Matching Treatment to Patient Needs in Opioid Substitution Therapy Treatment Improvement Protocol (TIP) Series 20
[Front Matter]
[Title Page]
Matching Treatment to Patient Needs in Opioid Substitution Therapy Treatment Improvement Protocol (TIP) Series 20
Janice Fay Kauffman, M.P.H. George E. Woody, M.D. Consensus Panel Co-Chairs
U.S. Department of Health and Human Services Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857
DHHS Publication No. (SMA) 95-3049 Printed 1995.
This publication is part of the Substance Abuse Prevention and Treatment Block
Grant technical assistance program. All material appearing in this volume except
quoted passages from copyrighted sources is in the public domain and may be reproduced
or copied without permission from the Center for Substance Abuse Treatment
(CSAT) or the authors. Citation of the source is appreciated.
This publication was written under contract number ADM 270-91-0007 from the
Center for Substance Abuse Treatment of the Substance Abuse and Mental Health
Services Administration (SAMHSA). Sandra Clunies, M.S., served as the CSAT Government
project officer. Robert A. Lubran, M.S., M.P.A., was the Government content advisor.
Writers were Carolyn Davis, Alan Gambrell, Constance Gartner, M.A., Linda
Harteker, Randi Henderson, and Deborah Shuman.
The opinions expressed herein are the views of the consensus panel members
and do not reflect the official position of CSAT or any other part of the U.
S. Department of Health and Human Services (DHHS). No official support or
endorsement of CSAT or DHHS for these opinions or for particular instruments or software
that may be described in this document is intended or should be inferred. The
guidelines proffered in this document should not be considered as substitutes for
individualized patient care and treatment decisions.
CSAT Treatment Improvement Protocols (TIPs) are prepared by the Quality Assurance
and Evaluation Branch to facilitate the transfer of state-of-the-art protocols
and guidelines for the treatment of alcohol and other drug (AOD) abuse from
acknowledged clinical, research, and administrative experts to the Nation's AOD abuse
treatment resources.
The dissemination of a TIP is the last step in a process that begins with the
recommendation of an AOD abuse problem area for consideration by a panel of experts.
These include clinicians, researchers, and program managers, as well as professionals
in such related fields as social services or criminal justice.
Once a topic is selected, CSAT creates a Federal resource panel, with members
from pertinent Federal agencies and national organizations, to review the state
of the art in treatment and program management in the area selected. Recommendations
from this Federal panel are then communicated to the members of a second group,
which consists of non-Federal experts who are intimately familiar with the topic.
This group, known as a non-Federal consensus panel, meets in Washington
for 5 days, makes recommendations, defines protocols, and arrives at agreement
on protocols. Its members represent AOD abuse treatment programs, hospitals,
community health centers, counseling programs, criminal justice and child welfare
agencies, and private practitioners. A Chair (or co-Chairs) for the panel is charged
with the responsibility for ensuring that the resulting protocol reflects true
group consensus.
The next step is a review of the proposed guidelines and protocol by a third
group whose members serve as expert field reviewers. Once their recommendations
and responses have been reviewed, the Chair approves the document for publication.
The result is a TIP reflecting the actual state of the art of AOD abuse
treatment in public and private programs recognized for their provision of high quality
and innovative treatment.
This TIP, Matching Treatment to Patient Needs in Opioid Substitution Therapy, offers guidelines to providers who are working to deliver the best treatment
possible to opiate-addicted persons. Patients in this population often need a broad
range of services in addition to opioid substitution therapy, and research has
shown that providing these services as part of the therapy program greatly increases
retention in treatment and improves outcomes. The TIP provides a model for matching
patients to services that takes into account the changing needs of patients at different
phases of treatment. The TIP outlines a comprehensive assessment process for
identifying patient needs and describes core treatment elements for addressing those
needs. Because evaluation and self-monitoring are important ways to ensure that
programs stay responsive to patient needs, the TIP presents step-by-step guidelines
to assist programs in designing and implementing evaluation studies.
The TIP includes a chapter on costs of opioid substitution therapy that reviews
several approaches to determining the costs and benefits of matching patients to
needed services.
This TIP represents another step by CSAT toward its goal of bringing national
leadership to bear in the effort to improve AOD abuse treatment.
Other TIPs may be ordered by contacting the National Clearinghouse for Alcohol
and Drug Information (NCADI), (800) 729-6686 or (301) 468-2600; TDD (for hearing
impaired), (800) 487-4889.
The Treatment Improvement Protocol (TIP) series fulfills CSAT's mission to
improve alcohol and other drug (AOD) abuse and dependency treatment by providing
best practices guidance to clinicians, program administrators, and payers.
This guidance, in the form of a protocol, results from a careful consideration
of all relevant clinical and health services research findings, demonstration
experience, and implementation requirements. A panel of non-Federal clinical researchers,
clinicians, program administrators, and patient advocates employs a consensus process
to produce the product. This panel's work is reviewed and critiqued by field
reviewers as it evolves.
The talent, dedication, and hard work that TIPs panelists and reviewers bring
to this highly participatory process have bridged the gap between the promise
of research and the needs of practicing clinicians and administrators. We
are grateful to all who have joined with us to contribute to advance our substance
abuse treatment field.
Nelba Chavez, Ph.D.
Administrator
Substance Abuse and Mental Health Services Administration
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