<unk>  Bridge Website: https://www.ovmcbridge.org/
Contact Tomas Fajardo, Substance Use Disorder Counselor, through Consult to Social Work
Contact Viviana Figueroa, Substance Use Disorder Counselor for Opioids, through Consult to Social Work, VOIP x75625
SASH Helpline (Substance Abuse Service Helpline) 1-844-804-7500;   24/7;  Patient will speak to a counselor who will ask questions and help patient obtain services for detox and rehab
http://myladhs.lacounty.gov/ov/Departments/DEM/Documents/Substance%20Abuse%20Service%20Hotline%20(SASH).pdf
http://myladhs.lacounty.gov/ov/Departments/DEM/Documents/Substance%20Abuse%20Service%20Hotline%20(SASH).pdf
Goal is to recognize opioid use disorder and initiate treatment with buprenorphine or methadone while the patient is in the ED or hospitalized.
Consult Social Work for ALL Opioid Use Disorder patients even if they do not want treatment
Consult to Social Work......Substance Abuse.....free text OUD
Ms. Viviana Figueroa is our Substance Use Navigator, Mon-Fri, generally 8am-4pm, VOIP x75625, pager 818-226-4824
Medications for Opioid Use Disorder (MOUD) On-call provider 8am-8pm 7 days per week:  818-313-1451
MOUD provider can help with recognition of OUD, help with buprenorphine or methadone initiation in the ED and MOUD provider will make sure the patient gets follow-up
PLEASE DOUBLE CHECK PATIENT'S CONTACT PHONE NUMBER IN CERNER
California Poison Control 24/7 access to addiction fellow/attending for help with difficult cases: 844-326-2626
UCSF Substance Use Warmline, access to help with difficult cases, Monday-Friday 6am-5pm:  855-300-3595<unk>  Buprenorphine Quick Start:
Consult to Social Work......Substance Abuse.....free text OUD
Ms. Viviana Figueroa is our Substance Use Navigator, Mon-Fri, generally 8am-4pm, VOIP x75625, pager 818-226-4824
MOUD provider can help with recognition of OUD, help with buprenorphine or methadone initiation in the ED and MOUD provider will make sure the patient gets follow-up
PLEASE DOUBLE CHECK PATIENT'S CONTACT PHONE NUMBER IN CERNER
PLEASE DOUBLE CHECK PATIENT'S CONTACT PHONE NUMBER IN CERNER
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dc255df2d46c2731a7b366c/1573017059129/CA+Bridge+-+Protocol+-+Bup+Hospital+Quick+Start+-+NOV+2019.pdf
Patient handout for home start of buprenorphine (MOUD provider may suggest that):  http://myladhs.lacounty.gov/ov/Substance_Use_Disorder_Management/PublishingImages/SitePages/Home/NIH%20Simplified%20Buprenorphine%20Home%20Start.pdf
Link to ED Bridge Website (California program for initiation of buprenorphine in hospitals): https://ed-bridge.org/
Link to Bridge to Treatment Website
https://www.bridgetotreatment.org
For any patient with opioid use disorder, OD, withdrawal or seeking care, please page the Meds for Opioid Use Disorder provider on-call 8am-8pm 7 days per week, 818-313-1451
Call Dr. McCollough if unable to reach MOUD provider OR anytime 8pm-8am. 310-614-5306 WE WANT TO KNOW ABOUT ALL OF THESE PATIENTS!
Please also Consult to Social Work....Substance Use Disorder....OUD in free text
Viviana Figueroa is the Substance Use Navigator for the Bridge OUD program - 747-210-5625, pager 818-226-4824, Mon-Fri 8am-5pm
ED initiation of buprenorphine (Bup) for patients with opiate use disorder has been shown to increase likelihood patients will continue with addiction treatment.  Bup has been shown to decrease mortality.
ED Bridge guidelines encourage a higher loading dose of Bup (up to 32mg) which allows patients time to get into an outside addiction treatment program.
Buprenorphine may be ordered during the ED visit by ED providers without an X-waiver.  ED providers without an X-Waiver have may treat a patient up to 72 hours (3 contiguous days) in order to bridge the patient to outpatient treatment.  This means the patient must return to the ED if symptoms reoccur.   ED providers WITHOUT an X-waiver cannot prescribe.
If patient really wants methadone instead, that also can be started in the ED.  Follow-up will be arranged by our Bridge team as patient must go to a licensed methadone clinic.  PLEASE MAKE SURE WE HAVE A CORRECT PHONE NUMBER
MOUD Providers all have their X-Waiver and can eprescribe buprenorphine to our pharmacy or to an outside pharmacy
Bridge program (Viviana and staff) will ensure patient gets follow-up PLEASE MAKE SURE WE HAVE A CORRECT PHONE NUMBER.<unk>  Substance Use Disorder Education and Management Website http://myladhs.lacounty.gov/ov/Substance_Use_Disorder_Management/SitePages/Home.aspx
ED Bridge Guide https://static1.squarespace.com/static/5adf7f1fa2772cb4f86018b2/t/5aff30cf758d46c1c95b5a40/1526673619420/ED-BRIDGE+BUP+GUIDE+-+MAY+2018+%282%29.pdf
ED Buprenorphine Initiation Algorithm
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dc255df2d46c2731a7b366c/1573017059129/CA+Bridge+-+Protocol+-+Bup+Hospital+Quick+Start+-+NOV+2019.pdf
ED Buprenorphine Initiation for Pregnant Patients Algorithm
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dc24f6e67488341e241a1c4/1573015410380/CA+Bridge+-+Protocol+-+Bup+Quick+Start+in+Pregnancy+-+NOV+2019.pdf
ED Buprenorphine Initiation after Overdose
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dc31217b305036def2229e9/1573065241235/CA+Bridge+-+Protocol+-+Bup+After+Overdose+-+NOV+2019.pdf
Buprenorphine and Acute Pain in the ED
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dce41a3b351797406dacc19/1573798309226/CA+Bridge+-+Protocol+-+Acute+Pain+and+Bup+-+ED+and+Critical+Care+-+NOV+2019.pdf
Buprenorphine and Acute Pain on the Med/Surg Unit
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dce418a59f2dd43d758b7c6/1573798284017/CA+Bridge+-+Protocol+-+Acute+Pain+and+Bup+-+Med-Surg+-+NOV+2019.pdf
Methadone Quick Start
https://static1.squarespace.com/static/5c412ab755b02cec3b4ed998/t/5dc2561cd90490301babf7f5/1573017118257/CA+Bridge+-+Protocol+-+Methadone+Hospital+Quick+Start+-+NOV+2019.pdf
Home Start of Buprenorphine Instructions http://myladhs.lacounty.gov/ov/Substance_Use_Disorder_Management/PublishingImages/SitePages/Home/NIH%20Simplified%20Buprenorphine%20Home%20Start.pdf
CA Bridge website https://www.bridgetotreatment.org/
Need help?
California Poison Control 24/7 access to addiction fellow/attending for help with difficult cases: 844-326-2626
UCSF Substance Use Warmline, access to help with difficult cases, Monday-Friday 6am-5pm:  855-300-3595
ED Bridge Office Hours https://ed-bridge.org/office-hours
ED Bridge Office Hours https://ed-bridge.org/office-hours
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