LOOPR: Local Opioid Overdose Prevention & Response

A Pilot Project partnership between the CDC, NACCHO, & NaRCAD

Cohort 1 Sites: Bell County, Kentucky | Boone County, West Virginia | Manchester, New Hampshire | Dayton, Ohio
Cohort 2 Sites: St. Francois County, Missouri | Ware County, Georgia
Visit the all-site Discussion Board
2-Day Training: All Slide DecKs, KEY MESSAGES & talking points
NaRCAD Training Presentations:
CORE DETAILING KIT FOR PRINTING
Your Core Detailing Aids for Detailing Success:
1-Page Project Overview (site-specific):  
Detailing Aid: Pocket Cards:
Printable 1-Pagers:
Easy Print Copies of Referenced Studies:
  • SPACE Trial (includes highlighted text for easy reading)
  • ER Study (includes highlighted text for easy reading)

Additional Educational Tools & Materials

CDC: Guidelines & Additional tools
the va academic detailing service: pain & opioid safety initiative
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
PATIENT-FACING MATERIALS FOR PROVIDERS
General Resources: Take Charge Ohio Initiative (examples for all sites and for Ohio site detailer use):Learn more and see even more resources at TakeChargeOhio's Healthcare Provider Toolkit Site
SAMHSA RESOURCES FOR MEDICATION-ASSISTED TREATMENT

​Research, Literature, & Publications

publications & Articles: AD & Opioids
news releases
​reference articles 
References 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

Selected Reference Articles from Don Teater Presentations 
  • Banta-Green CJ, Coffin PO. Commentary on Pierce et. al. (2016): Raising the bar of addiction treatment- first do no harm. Society for the Study of Addiction. Addiction 111:309-310.
    Full Article PDF
  • Fatseas M, Auricombe M. Why Buprenorphine Is So Successful in Treating Opiate Addiction in France. Current Psychiatry Reports. 2007; 9: 358-364.
    Full Article PDF
  • Miech R, Johnston L, O'Malley PM, Keyes KM, Heard K. Prescription Opioids in Adolescence and Future Opioid Misuse. Pediatrics. 2015 November; 136(5).
    Full Article PDF
  • Nummenmaa L, Tuominen L. Opioid system and human emotions. British Journal of Pharmacology. 2018 July; 175(4):2737-2749.
    PubMed
Reference Articles on MAT and Adolescents
  • AAP COMMITTEE ON SUBSTANCE USE AND PREVENTION. Medication-Assisted Treatment of Adolescents With Opioid Use Disorders. Pediatrics. 2016;138(3):e20161893
    Full Article PDF
  • Chang DC, Klimas J, Wood E, Fairbairn N. Medication-assisted treatment for youth with opioid use disorder: Current dilemmas and remaining questions. The American Journal of Drug and Alcohol Abuse. 2018; 44(2):143-146.
    Full Article PDF
  • Hadland SE, Park TW, Bagley SM. Stigma associated with medication treatment for young adults with opioid use disorder: a case series. Addiction Science and Clinical Practice. 2018;13(15).
    Full Article PDF
  • Hadland SE, Wharam JF, Schuster MA, Zhang F, Samet JH, Larochelle MR. Trends in Receipt of Buprenorphine and Naltrexone for Opioid Use Disorder Among Adolescents and Young Adults, 2001-2014. JAMA Pediatr. 2017;171(8):747–755. doi:10.1001/
​           JAMA​
PRESENTATIONS, VIDEO TOOLS, & SPECIAL FEATURES
​​Presentation: Opioids, Pain, and Addiction | Don Teater, MD, MPH, Founder, Teater Health Solutions | Presentation given at NACCHO LOOPR In-Person Meeting at the CDC (April 10 + 11, 2019)

​Presentation:  Medication-Assisted Treatment| Don Teater, MD, MPH, Founder, Teater Health Solutions | Presentation given at NACCHO LOOPR In-Person Meeting at the CDC (April 10 + 11, 2019)

​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 ​​​

Site-Specific Resources

dayton, ohio
sT. fRANCOIS, mISSOURI
MANCHESTER, NEW HAMPSHIRE
ware county, georgia


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