Quick Answer: Collaborative Care for Opioid Use Disorder leverages a holistic approach to treating opioid use disorder by integrating medical, behavioral health, care coordination, and support services. This integration of healthcare providers can help increase access to and utilization of evidence-based treatment, engagement in treatment, and recovery outcomes.
Key Takeaways
- When medical and behavioral health professionals collaborate, they work on a shared treatment plan.
- Medications for opioid use disorder, counseling, care planning, and addiction support can be used during treatment.
- Opioid use disorder can be treated with medications, including buprenorphine, methadone, and naltrexone, which were approved by the FDA to treat this disorder.
- Collaborative care has been shown to boost access to empirical evidence-based OUD treatment.
- Each person’s treatment plan needs to be unique to their recovery and medical and behavioral needs.
- Collaborative care can be particularly helpful when combined with other conditions such as depression, anxiety, trauma, or other health issues, along with opioid use disorder.
What is Collaborative Care for Opioid Use?
Collaborative Care for Opioid Use (CCOU) is an integrated approach where various healthcare providers collaborate to provide care for opioid use disorder (OUD). Rather than relying on a single provider to provide all of the supports needed for recovery, medical, behavioral health, and care-management providers are called upon to provide coordinated assistance to the person.
The simple answer is to increase the accessibility and connectedness of treatment.
Someone might get medication for OUD from the provider as well as food, cooking, and handling the cravings, stress, trauma, or relationship issues with a therapist. Then a care coordinator can work to help the person get linked to other services and follow up.
This places the understanding that opioid dependence impacts a person’s life in many ways. Gender, age, physical and mental health, relationships, housing and employment status, and recovery supports can all impact treatment.
There is research to support this integrated model. Unlike usual primary care, the percentage of adults in collaborative care who received effective treatment was significantly higher in SUMMIT. At six months, 39% of people in the collaborative-care group received treatment compared with 16.8% in usual care.
How Does Collaborative Care Work?
With collaborative care for opioid use, multiple professionals are likely in communication about the person and their treatment and progress.
People who work on the treatment team may include:
- Physician, psychiatrist, nurse practitioner, or any other medical professional.
- A professional from a behavioral health treatment center or therapist
- One nurse or in-home care manager
- A case manager
- Peer recovery specialist
- Healthcare/community providers as appropriate
The team is not a set of standalone services; they collaborate towards set practice treatment goals.
For example, a health professional might assess the need to use medication. A therapist can assist the patient in finding greater strategies to cope with stress and triggers. A care manager can make follow-ups between visits and work on issues that could prevent care.
The same team can consist of different people. Collaborative care is not “one program.” A method of arranging treatments so that important parts of care “work together.”
What Treatments May Include?
Evidence-based treatment that includes medication is critical to opioid use disorder.
Buprenorphine, methadone, and naltrexone are the FDA-approved medicines that are most often used for OUD. These medications act differently and are chosen based on a person’s medical condition, treatment objectives, and clinical experience/expertise.
Buprenorphine
Buprenorphine will decrease opioid withdrawal symptoms and cravings for opioids. Can be administered in a variety of forms and could enable an addict to be treated outside of a traditional OTP setting.
Methadone
Methadone is a well-known treatment for opioid use disorder (OUD). It can help ease the symptoms of withdrawal and decrease cravings and is given through certified opioid treatment programs in the U.S.
Naltrexone
Naltrexone is an opioid blocker that can block out the effects of opioids and help prevent them from taking effect. It needs to be started after a proper opioid-free time period, or else patients can have quite severe withdrawal symptoms if it is started early.
Medicines can be used in conjunction with counseling and behavioral treatments. SAMHSA states that this blend is a “whole person” approach to an alcohol and drug use disorders treatment plan.
Why is Collaborative Care Important for Opioid Use Disorder?
OUD is usually not in isolation.
A person experiencing opioid use disorder can be depressed, anxious, suffer from post-traumatic stress, have chronic pain, have trouble sleeping, financial stress or trouble in relationships. Without taking these elements into account, opioid treatment may lack necessary care components.
Collaborative care develops a dynamic system of meeting these concerns together.
It can also be a way to mitigate a challenge known as “the journey alone,” a lack of someone to go through the health-care system with you. Coordinated care can be accomplished by members of the care team communicating rather than repeating the same scenario to various providers.
This practice is supported by the evidence from the SUMMIT study. The collaborative care group exhibited higher levels of treatment initiation and engagement as well as higher abstinence rates from opioids and alcohol at six months compared to usual care.
This is not to say that collaborative care is a sure road to recovery. Addiction treatment is definitely personalized, and results are varied. But some hurdles to treatment can be taken down with coordinated access to evidence-based treatment.
What are the Three Main Elements of Collaborative Care?
Although the models vary, there are, in general, three key components of collaborative care:
A care team
Several people working on the treatment instead of individually.
A care manager
A key individual facilitates services, provides feedback with the patient, monitors progress and works out limitations.
Clinical consultation
Progress is reviewed with qualified medical and/or behavioral health practitioners to make adjustments to treatment as necessary.
All these aspects provide a better-organized method to treatment.
Collaborative Care and Mental Health Recovery
One of the components of opioid recovery is frequently mental health treatment.
Opioids can be used to deal with emotional pain, trauma, anxiety, and depression, as well as excessive stress. This is not to suggest that everyone who develops OUD will have some form of mental health problem, but when it comes to OUD, it is certainly not rare for an issue to arise and, when relevant, checking up on it is prudent.
By working together, behavioral health treatment is integrated into the recovery plan.
Therapy can assist the person to:
- Identify high-risk situations for at least using opioids
- Learn ways to cope that are better for health
- Banish thoughts of negativity
- Improve emotional regulation
- Strengthen relationships
- Manage stress
- Build relapse-prevention strategies
- Address trauma (as clinically appropriate)
This is not meant to take the place of the medication treatment in cases where the medication is needed. Instead, therapy and medical care can go together.
What is the Treatment for Opioid Use Disorder?
There is no one single treatment that is best for everyone. However, OUD medication is a main evidence-based treatment, and buprenorphine, methadone, and naltrexone have been approved as treatments by the Food and Drug Administration (FDA).
The CDC says the level of evidence for these drugs for successful recovery is considerable, and treatment should be tailored to each person. Medication should also be available for OUD without psychosocial treatment; failure to offer counseling should not hinder access to medication.
That is, it’s not about choosing medications or therapy just because one sounds better. The right plan could be medical services, medication, counseling, recovery support, and/or a combination of services.
When Should Someone Consider Collaborative Care?
For people whose opioid use is impacting their health, relationships, work, finances, or day-to-day living, collaborative care may be appropriate.
May be especially helpful if someone
- Continually experiences failing to cease opioid use
- Feels compelled to use or experiences cravings or withdrawal symptoms
- Has resumed opioid use
- Deals with an additional mental health issue
- Needs medication treatment and behavioral support
- Has trouble with interaction and coordination of various health care services
- Will not stop asking for support after it is done.
A professional evaluation can be used to decide on a level of care.
What Does Collaborative Care Look Like in Practice?
So think of somebody who’s in treatment for opioid use disorder and is suffering with anxiety.
Issues of anxiety and coping can be addressed by a behavioral health professional, with medical treatment for OUD coordinated by the same and other team members. A care manager can ensure that the person doesn’t fall behind on contact with appointments and seek to understand what challenges are in the way of ongoing care.
Get Support for Opioid Use Disorder in Orlando
When you look for opioid addiction treatment, you haven’t failed. It implies that you’re treating a serious issue seriously.
Orlando Treatment Solutions offers supportive treatment options for people who are suffering from substance use and related mental health issues. When your life begins to be dominated by opioid use, first identifying the problem is the first step towards a safer, more stable future.
To learn more about your treatment options and to take your first step towards recovery, call Orlando Treatment Solutions today.
Take the Next Step Toward Recovery
Treatment exists for opioid use disorder, and treatment doesn’t have to be done alone. Combining collaborative care with opioid use disorder treatment can integrate medical treatment, therapy, care coordination, and recovery support all in one coordinated care plan.
For anyone or a loved one who is having difficulties with opioid use disorder, you can start with Orlando Treatment Solutions to discuss how there are options available other than turning a blind eye! Call the team today for more information on options for support and to take a step in recovery.
Frequently Asked Questions
What is an example of collaborative care?
An example is a person receiving buprenorphine treatment from a medical provider while working with a therapist and care manager. The professionals communicate about treatment progress, barriers, symptoms, and support needs instead of working independently.
What are the three elements of the collaborative care model?
The three commonly recognized functions are a multidisciplinary care team, a care manager who coordinates treatment and follow-up, and regular clinical consultation. Together, these elements help organize treatment and support timely adjustments based on patient progress.
What is the gold standard treatment for opioid use disorder?
Evidence-based treatment for opioid use disorder commonly includes FDA-approved medications such as buprenorphine, methadone, or naltrexone. Counseling and behavioral support may also be included according to individual needs. Treatment should be determined with a qualified healthcare professional.
What is the collaborative approach in mental health recovery?
A collaborative approach involves mental health professionals, medical providers, care managers, and the patient working together toward shared goals. It may combine medication management, therapy, monitoring, education, and practical support based on the person’s individual needs.
What is the meaning of collaborative care?
Collaborative care means coordinating healthcare services so multiple professionals work together around one person’s treatment goals. Instead of receiving disconnected services, the patient receives an organized plan that addresses medical, behavioral, and practical recovery needs.
What is most commonly associated with the collaborative care model?
Collaborative care is commonly associated with coordinated treatment, care management, measurement or monitoring of progress, and clinical consultation. In behavioral health, it is often used to connect primary care with mental health and substance use treatment.
What is another word for collaborative care?
There is no single perfect synonym for collaborative care. Depending on the setting, related terms include integrated care, coordinated care, team-based care, or integrated behavioral healthcare. These terms generally describe healthcare professionals working together around shared patient needs.
What is the role of the nurse in collaborative care?
A nurse may monitor symptoms, provide education, coordinate appointments, support medication adherence, communicate with other providers, identify changes in health, and help patients navigate treatment. The specific responsibilities depend on the care setting and the nurse’s professional role.
What are three types of collaboration?
Three common forms of healthcare collaboration are multidisciplinary, interdisciplinary, and transdisciplinary collaboration. They differ in how professionals share responsibilities and integrate their expertise. All three aim to improve communication, coordination, and patient-centered care.
Disclaimer
This article is provided for general educational and informational purposes only. It is not medical advice, diagnosis, or a substitute for evaluation and treatment from a qualified healthcare professional. Medication decisions for opioid use disorder should be made with an appropriately licensed medical provider. If you believe someone is experiencing an opioid overdose or another medical emergency, seek emergency medical assistance immediately.
References
- Watkins KE, Ober AJ, Lamp K, et al. Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care: The SUMMIT Randomized Clinical Trial. JAMA Internal Medicine. 2017. PubMed: Collaborative Care for Opioid and Alcohol Use Disorders
- SAMHSA: Treatment Options for Substance Use Disorder
- SAMHSA: Medications for Opioid Use Disorder, TIP 63
- CDC: Treatment of Opioid Use Disorder
- CDC: Opioid Use Disorder Treatment Guidance
