Medications for Opioid Use Disorder (MOUD)

What is MOUD?

• MOUD is a safe, effective, and evidence-based treatment which uses FDA-approved medication to treat opioid use disorder (OUD).

• FDA-approved treatment for OUD includes:

• buprenorphine
• methadone
• naltrexone

• Medication Assisted Treatment (MAT) is sometimes used instead of MOUD. The term MAT can include both counseling and medication to support people with OUD. However, the term MOUD is sometimes preferred to emphasize that the opioid use disorder is what is being treated.

​Benefits of MOUD

• reduces or eliminates cravings to use opioids
• reduces or eliminates withdrawal symptoms
• blocks the effects of opioids
• reduces illicit opioid use
• supports people in treatment
• reduces the risk of overdose 

​It is best when patients with OUD have access to counseling, mental health services, medical care, and support services to meet the specific needs of the whole person as part of treatment.

DATA-Waiver (X-Waiver) Removal

There is no longer a federal requirement for practitioners to submit a waiver to prescribe medications, like buprenorphine, to treat OUD. Prescriptions for OUD, like all prescriptions, now only require a standard Drug Enforcement Agency (DEA) registration number. For more information visit SAMHSA’s Waiver Elimination webpage.

Resources for Providers

Treatment Resources

• Effective linkage to evidence-based care with MOUD is vital for patient health and for public health. Center for Disease Control and Prevention’s (CDC) Linking People with Opioid Use Disorder to Medication Treatment offers guidance for linkage to care strategies for health care professionals and other community leaders.
• Call the California Substance Use Line at (855) 300-3595. The call line is available Monday - Friday 6 a.m.–5 p.m.​ PT, and provides teleconsultation services for California physicians, nurses, and other clinicians with questions about substance use prevention and treatment efforts.
• Visit the California Department of Health Care Service’s Choose Change California to search for MAT providers by ZIP code. More information about the treatment process, including patient participation, is available on the same website.
• Get training materials and resources on MAT and other treatment options from the Substance Abuse and Mental Health Services Administration (SAMHSA).
• Locate certified practitioners who treat substance use disorder using SAMSHA’s Substance Use Treatment Locator and Buprenorphine Practitioner Locator.

Addiction Medicine Toolkit

CDC’s Addiction Medicine Toolkit provides an overview of substance use disorders and the field of addiction medicine, including diagnosis and treatment of substance use disorders, linkage to care, methods to reduce stigma, and communication strategies that foster trust and help to build a collaborative patient relationship. Free continuing education (CE) credit is available.

Opioid Prescribing and Stewardship Resources

• CDC Clinical Practice Guidelines for Prescribing Opioids for Pain: These guidelines focus on prescribing opioids for treating chronic pain outside of active cancer treatment, palliative care, and end-of-life care. The recommendations are for patients 18 and older in primary care settings. ​
  

• ​​Opioids and Chronic Pain: A Guide for Primary Care Providers: This California edition guide provides information on prescribing opioids for chronic pain, opioid stewardship, and information on opioid use disorder management. Visit the Center for Innovative Academic Detailing on Opioids & Stimulants’ (CIAO) webpage for more resource materials, trainings, and services to support clinicians.​

• ​Recommendations for Providers who Inherit Patients on Opioids (PDF): Providers may inherit patients receiving treatment with opioid therapy for several reasons, including clinic closures and provider shortages. In these instances, providers are encouraged to consider these best practices:

1. Continue opioid therapy for patients in transition,
2. Develop a patient-centered, individualized care plan,
3. Use caution when tapering opioid therapy,
4. Document patient care decisions, and
5. Prescribe buprenorphine when appropriate.

For more information on this topic, see CIAO’s What Do I Do With Inherited Patients on Opioids?: A Webinar for Providers. CIAO also created a shorter six-minute video: Inheriting Patients on Long Term Opioids: A Quick Primer for Clinicians.

​Online Trainings and Continuing Education 

• CDC’s 2022 Clinical Practice Guideline for Prescribing Opioids for Pain: This CDC training highlights the 12 recommendations and contains information on implementation as well as patient scenarios. Continuing education credits are available.
• The California Bridge On Demand Training: The California Bridge Program, which works to provide access to medication for substance use disorder in emergency departments, offers a host of evidence-based on demand trainings for providers and clinicians. Topic areas include clinical treatment, navigation to care, and culture of harm reduction. MDs, DOs, PAs, and NPs can earn Continuing Medical Education (CME) credits through the Bridge Academy, which can be applied to the one-time DEA license renewal requirements. Nurses can use the Bridge Academy to watch trainings and earn CE Contact Hours.
• Management of Opioids and Chronic Pain in the Primary Care Setting - Online Curriculum: CIAO has prepared online on-demand course modules designed for health professionals who care for patients who use opioids, with potential for CME credits.​