Table 3.

Strategies and sample resources to enhance delivery of medication for opioid use disorder (MOUD) maintenance treatment.

Strategies	Sample Resources
	a) Expand MOUD Treatment Availability (Capacity building; required)
Adding/expanding MOUD treatment in primary care, other general medical and behavioral/mental health settings (Brooklyn and Sigmon, 2017; Heinzerling et al., 2016; National Academies of Sciences Engineering and Medicine et al., 2019; Townley and Dorr, 2017) and in specialty addiction/ substance use disorder treatment settings and recovery programs (Clark et al., 2010; SAMHSA-HRSA Center for Integrated Health Solutions, 2014)	•Providers Clinical Support System SUD 101 Curriculum (Providers Clinical Support System, 2019b) •National Academy for Science, Engineering and Medicine: Medication for Opioid Use Disorder Saves Lives (National Academies of Sciences Engineering and Medicine et al., 2019) •Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder (Wakeman et al., 2020) •Clinical Guidelines for Use of Depot Buprenorphine in the Treatment of Opioid Dependence (New South Wales Ministry of Health, 2019) •Providers Clinical Support System Primer on Antagonist-Based Treatment of Opioid Use Disorder in the Office Setting (Providers Clinical Support System, 2017b) •SAMHSA: Clinical use of extended-release injectable naltrexone in the treatment of Opioid Use Disorder: A Brief Guide (Substance Abuse and Mental Health Services Administration, 2015a) •American Academy of Addiction Psychiatry, State Targeted Response Technical Assistance Consortium Opioid Response Network (American Academy of Addiction Psychiatry and State Targeted Response Technical Assistance Consortium, 2018) •Project ECHO (Boston Medical Center, 2019b; Northeast Ohio Medical University, 2019; Project ECHO Cincinnati, 2019; University of New Mexico, 2019) •SAMHSA Buprenorphine Practitioner Locator (Substance Abuse and Mental Health Services Administration, 2020b) •American Society of Addiction Medicine: Live & Online CME Trainings (American Society of Addiction Medicine, 2019a) • Harvard Medical School free, accredited online courses in Opioid Use Disorder Education o Understanding Addiction (Harvard Medical School CME Online, 2017c) o Identification, Counseling, and Treatment of OUD (Harvard Medical School CME Online, 2017b) o Collaborative Care Approaches for the Management of OUD (Harvard Medical School CME Online, 2017a) •MOUD Implementation Checklist (SAMHSA-HRSA Center for Integrated Health Solutions, 2020) •Expanding the Use of Medications to Treat Individuals with Substance Use Disorders (SAMHSA-HRSA Center for Integrated Health Solutions, 2014) •Procedures for Medication-Assisted Treatment of Alcohol or Opioid Dependence in Primary Care (Heinzerling et al., 2016) •Getting Started with MOUD with Lessons from Advancing Recovery (Clark et al., 2010) •SAMHSA TIP 63: Medications for OUD (Substance Abuse and Mental Health Services Administration, 2020d) •SAMHSA MAT Guide for Pregnant Women with OUD (Substance Abuse and Mental Health Services Administration, 2018a) •SAMHSA TIP 42: Substance Abuse Treatment for Persons with Co-Occurring Disorders (Substance Abuse and Mental Health Services Administration, 2020f) •American Psychological Association: The Opioid Guide (American Psychological Association Cross-Divisional Taskforce on Clinical Responses to the Opioid Crisis, 2019) •Integrating Buprenorphine Treatment for OUD in Primary Care (Cunningham and Lum, 2017) •Medication-assisted treatment models of care for opioid use disorder in primary care settings (Chou et al., 2016b) •Boston Medical Center Office Based Addiction Treatment TTA and Addiction CHAT Live (Boston Medical Center, 2019a) •SAMHSA Apply for a Practitioner Waiver (Substance Abuse and Mental Health Services Administration, 2020a) •American Academy of Addiction Psychiatry 8 h and 24 h Waiver Training (American Academy of Addiction Psychiatry, 2019) •American Society of Addiction Medicine Waiver Qualifying Training (American Society of Addiction Medicine, 2019c) •Providers Clinical Support System Overview of Medication Assisted Treatment (Providers Clinical Support System, 2020b) •Provider Clinical Support System Mentoring Program (Providers Clinical Support System, 2020c) •Boston Medical Center Office Based Addiction Treatment Clinical Tools and Forms (Boston Medical Center, 2019d) •California Bridge (California Department of Health Care Services, 2018) and Project “Support for Hospital Opioid Use Treatment” (Project SHOUT and California Health Care Foundation, 2018) •Buprenorphine Home Induction smart phone application(Amston Studio LLC, 2019) •National Institute on Drug Abuse Home Induction guide (National Institute on Drug Abuse, 2019) •Boston Medical Center Addiction Chat Live (Boston Medical Center, 2018) •Continuum of Care ECHO: Inpatient treatment programs and Methadone providers (Boston Medical Center, 2019b) •Boston Medical Center Office Based Addiction Treatment Clinical Guidelines (Boston Medical Center, 2019c) •American College of Emergency Physicians Addressing the Opioid Stigma in the Emergency Department (American College of Emergency Physicians, 2020b) •Initiating Buprenorphine treatment in detoxification settings (Stein et al., 2020) •Association between mortality rates and medication and residential treatment (Walley et al., 2020) •Institute for Health and Recovery Maternal Opioid Use During Pregnancy Toolkit (Institute for Health and Recovery Massachusetts Perinatal Quality Collaborative, 2018) •Adolescent Substance Use and Addiction Program – Primary Care (Levy et al., 2018) •Integrating BUP treatment in HIV primary care settings (Target HIV, 2019) •Case Western Intensive Course Series continuing medical education on controlled substance prescribing and buprenorphine (Case Western University School of Medicine, 2019)S tate-Specific Resources oKentucky •Find Help Now Kentucky (Locate Addiction Specialty Clinics) (Find Help Now KY, 2020) oMassachusetts •Help Online (Locate Addiction Specialty Clinics) (The Massachusetts Substance Use Helpline, 2019) •Journey Recovery Project Pregnancy and Parenting (Journey Recovery Project, 2019) •Massachusetts Health Hospitals Association Guideline Treating Opioid Use Disorder in the Emergency Department (Massachusetts Health Hospital Association, 2019) •Protecting others and protecting treatment (Massachusetts Department of Public Health, 2016)
Adding/expanding MOUD treatment in Criminal Justice settings (e.g., pre-trial, jail, prison, probation, parole) (Binswanger, 2019; Green et al., 2018; Marsden et al., 2017; Moore et al., 2019; Rich et al., 2015)	•National Commission on Correctional Healthcare Jail-Based Medication-Assisted Treatment: Promising Practices, Guidelines, and Resources for The Field (National Commission on Correctional Healthcare, 2018) •SAMHSA: Use of Medication Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings (Substance Abuse and Mental Health Services Administration, 2019e) •SAMHSA. Medication Assisted Treatment in the Criminal Justice System: Brief Guidance to the States. 2019 (Substance Abuse and Mental Health Services Administration, 2019b) •California Health Care Foundation Medication-Assisted Treatment in County Criminal Justice Settings Project (California Health Care Foundation, 2018) •American Society of Addiction Medicine Treatment in Correctional Settings Toolkit (American Society of Addiction Medicine, 2019b) •Principles of Drug Abuse Treatment for Criminal Justice Populations-A Research-Based Guide (National Institute on Drug Abuse, 2014a) •Protocol for Consent to Treatment with Medications for Opioid Use Disorder in Correctional Facilities (Massachusetts Bureau of Substance Addiction Services, 2019)
Expanding access to MOUD treatment through telemedicine, interim buprenorphine or methadone, or medication units	•Medication units: electronic-Code of Federal Regulations - 8.11 (Office of the Federal Register and Government Publishing Office, 2019b; Substance Abuse and Mental Health Services Administration, 2015b) •Interim methadone: electronic-Code of Federal Regulations – 8.11 (Newman, 2014; Office of the Federal Register and Government Publishing Office, 2019a; Schwartz et al., 2006) •Interim buprenorphine (Office of the Federal Register and Government Publishing Office, 2019b; Sigmon et al., 2016) •Low Barrier Tele-Buprenorphine (Harris et al., 2020) •MOUD Bridge Programs (Snow et al., 2019) •San Francisco Street Medicine Team (Carter et al., 2019) •Telemedicine&Prescribing Buprenorphine for the Treatment of Opioid Use Disorder (U.S. Department of Health and Human Services, 2018) •Project “Support for Hospital Opioid Use Treatment” Webinar on Telemedicine and MOUD Treatment (Project SHOUT and California Health Care Foundation, 2018)
	b) Interventions to Link to MOUD (required)
Linkage Programs (all relevant settings)	Within (or initiated within) Service Settings •Massachusetts Post-Overdose Public Health – Public Safety Partnerships (Formica et al., 2018) •SAMHSA “Now What? The Role of Prevention Following a Nonfatal Opioid Overdose” (SAMHSA Center for the Application of Prevention Technologies, 2018) •Police Assisted and Addiction Recovery Initiative (Schiff et al., 2017 •Community Reinforcement and Family Training (Center for Motivation and Change, 2014) •The 20 min Guide (Center for Motivation and Change, 2017) •The Foundation for Opioid Response Efforts (Foundation for Opioid Response Efforts, 2018) Within Outreach/Field Settings •Colerain (Cincinnati) Quick Response Teams (Merrick et al., 2016) •Safety and Health Integration in the Enforcement of Laws on Drugs (Arredondo et al., 2019) •Harmonizing Disease Prevention and Police Practice model (Silverman et al., 2012) •Bureau of Justice Assistance Law Enforcement Naloxone Toolkit (Bureau of Justice Assistance National Training and Technical Assistance Center, 2018) •Post opioid overdose outreach by public health and public safety agencies: Exploration of emerging programs in Massachusetts (Formica et al., 2018) •Plymouth County Outreach (Plymouth County District Attorney’s Office, 2019) •Massachusetts Access to Recovery (Massachusetts Access to Recovery, 2020) Peer Navigation •Ohio Mental Health & Addiction Services: Peer Recovery Support 101 (Ohio Department of Mental Health and Addiction Services, 2020) •Recovery Coach Academy (Friends of Recovery, 2020) •Providers Clinical Support System (Providers Clinical Support System, 2016a) and Addiction Technology Transfer Center Motivational Interviewing Training (Addiction Technology Transfer Center Network, 2019) •AnchorED (peer support in EDs following overdose) (The Providence Center, 2019) •Voices of Hope (Voices of Hope, 2019) •Boston Medical Center Recovery Coach Live (Boston Medical Center, 2019a) Referral Only •SAMHSA/HRSA Three Strategies for Effective Referrals to Specialty Mental Health and Addiction Services (SAMHSA-HRSA Center for Integrated Health Solutions, 2015) •New York Office of Addiction Services and Supports Guidance on Referral to a Pain or Addiction Specialist (New York Office of Addiction Services and Supports, 2012) •A Scoping Review of Post Opioid Overdose Interventions in Preventative Medicine (Bagley et al., 2019)
Starting individuals on MOUD as an adjunct to linkage programs (all relevant settings) (Busch et al., 2017; Cushman et al., 2016; D’Onofrio et al., 2015; Gordon et al., 2017; Weinstein et al., 2018; Zaller et al., 2013)	Within (or initiated within) Service Settings •SAMHSA TIP 63: Medications for OUD (Substance Abuse and Mental Health Services Administration, 2020d) •California Bridge (California Department of Health Care Services, 2018) and Project “Support for Hospital Opioid Use Treatment” (Project SHOUT and California Health Care Foundation, 2018) •National Commission on Correctional Healthcare Jail-based Medication Assisted Treatment (National Commission on Correctional Healthcare, 2018) •SAMHSA: Use of Medication Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings (Substance Abuse and Mental Health Services Administration, 2019e) •“Principles of Drug Abuse Treatment of Criminal Justice Populations: A Research-Based Guide”(National Institute on Drug Abuse, 2014a) •SAMHSA: Clinical use of extended-release injectable naltrexone in the treatment of Opioid Use Disorder: A Brief Guide (Substance Abuse and Mental Health Services Administration, 2015a) •Opioid Response Network (American Academy of Addiction Psychiatry and State Targeted Response Technical Assistance Consortium, 2018) •Yale School of Emergency Medicine: Emergency Department-Initiated Buprenorphine (Yale School of Medicine, 2019) •American College of Emergency Physicians Emergency Quality Network Opioid Toolkit (American College of Emergency Physicians, 2020a) •SAMHSA National Helpline (Substance Abuse and Mental Health Services Administration, 2020e) •Harm Reduction agencies as potential site for buprenorphine treatment (Fox et al., 2015) •Addiction consultation services – Linking Hospitalized patients to outpatient addiction treatment (Trowbridge et al., 2017) •A Transitional Opioid program to Engage Hospitalized Drug Users (Shanahan et al., 2010) •MOUD Bridge Programs (Snow et al., 2019) •San Francisco Street Medicine Team (Carter et al., 2019)
	c) MOUD Treatment Engagement and Retention (required)
Enhancement of clinical delivery approaches that support engagement and retention (Plater-Zyberk et al., 2012; Substance Abuse and Mental Health Services Administration, 2020)	•A Systematic Review: Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction (Providers Clinical Support System, 2016b) •Developing a Behavioral Treatment Protocol in Conjunction with Medication Assisted Treatment (Revised) (Providers Clinical Support System, 2018a) •Contingency Management (Carroll and Weiss, 2017) with Community Reinforcement Approach; Promoting Awareness of Motivational Incentives (Center for the Application of Substance Abuse Technologies, 2019) •Addiction Technology Transfer Center Network Motivational Interviewing Training (Addiction Technology Transfer Center Network, 2019) •Boston Medical Center Recovery Coach Live (Boston Medical Center, 2019a)
Use of virtual retention approaches (e.g., mobile, web, digital therapeutics) (Pear Therapeutics, 2020; Substance Abuse and Mental Health Services Administration, date unknown)	•reSET® Prescription Digital Therapeutic Software (Pear Therapeutics, 2020) •Computer-Based Training for Cognitive Behavioral Therapy (Carroll, 2008; Carroll et al., 2014; Shi et al., 2019) •Connections smartphone app (CHESS Health, 2020) •Center for Technology and Behavioral Health: Program Reviews (Center for Technology and Behavioral Health, 2020)
Utilize retention care coordinators	•SAMHSA: Wraparound Implementation and Practice Quality Standards (Substance Abuse and Mental Health Services Administration and Wraparound Evaluation and Research Team, 2016) •Centers for Disease Control: HIV Care Coordination Program (Centers for Disease Control and Prevention, 2018b) •Patient-centered Primary Institute Care Coordination Tip Sheet (Patient-Centered Primary Care Institute, 2016) •Patient-centered Primary Institute Referral and Care Coordination (Patient-Centered Primary Care Institute, 2015) •Boston Medical Center Office Based Addiction Treatment Continuum of Care ECHO (Boston Medical Center, 2019b) •Boston Medical Center Nurse Care Manager Office Based Addiction Treatment (Boston Medical Center, 2019a)
Mental health and polysubstance use treatment integrated into MOUD care (Krawczyk et al., 2017; Sullivan et al., 2010)	•Preventing Addiction Related Suicide (Voss et al., 2013) •SAMHSA: General Principles for the Use of Pharmacological Agents To Treat Individuals With Co-Occurring Mental and Substance Use Disorders (Substance Abuse and Mental Health Services Administration, 2012a) •SAMHSA: TIP 42: Substance Abuse Treatment for Persons With Co-Occurring Disorders (Substance Abuse and Mental Health Services Administration, 2020f) •SAMHSA: Pharmacologic Guidelines for Treating Individuals with Post-Traumatic Stress Disorder and Co-Occurring Opioid Use Disorders (Substance Abuse and Mental Health Services Administration, 2012b) •American Psychiatric Association Learning Center: Treating Co-Occurring Depression and Opioid Use Disorder: A Case Discussion (American Psycihatric Association, 2015) •Integrated Group Therapy bipolar and substance use disorders (Weiss and Connery, 2011) •Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (Barlow et al., 2018) •Contingency Management (Carroll and Weiss, 2017) combined with Community Reinforcement Approach; Promoting Awareness of Motivational Incentives (Center for the Application of Substance Abuse Technologies, 2019) •Addiction Technology Transfer Center Network Motivational Interviewing Training (Addiction Technology Transfer Center Network, 2019) •Providers Clinical Support System Webinars (Providers Clinical Support System, 2019a) •National Institute on Drug Abuse Health Principles of Drug Addiction Treatment: A Research-Based Guide (National Institute on Drug Abuse, 2018) •SAMHSA In Brief: Substance Use and Suicide: A Nexus Requiring A Public Health Approach (Substance Abuse and Mental Health Services Administration, 2015c) •SAMHSA: TIP 50: Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment (Substance Abuse and Mental Health Services Administration and Center for Substance Abuse Treatment, 2009) •National Institute of Mental Health Suicide Prevention Website (National Institute of Mental Health, 2019) •Suicide Prevention Resource Center (Suicide Prevention Resource Center, 2019)
Reducing barriers to housing, transportation, childcare and accessing other community benefits for people with opioid use disorder	•SAMHSA Homelessness Programs and Resources (Substance Abuse and Mental Health Services Administration, 2019d) •Ryan White HIV/AIDS Medical Case Management (Lopez et al., 2018) •Massachusetts Access to Recovery (Massachusetts Access to Recovery, 2020; The Massachusetts Substance Use Helpline, 2019) •Ohio recovery housing (Ohio Recovery Housing, 2019) •Kentucky: Voices of Hope (Voices of Hope, 2019) •Kentucky: Chrysalis House (residential SUD treatment and supportive housing) (Chrysalis House Inc., 2019) •Kentucky: Acquired Immunodeficiency Syndrome Volunteers KY (supportive housing, recovery support services) (AVOL KY Inc., 2019)

Footnotes. MOUD = Medication for opioid use disorder; SAMHSA = Substance Abuse and Mental Health Services Administration; ECHO = Extension for community healthcare outcomes; HRSA = The Health Resources and Services Administration.