BMC MAT Quick Start1.4.1

This app offers healthcare providers the latest evidence-based guidance for treating opioid and alcohol use disorders (OUD and AUD) assisting in the initiation of medications such as buprenorphine and naltrexone. This is an essential tool for those starting patients on these medications, providing step-by-step clinical decision trees and valuable resources for managing not only AUD and OUD but acute and chronic pain for patients already on buprenorphine or naltrexone. With interactive tools, treatment protocols, and patient messaging features, this app empowers clinicians to deliver life-saving care while improving while improving treatment outcomes for substance use disorders.

More than 46 million people aged 12 or older (or 16.5% of the US population) met the DSM-5 criteria for having a substance use disorder (SUD) in the past year based on the latest data from the 2021 National Survey on Drug Use and Health (NSDUH). However, only about 6% of people received any treatment for their SUD. Providing addiction treatment, including the use of FDA- approved medications and behavioral health therapies, has been shown to save lives and increase retention in treatment.

The interactive clinical algorithms in this app walk you through each step of the clinical decision- making process to help you care for patients with an OUD or AUD. The clinical algorithms are also available in PDF format for easy viewing along with ability to securely text message patient tools to get started on buprenorphine. Additionally, several other clinical tools and resources related to SUD are included.

BMC MAT QUICK START FEATURES:

CLINICAL ALGORITHMS
* Buprenorphine Initiation Guide: Decision trees for starting patients with an opioid use disorder on buprenorphine who are not currently physically dependent on opioids, opioid-dependent and not yet in withdrawal, and opioid-dependent and in active withdrawal.
* Initiation of Extended-Release Injectable Buprenorphine: Guidance for starting a patient on new weekly and monthly formation formulations of extended-release injectable buprenorphine.
* Naltrexone Initiation for Alcohol Use Disorder: Guidance for starting a patient on naltrexone for the treatment of alcohol use disorder.
* Naltrexone Initiation for Opioid Use Disorder: Guidance for starting a patient on naltrexone for the treatment of opioid use disorder. Includes strategies for managing opioid withdrawal during the required “washout period” prior to starting naltrexone and avoiding precipitated withdrawal.
* Pain Management While on Buprenorphine for Opioid Use Disorder: Guidance for managing acute and chronic pain in patients already on buprenorphine for opioid use disorder.
* Pain Management While on Naltrexone: Guidance for managing acute pain (both anticipated and unanticipated) and chronic pain in patients already on naltrexone for opioid use disorder.
* New! List of medication classes to assist in the management of opioid withdrawal symptoms.

CLINICAL TOOLS
* DSM-5 criteria for diagnosis of an opioid use disorder
* Clinical Opiate Withdrawal Scale (COWS) to measure the severity of opioid withdrawal
* Alcohol Use Disorders Identification Test (AUDIT-C) to identify risky drinking patterns

PATIENT HANDOUTS
* Buprenorphine Initiation Guide: A guide to give to patients who are starting buprenorphine in the home or community setting.

Note: This app is designed exclusively for the use of healthcare providers. This app is not intended for use to diagnose a disease or to cure, mitigate, treat, or prevent any condition or disease. It is the responsibility of the treating clinician to rely on their own experience and knowledge about their specific patient to determine dosages and the best treatment for that
patient.

Version History We've made important updates to enhance your experience! In addition to guidance for buprenorphine initiation, pain management for patients on buprenorphine and naltrexone, updates for initiation of weekly and monthly extended-release injectable buprenorphine have been added. We've also refined the interactive design for a smoother navigation experience. Clinical decision trees have been streamlined to provide clearer, more concise guidance, helping you make informed decisions quickly. 1.4.1 Jan 6 We've made important updates to enhance your experience! In addition to guidance for buprenorphine initiation, pain management for patients on buprenorphine and naltrexone, updates for initiation of weekly and monthly extended-release injectable buprenorphine have been added. We've also refined the interactive design for a smoother navigation experience. Clinical decision trees have been streamlined to provide clearer, more concise guidance, helping you make informed decisions quickly. 1.4 10/11/2025 We've made important updates to enhance your experience! In addition to guidance for buprenorphine initiation, pain management for patients on buprenorphine and naltrexone, updates for initiation of weekly and monthly extended-release injectable buprenorphine have been added. We've also refined the interactive design for a smoother navigation experience. All clinical algorithms have been streamlined to provide clearer, more concise guidance, helping you make informed decisions quickly. Update now to explore these improvements! 1.3 11/14/2024 - Updated information for starting buprenorphine and a list of medication classes to manage opioid withdrawal symptoms
- Updates in the management of pain for patients on naltrexone
- Improved linkage to warmline contact for clinical peer-to-peer support 1.2 02/16/2023 Formerly known as the Office Based Addiction Treatment Program Training and Technical Assistance (OBAT TTA), Boston Medical Center (BMC) Grayken Center for Addiction Training and Technical Assistance (TTA) has rebranded to reflect the expanding training and resources offered to clinical care teams across the country and globally.

Updated information for initiation of buprenorphine and list of medication classes to manage common symptoms of opioid withdrawal.
Updates in the management of pain for patients on naltrexone.
Improved linkage to warmline contact for clinical peer-to-peer support. 1.1 11/11/2022 1.0 03/10/2021