ScalaNW Clinical Guidance Materials

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Please complete the survey below to help determine the most useful clinical guidance materials to develop for ScalaNW.org, which supports the care of patients with substance use disorders in acute care settings.

Background

ScalaNW is a program of the Washington State Healthcare Authority that supports the care of patients with substance use disorders in acute care settings (i.e., hospitals and emergency departments). Clinical guidance is developed by clinical partners at the University of Wasington's Addictions, Drug, and Alcohol Institute and the statewide, multidisciplinary contributers the convene for this work. The clinical guidance is published on ScalaNW.org and available to the public. Hospitals enrolled in the ScalaNW program receive technical assistance for implementating Medication for Opioid Use Disorder (MOUD) programs in hospitals or emergency deparments and access to 24/7 follow-up appointment scheduling for ongoing outpatient care. Hospitals participate free of charge and can enroll at ScalaNW.org.

Intent of this survey

This survey asks clinicians in acute care settings what kind of guidance their teams need to provide quality care for patients with substance use disorders. The results will help determine the materials we request from our partners at the Univerity of Washingon's Addictions, Drug, and Alcohol Institute, who convene multidisciplary contributors statewide to develop ScalaNW clinical guidance.

Materials already generated

Many guidance materials have been developed already or are in progress. The following will be live on the site in the coming year, if they are not already. Please take this into consideration when making recommendations for additional guidance. Many of the topics include a prescriber workflow and nursing considerations. Specifc to ED settings unless specified inpatient.

Medications for opioid use disorder (MOUD)
- Shared decision-making guide for initiation of MOUD
- Pre-hospital (Emergency Medical Services in-feild) buprenorphine initiation
- Buprenorphine Initiation (general population)
- Buprenorphine Initiation at home (general population)
- Buprenorphine Initiation at home for adolescents
- Buprenorphine Initiation in pregnancy
- Buprenorphine Initiation at home in pregnancy
- Long acting injectable buprenorphine
- Inpatient buprenorphine initiation (low dose up titration)
- Methadone initiation in the ED (general population)
- Methadone initiation in pregnancy
- Inpatient methadone initiation
Acute care of patients with stimulant use disorder
Medications for alcohol use disorder
Withdrawal managment
- Alcohol withdrawal
- Severe/precipitated opioid withdrawal (general population)
- Severe/precipitated opioid withdrawal in pregnancy
- Adjunct medications for opioid withdrawal (general population, youth, pregnancy, lactation)
Administrative & leadership considerations
- Utilizing peers in acute care settings
- Stigma and culture change
Pain
- Acute pain management
- Buprenorphine in the context of acute pain
- Patient-controlled analgesia
Clinical implications of emerging adulterants in the drug supply

Benzodiazepine withdrawal management

High priority

Medium priority

Low priority

Not useful

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