide
Pharmacists: On the Front Lines
Pocket Guide: Tapering Opioids for Chronic Pain
Guideline for Prescribing Opioids for Chronic Pain: Recommendations 
Checklist for Prescribing Opioids for Chronic Pain
Nonopioid Treatments for Chronic Pain
Assessing Benefits and Harms of Opioid Therapy
Calculating Total Daily Dose of Opioids for Safer Dosage
the va academic detailing service: pain & opioid safety initiative
Pain & Opioid Safety Initiative (OSI) Materials:
Quick Reference Guide | Education Guide | Chronic Pain and Suicide Factsheet | Opioid Dose Adjustments | Opioid Taper Tool
public health ad programs: opioid safety campaign materials
California Department of Public Health | Prescription Drug Overdose Prevention Initiative
Prescribing Guidelines (PDF)
CDC Tapering Pocket Guide (PDF)
Opioid Prescribing and Treatment Resources (PDF)
Prescription Drug Monitoring Program – CURES
Referral and Treatment Services Locator (PDF)
Related Publications (PDF)
Full Resource Sheet which contains all resources listed above (PDF)
CDC and MBC Guidelines Comparison (PDF)

The New York Department of Health and Mental Hygiene | Opioid Analgesic Campaign
Letter from the Health Commissioner
Preventing Misuse of Prescription Opioid Drugs
Opioid Calculator
Buprenorphine Pamphlet for Providers
Naloxone / Harm Reduction Palm Card
Naloxone Guidelines


The San Francisco Department of Public Health | Opioid Stewardship Campaign
Detailing Brochure: Prescribing Naloxone to Patients Who Use Opioids

The Rhode Island Department of Public Health | Prescription Drug Overdose Prevention Program
Fact Sheet: Updated Regulations on Acute Pain Management ​
Agreement: Sample Patient - Provider Agreement for Opioid Treatment
Consent: Sample for Treatment with Opioids for Non-Cancer related Chronic Pain
Evaluation: Opioid Risk Tool
medical universities: supports and tools
University of Washington Pain Center
  • Opioid Dose Calculator: AMDG Opioid Dose Calculator 
Medical University of South Carolina: SCORxE Program
  • Brochure: Monitoring Practices to Promote Safe Opioid Use in the Treatment of Chronic Non-Cancer Pain & Reduce Risk of Misuse 
​
PATIENT-FACING MATERIALS FOR PROVIDERS
General Resources:
  • Patient Brochure: Safe Treatment of Acute Pain (Alosa Health)
  • Patient Tear-off Sheet: Non-Opioid "Prescription" for Pain Care (Alosa Health) 
  • Patient-Provider Agreement Example (Alosa Health)
  • Patient Tool: Assessing Benefit Using the PEG (Pain, Enjoyment, General Activity) Scale 
Take Charge Ohio Initiative (examples for all sites and for Ohio site detailer use):
  • Patient 1-Pager: Risks of Opioids
  • Patient Brochure: Overview of Initiative with Opioid Use Statistics
  • Patient and Clinician Safe Prescribing Plan
  • Public Flier: Knowing When Someone is at Risk
  • Public Posters: Safe Storage and Handling of Opioids | Non-Opioid Treatment | Pain is Part of the Healing Process
Learn more and see even more resources at TakeChargeOhio's Healthcare Provider Toolkit Sitehttps://alosahealth.org/wp-content/uploads/2018/11/PatientBro_AcutePain.pdf
SAMHSA RESOURCES FOR MEDICATION-ASSISTED TREATMENT
  • Interactive State Map of  MAT (Medication-Assisted Treatment) Providers
  • Buprenorphine Training for Physicians
  • Opioid Prescribing Courses for Physicians
  • Webinars, Workshops, and Summits
  • Physician and Program Data
  • Publications and Research
  • Organizations that Support MAT​​​

​Research, Literature, & Publications

publications & Articles: AD & Opioids
  • March 2018 Study: Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial | JAMA | Erin E. Krebs, MD, MPH1,2; Amy Gravely, MA1; Sean Nugent, BA1; et al
  • November 2017 Study: Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department: A Randomized Clinical Trial | Andrew K. Chang, MD, MS; Polly E. Bijur, PhD; David Esses, MD; et al
  • May 2013 Study: Opioid agonist treatments and heroin overdose deaths in Baltimore, Maryland, 1995-2009. | Schwartz RP1, Gryczynski J, O'Grady KE, Sharfstein JM, Warren G, Olsen Y, Mitchell SG, Jaffe JH.
  • ​Publication: Educational Outreach to Opioid Prescribers: The Case for AD |  PubMed.gov | Trotter Davis M, Bateman B, Avorn J.
  • ​​Publication: Improving Adherence to Long-term Opioid Therapy Guidelines to Reduce Opioid Misuse in Primary Care: A Cluster-Randomized Clinical Trial | PubMed.gov + National Institutes of Health | Liebschutz JM, et al​
  • Publication: Implementing Opioid Risk Reduction Strategies Into Primary Care Practice | ClinicalTrials.gov | Karen Lasser, Boston Medical Center
  • Publication:  Trends in naloxone prescriptions prescribed after implementation of a National Academic Detailing Service in the Veterans Health Administration: A preliminary analysis | Bounthavong, et al | JAPhA: The Journal of the American Pharmacists Association
  • Publication: Vital Signs: Changes in Opioid Prescribing in the United States, 2006–2015  The Center for Disease Control (CDC)
  • Publication: Medication-Assisted Therapies — Tackling the Opioid-Overdose Epidemic | NEJM | Nora D. Volkow, M.D.,  Thomas R. Frieden, M.D., M.P.H., Pamela S. Hyde, J.D., Stephen S. Cha, M.D.
  • ​​Data Brief: Unintentional Opioid Analgesic Poisoning (Overdose) Deaths Involving Heroin and/or Fentanyl in New York City, 2000 - 2015 | NYC DOHMH
  • ​Overview: Prescription Drugs: Academic Detailing: Evidence of Quality Improvements | Evidence of Savings | Key Considerations | Further Resources | State-by-State Ratings | Community Catalyst
  • Further Reading: JAMA Opioid Research Archives
news releases
Maryland News:
  • News Release: Opioid Crisis Continues Unabated in MD and Elsewhere; Here's a Plan of Action
  • News Release: As Maryland's Opioid Crisis Rages On, So Does Grief
  • News Release: Baltimore's Forgotten Opioid Epidemic 
  • News Release Archive: Heroin Addiction Baltimore
National News:
  • News Release: Taking A Page From Pharma’s Playbook To Fight The Opioid Crisis | Kaiser Permanente Health News
  • ​News Release: Program to help doctors prescribe safer alternatives to opioids | Pittsburg Post-Gazette
  • News Release: Stemming the Opioid Epidemic | AAMC News: The Association of American Medical Colleges 
  • News Release: FDA’s Dilemma With the Opioid Pain Medication Zohydro ER: Forbes
  • News Release: Naloxone – a Potential Life Saver: NIDA article
​reference articles on pain
  • Argoff CE, Albrecht P, Irving G, Rice F. Multimodal analgesia for chronic pain: rationale and future directions. Pain medicine. 2009;10 Suppl 2:S53-66. Epub 2009/08/26. doi: 10.1111/j.1526-4637.2009.00669.x. PubMed PMID: 19691685.
    PubMed
  • Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med. 2003 Nov 13;349(20):1943-53.
    PubMed
  • Ballantyne JC, Shin NS. Efficacy of opioids for chronic pain: A review of the evidence. Clin J Pain. 2008 Jul-Aug;24(6):469-78.
    PubMed
  • Benedetti F, Carlino E, Pollo A. How placebos change the patient's brain. Neuropsychopharmacology. 2011 Jan;36(1):339-54. doi: 10.1038/npp.2010.81. Epub 2010 Jun 30.
    PubMed
  • Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007 Jan;10(1):7-111.
    PubMed
  • Cahana A, Dansie EJ, Theodore BR, Wilson HD, Turk DC. Redesigning delivery of opioids to optimize pain management, improve outcomes, and contain costs. Pain Med. 2013 Jan;14(1):36-42. 
    Full article PDF | PubMed
  • Carragee EJ. Clinical practice. Persistent low back pain. N Engl J Med. 2005 May 5;352(18):1891-8.
    PubMed
  • Chou R, Cruciani RA, Fiellin DA, et al. Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Society. The journal of pain : official journal of the American Pain Society 2014;15:321-37.
    Full article PDF | PubMed
  • Chou R, Fanciullo GJ, Fine PG, et al; American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10:113-130. 
    The Journal of Pain
  • Chou R, Fanciullo GJ, Fine PG, Miaskowski C, Passik SD, Portenoy RK. Opioids for chronic noncancer pain: prediction and identification of aberrant drug-related behaviors: a review of the evidence for an American Pain Society and American Academy of Pain Medicine clinical practice guideline. J Pain. 2009 Feb;10(2):131-46. doi: 10.1016/j.jpain.2008.10.009.
    PubMed
  • Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91.
    PubMed
  • Christo PJ, Manchikanti L, Ruan X, Bottros M, Hansen H, Solanki DR, Jordan AE, Colson J. Urine drug testing in chronic pain. Pain Physician. 2011 Mar-Apr;14(2):123-43.
    PubMed
  • Clauw, D. Fibromyalgia: A Clinical Review. JAMA. 2014 April;16(1):1547-1555.
  • Dickenson AH, Baron R. Descending controls: insurance against pain? Pain. 2011 Dec;152(12):2677-8. doi: 10.1016/j.pain.2011.07.003. Epub 2011 Aug 15.
    PubMed
  • Dunn KM, Sounders KW, Rutter CM, et al. Opioid prescriptions for chronic pain and overdose: A cohort study. Annals of Internal Medicine. 2010;152(2):85-92. 
    Ann Intern Med
  • Fine PG, Finnegan T, Portenoy RK. Protect your patients, protect your practice: Practical risk assessment in the structuring of opioid therapy in chronic pain. J Fam Pract. 2010 Sep;59(9 Suppl 2):S1-16. 
    PubMed
  • Fleming MF, Davis J, Passik SD. Reported lifetime aberrant drug-taking behaviors are predictive of current substance use and mental health problems in primary care patients.Pain Med. 2008 Nov;9(8):1098-106. doi: 10.1111/j.1526-4637.2008.00491.x. Epub 2008 Aug 18.
    PubMed
  • Giamberardino MA, et al. Viscero-visceral hyperalgesia: characterization in different clinical models. Pain. 2010 Nov;151(2):307-22. doi: 10.1016/j.pain.2010.06.023. Epub 2010 Jul 16.
    PubMed
  • Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, Clauw DJ. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum. 2004 Feb;50(2):613-23.
    PubMed
  • Glombiewski JA, Sawyer AT, Gutermann J, Koenig K, Rief W, Hofmann SG. Psychological treatments for fibromyalgia: a meta-analysis. Pain. 2010 Nov;151(2):280-95. doi: 10.1016/j.pain.2010.06.011. Epub 2010 Aug 19. 
    PubMed
  • Gourlay DL, Heit HA. Universal precautions revisited: managing the inherited pain patient. Pain Med. 2009 Jul;10 Suppl 2:S115-23. doi: 10.1111/j.1526-4637.2009.00671.x.
    PubMed
  • Institute of Medicine (U.S.). Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and esearch. Washington, DC; The National Academies Press. 2011. 
    National Academies Press
  • Ives TJ, Chelminski PR, Hammett-Stabler CA,et al. Predictors of opioid misuse in patients with chronic pain: a prospective cohort study. BMC Health Serv Res. 2006 Apr 4;6:46.
    PubMed
  • Laine C, Goldman D, Wilson, J (eds). In the Clinic Migraine.Annals of Internal Medicine. American College of Physicians. 2007(14).
    Full article PDF
  • Lamb SE, Hansen Z, Lall R, et al. Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. Lancet. 2010 Mar 13;375(9718):916-23. doi: 10.1016/S0140-6736(09)62164-4. Epub 2010 Feb 25.
    PubMed
  • Mease PJ. Further strategies for treating fibromyalgia: the role of serotonin and norepinephrine reuptake inhibitors.Am J Med. 2009 Dec;122(12 Suppl):S44-55. doi: 10.1016/j.amjmed.2009.09.010.
    PubMed
  • Mendell JR, Sahenk Z. Clinical practice. Painful sensory neuropathy. N Engl J Med. 2003 Mar 27;348(13):1243-55.
    PubMed
  • Morasco BJ, Corson K, Turk DC, Dobscha SK. Association between substance use disorder status and pain-related function following 12 months of treatment in primary care patients with musculoskeletal pain. J Pain. 2011 Mar;12(3):352-9. doi: 10.1016/j.jpain.2010.07.010. Epub 2010 Sep 20.
    PubMed
  • Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010;363:1981-1985
    N Engl J Med
  • Portenoy RK, Fine PG. Pain TV: Chronic Pain in America.Medscape Education Family Medicine, 2011 Oct 14. Available from: http://www.medscape.org/sites/advances/pain-tv 
    Medscape Online Video Learning Modules - Subscription Required
  • Ramachandran VS. Plasticity and functional recovery in neurology. Clin Med. 2005 Jul-Aug;5(4):368-73.
    PubMed
  • Reisfield GM. Medical cannabis and chronic opioid therapy. J Pain Palliat Care Pharmacother. 2010 Dec;24(4):356-61. doi: 10.3109/15360288.2010.519431.
    PubMed
  • Richardson LP, Russo JE, Katon W, McCarty CA, Devries A, Edlund MJ, Martin BC, Sullivan M. Mental Health Disorders and Long-term Opioid Use Among Adolescents and Young Adults With Chronic Pain. J Adolesc Health. 2012 Jun;50(6):553-8. Epub 2012 Feb 28.
    PubMed
  • Sullivan LE, Fiellin DA. Narrative review: buprenorphine for opioid-dependent patients in office practice. Ann Intern Med. 2008 May 6;148(9):662-70.
    PubMed
  • Sullivan MD. Who gets high-dose opioid therapy for chronic non-cancer pain? Pain. 2010 Dec;151(3):567-8. doi: 10.1016/j.pain.2010.08.036. Epub 2010 Sep 9.
    PubMed
  • Turk DC, Wilson, HD, Cahana A. Treatment of chronic non-cancer pain.linder1 The Lancet. 2011 (Jun25);377:2226-2235. 
    PubMed
  • Verdu B, Decosterd I, Buclin T, et al. Antidepressants for the treatment of chronic pain. Drugs. 2008;68(18):2611-2632.
    PubMed
  • Walker JM, Farney RJ, Rhondeau SM, Boyle KM, Valentine K, Cloward TV, Shilling KC. Chronic opioid use is a risk factor for the development of central sleep apnea and ataxic breathing. J Clin Sleep Med. 2007 Aug 15;3(5):455-61.
    PubMed
  • Woolf CJ; American College of Physicians; American Physiological Society. Pain: moving from symptom control toward mechanism-specific pharmacologic management.Ann Intern Med. 2004 Mar 16;140(6):441-51.
    PubMed
  • Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011 Mar;152(3 Suppl):S2-15. doi: 10.1016/j.pain.2010.09.030. Epub 2010 Oct 18.
    PubMed
  • Yunus MB. Fibromyalgia and Overlapping Disorders: The Unifying Concept of Central Sensitivity Syndromes. Seminars in Arthritis and Rheumatism 2007(Jun);36(6):339-356. 
    PubMed
PRESENTATIONS, VIDEO TOOLS, & SPECIAL FEATURES
​Presentation: Addressing the Opioid Epidemic: The New York State Department of Health | Kitty Gelberg, Ph.D., MPH, Director, Bureau of Occupational Health & Injury Prevention | Columbia University Medical Center: Center for Injury Epidemiology & Prevention

Presentation & Video:  Public Health Plenary: Academic Detailing to Improve Opioid Safety (ADIOS) | San Francisco Department of Public Health

Video Talk: Statewide Strategies Combatting Opioids |  Youtube | Dr. Karen Smith, Director of CDPH: 

Presentation:  Gaining Clinician Access: Success & Challenges in AD Primary Care Physician Recruitment | Patricia Chan, BScPharm, PharmD & Tanya Marshall, BScPharm, PharmD | Download Slidedeck PDF​

Presentation
: Your AD Territory is HOW Big? Trials, Tribulations, and Breakthroughs in Rural AD (Aron Nenninger,  BScPharm, RPh  & Cristi Froyman, BScPharm, RPh) | Watch Complete Video Recording

Video Training Tools:
 Examples of a Public Health Academic Detailing Visit | San Francisco Department of Public Health's HIV PrEP Campaign
Video/Scenario #1 | Video/Scenario #2 | Q+A Reflection Segment

Webinar: 
Academic Detailing: Changing Prescriber Behavior Through Brief, In-Person Encounters | San Francisco Department of Public Health

Special Blog: Prioritizing Evaluation for Opioid-Related Initiatives: The ​National Academic Detailing Service’s ​Opioid Overdose Education & Naloxone Distribution (OEND) Program ​​​

Maryland State: Customized Resources

Picture
Maryland resources on opioid safety
Resource: MD Overdose Prevention (MD Department of Public Health)

Resource: MD Local Addiction Authorities (MD Department of Public Health)

Resource:  Opioid Resources for Hospitals  (Maryland Hospital Association) 

Presentation: Opioid Prescribing Guidance (Maryland Medicaid Pharmacy Program)

Resource: Baltimore Opioid Addiction Treatment Resources (Baltimore City Health Department)

​Resource: Maryland State Opioid Statistics (Amfar.org)

Brochure: Maryland Addiction Consultation Services (MACS)

Coalition: Maryland Coalition of Families 

Website: Before It's Too Late

Toolkit: Maryland Heroin and Opioid Awareness Prevention Toolkit (Maryland State Department of Education)

PDMP Mandate: Delegate Fact Sheet (Maryland PDMP)

PDMP Mandate: Pharmacist Fact Sheet (Maryland PDMP)

PDMP Mandate: Delegators Fact Sheet (Maryland PDMP)

PDMP Mandate: Prescriber Fact Sheet (Maryland PDMP)


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​NaRCAD is a program of the Boston Medical Center, founded at the Division of Pharmacoepidemiology & Pharmacoeconomics [DoPE], at Brigham & Women's Hospital.

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