A Joint Effort by the California Institute for Behavioral Health Solutions and Advocates for Human Potential, Inc. and funded by the California Department of Health Care Services Community Services Division
Overview
The following is a collection of protocols, toolkits, tools, and guidance materials supporting federal, state, and community-based agencies’ efforts to implement best practices leading to systems change, improved outcomes, enhanced access, and improved delivery of prevention, treatment, and recovery services to California’s youth with, or at risk of, opioid or stimulant use disorders and their families. This list is updated with additional and new resources on a regular basis.
The ASAM National Practice Guideline – Special Populations: Adolescents (Chapter 10) – This resource is to support states in their ongoing efforts to introduce SUD service coverage and delivery system reforms by providing information about the preventive, treatment, and recovery services and the levels of care comprising the continuum of SUD care. It also provides an overview of nationally developed guidelines for SUD treatment criteria, including provider and service standards for each level of care. In addition, it provides useful tools and examples of state-based initiatives that can assist states in their efforts to ensure that care is delivered consistent with industry standard SUD treatment guidelines and that Medicaid beneficiaries receive the most appropriate services given their treatment and recovery needs. Published by: American Society of Addiction Medicine (ASAM), June 2015
Evidence-Based Strategies for Prevention Opioid Overdose: What’s Working in the United States – This document was designed to assist community leaders, local and regional organizers, non-profit groups, law enforcement, public health, and members of the public in understanding and navigating effective strategies to prevent opioid overdose in their communities. Published by: Centers for Disease Control and Prevention (CDC), 2018
Screening and Assessing Adolescents for Substance Use Disorders TIP Series 31 – This manual provides guidelines in screening and assessing teens for substance use conditions. It covers confidentiality laws and screening and assessment in juvenile justice settings. The manual also includes screening and assessment tools. Published by: SAMHSA Center for Substance Abuse Treatment (CSAT), 1998 (first published)
Protocols – Substance Use Disorders – Youth Specific
Substance Abuse Treatment (Adolescent) – Substance Abuse Treatment (adolescent) is defined by the CEBC as the treatment of adolescents (ages 12-17) with active substance use issues, including alcohol, marijuana, and/or other drugs. The CEBC has evaluated only replicable programs that do not use medication as a component of treatment and focused on treatment programs, as opposed to programs designed to prevent the onset of substance use. Treatment can occur in a variety of settings, including outpatient, day treatment, residential, or inpatient, and may involve detoxification, counseling, education, relapse prevention training, life skills training, and self-help groups. Although many of these treatment programs may also be used in adults, the CEBC review and rating examines the research base for these treatments in adolescents only. & Published by: The California Evidence-Based Clearing House for Child Welfare, 2019
Youth Services Policy Manual – The purpose of the Youth Services Policy Manual (YSPM) is to provide instruction for the delivery of SUD services for adolescents in California funded by federal and state funds. The YSPM sets the minimum standards for delivery of services along with considerations for services across the Continuum of Care (COC). It is also hoped that this policy manual will serve as an educational resource for policymakers and professionals working in other youth services systems and a guide for juvenile and family court judges for choosing and placing adolescents in effective programs, Published by: California Department of Health Care Services (DHCS), 2016
Adolescent SBIRT – This curriculum offers skills-based education on Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT). The curriculum is comprised of an instructor’s toolkit containing the Learner’s Guide to Adolescent SBIRT with companion slide decks and supplemental resources, and the web-based SBI with Adolescents simulation program. Published by National Institute on Drug Abuse (NIDA) for Teens, n.d.
Increasing resources for MAT within primary care and access to developmentally appropriate SUD counseling in community settings,
Offering MAT to adolescent and young adult patients with severe OUD or discuss referral to other providers for this service among pediatricians; and
Supporting further research focusing on developmentally appropriate treatment of SUDs in adolescents and young adults, including primary and secondary prevention, behavioral interventions, and medication treatment.
Published by American Academy of Pediatrics (AAP), 2016
American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. (Part 10 Special Populations – Adolescents) – ASAM developed these practice guide to provide information on evidenced-based treatment of OUD. Specific pharmacological agents used in the treatment of addiction exert effects via action on specific receptors. Hence, the medications used in the treatment of addiction have specific efficacy based on their own molecular structure. Medications developed for the treatment of addition involving opioid use may have benefits in the treatment of addiction involving an individual’s use of other substances. Published by: American Society of Addiction Medicine (ASAM), 2015
Applying CDC’s Guideline for Prescribing Opioids: An Online Training Series for Providers – This interactive online training series aims to help health care providers apply CDC’s recommendations in clinical settings through patient scenarios, videos, knowledge checks, tips, and resources. Providers can gain a better understanding of the recommendations, the risks and benefits of prescription opioids, nonopioid treatment options, patient communication, and risk mitigation. Each stand-alone module is self-paced and offers free continuing education credit. Published by: Center for Health Care Strategies Inc., August 29, 2017
Building Community Supports for Young People in Transition Years – This tip sheet suggests ways providers can assist young people to strengthen their existing supports and/or to connect with other supports Published by: Pathways to Positive Futures, January 2016
Buprenorphine Treatment for Young Adults – This training package, consisting of a trainer and participant manual, as well as presentation slides, highlights the findings of the NIDA CTN study that compared long- versus short-term buprenorphine/naloxone treatment in an outpatient setting. Published by: Addiction Technology Transfer Center (ATTC), January 2018
Children and Trauma: Tips for Mental Health Professionals – This tip sheet provides basic information every mental health professional should know about PTSD and trauma in youth; how to identify PTSD and/or trauma, and provide care to children, adolescents, and their families; and the pitfalls to avoid when encountering trauma and PTSD in youth. Published by the American Psychological Association (APA), n.d.
Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Children – This publication provides comprehensive, national guidance for the optimal management of pregnant and parenting women with OUD and their infants based on the recommendations of experts reviewing the limited evidence available for this population as of 2017. Published by: Substance Abuse and Mental Health Services Administration (SAMHSA), 2018
Criteria for Adolescents – This excerpt provides use in connection with the review of a claim for benefits for adolescents. Published by: ASAM, 2013
Coverage of Behavioral Health Services for Youth with Substance Use Disorders Joint CMCS and SAMHSA Information Bulletin – This bulletin is intended to assist states to design a benefit that will meet the needs of youth with substance use disorders (SUD) and their families and help states comply with their obligations under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements. Published by: Center for Medicaid and CHIP Services (CMCS) and SAMHSA, January 26, 2015
Decisions in Recovery: Treatment for Opioid Use Disorders – This handbook provides guidance on using the web-based, multimedia tool Decisions in Recovery: Medications for Opioid Addiction. This handbook and the web-based tool offers information about medication-assisted treatment. Both resources help people living with opioid use disorder compare treatment options and discuss their preferences with a provider. Published by: SAMHSA, December 2016
Emerging Strategies for Engaging Young People in Systems of Care – This tip sheet explores ways in which systems of care are developing new approaches and adaptations to delivery models to increase engagement among older youth and young adults. Published by: Pathways to Positive Futures, 2019
Ending Youth Homelessness Guidebook Series: Promising Program Models – This series of three guidebooks is designed for Continuum of Care leadership and stakeholders to use as a direct, hands-on action plan in efforts to prevent and end youth homelessness, as they have been directed to ensure there is an effective and efficient system of care for all persons and households experiencing homelessness. Published by: U.S. Department of Housing and Urban Development (HUD), n.d.
Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health – This report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person’s overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone—individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers—can take to prevent substance misuse and reduce its consequences. Published by: Office of the Surgeon General, November 2016
First-Episode Psychosis and Co-Occurring Substance Use Disorders – This guide supports health care providers, systems, and communities to address first-episode psychosis and co-occurring substance use disorders. It describes relevant research, examines emerging and best practices, identifies knowledge gaps and implementation challenges, and offers resources. Published by: SAMHSA, August 2019
Guidance to States and School Systems on Addressing Mental Health and Substance Use Issues in Schools – This joint informational bulletin calls for the urgent need to identify children and adolescents who have or are at risk for mental and substance use disorders and connect them with other services they need. The bulletin outlines best practice models, discusses funding for school-based mental health and substance use related prevention and treatment services, and provides specific examples of state-level strategies for Medicaid and other financing of school-based mental health services. Published by: SAMHSA and CMCS, July 1, 2019
Medication-Assisted Treatment of Adolescents with Opioid Use Disorder – This policy statement advocates for increasing resources to improve access to MAT for opioid-addicted adolescents and young adults. Published by: American Academy of Pediatrics, Committee on Substance Use and Prevention, September 2016
Mental Health: Universal School-Based Cognitive Behavioral Therapy Programs to Reduce Depression and Anxiety – This one-page handout summarizes the Community Preventive Services Task Force (CPSTF) recommendation and systematic review evidence for universal school-based cognitive behavioral therapy programs to reduce depression and anxiety symptoms. Published by: The Community Preventive Services Task Force (CPSTF), September 2019
Naloxone: Understanding Its Role and Expanding its Access in Community Pharmacies – Drug overdose is the leading cause of unintentional death in the United States, and opioids are the most common cause of fatal overdoses. With the ability to stop an overdose in its tracks, naloxone is a lifesaving medication. Through this recorded webinar, learn about the laws surrounding its use, the available naloxone products, and the logistics of dispensing take-home formulations. Published by: American Pharmacists Association (APhA), March 16, 2018
Opioid Use and Opioid Use Disorder in Pregnancy – This American College of Obstetricians and Gynecologists (ACOG) Committee Opinion publicized its recommendations in treating and caring for women with an OUD in pregnancy. Published by: ACOG and ASAM, 2017
Pediatricians First Responders for Preventing Substance Use – This report examines the role of pediatricians in fighting substance use. The report identifies weak areas in training, tools, and support that pediatricians need to effectively speak with youth about not trying substances. Published by: Hazelden Betty Ford Foundation, n.d.
Practice Brief: Supporting the Youth Peer Workforce – This brief provides guidance around organizational policy and procedure and supervision to youth peers. Published by: Northwest Mental Health Technology Transfer Center, February 26, 2020
Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century – This consensus study report identifies key program factors that can improve health outcomes related to adolescent behavior and provides evidence-based recommendations toward effective implementation of federal programming initiatives. This study explores normative adolescent development; the current landscape of adolescent risk behavior; core components of effective programs focused on optimal health; and recommendation for research, programs, and policies. Published by: The National Academies of Sciences, Engineering, and Medicine, 2020
State Adolescent Substance Use Disorder Treatment and Recovery Practice Guide – Because the complex needs of this population are remarkably different from those of the traditional adult treatment population and requires different expertise and guidance to States on how their treatment and recovery systems can best serve adolescents, NASADAD and its federal and state partners collaborated to create this guidance document for states. This guidance is divided into three broad sections:
Overarching principles of care;
Service elements, including screening, assessment, and treatment and recovery services; and
Administrative considerations for states.
Published by: National Association of State Alcohol and Drug Abuse Directors (NASADAD), September 24, 2014
Suicide Safe – This app equips health providers with education and support resources to assess a patient’s risk of suicide, communicate effectively with patients and families, determine appropriate next steps, and make referrals to treatment and community resources. Suicide Safe won the FedHealthIT Innovation Award in the Mobile/IoT Category and is a winner of a Silver Digital Health Award in the Mobile Health Resources Category from the Health Information Resource Center. Published by: SAMHSA, February 2015
Telehealth for Transition Age Youth and Young Adults – This tip sheet provides options for protecting the emotional safety, privacy, and welfare of transition-age youth and young adults while they are participating in virtual mental health care. Published by: Pathways to Positive Futures, 2017
The Promise of Adolescence: Realizing Opportunity for All Youth – This report, second in a series from the Culture of Health Program, examines the neurobiological and socio-behavioral science of adolescent development and identifies how these findings can be applied to four key sectors: health, education, justice, and child welfare. Published by: The National Academies of Sciences, Engineering, and Medicine, 2019
TIP 42: Substance Abuse Treatment for Persons with Co-Occurring Disorders – This guide gives substance use disorder treatment providers information on mental illness, substance use disorders, or both. It discusses terminology, assessment, and treatment strategies and models. Published by: SAMHSA, May 2013
2012 National Strategy for Suicide Prevention: Goals and Objectives for Action – This revised national strategy emphasizes the role every American can play in protecting friends, family members, and colleagues from suicide. It also provides guidance for schools, businesses, health systems, clinicians, and many other sectors. This guidance considers nearly a decade of research and other advancements in the field since the last strategy was published. Published by: Office of the Surgeon General and National Action Alliance for Suicide Prevention, 2012
Toolkits - Under 18
Brief Screener for Tobacco, Alcohol, and Other Drugs (BSTAD) – This tool consists of frequency of use questions to identify risky substance use by adolescent patients. The accompanying resources assist clinicians in providing patient feedback and resources for follow-up. Published by: National Institute on Drug Abuse (NIDA) for Teens, n.d.
Building on Strengths: Tools for Improving Positive Outcomes – This tool is intended to help state- and local-level prevention practitioners identify effective and innovative programs that provide opportunities to, and improve outcomes for, boys and young men of color. Published by: Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Center for Application of Prevention Technologies, January 2016
Drug Overdose Deaths in the United States – This community assessment tool provides a snapshot of user-friendly, county-by-county data about drug overdose deaths and socio-economic conditions in a county to help leaders build grassroots solutions for prevention, treatment, and recovery. Published by: NORC at the University of Chicago, n.d.
Marijuana Prevention and Education Toolkit – This is a set of marijuana prevention and education resources. Published by the New England Prevention Technology Transfer Center Network, October 4, 2019
Overview of the K-12 Toolkit for Mental Health Promotion and Suicide Prevention – This toolkit created by the Health Care Alliance for Response to Adolescent Depression (HEARD) in 2013 (updated in 2017), in response to a need for schools to promote student mental health and wellbeing, to prevent suicide and, in particular, how to respond after a suicide loss. The toolkit convenes national best practices from SAMHSA, the NCSMH, and other organizations. Published by: Mental Health Technology Transfer Center (MHTTC) Coordinating Office, August 8, 2019
Screening to Brief Intervention (S2BI) – This screening tool consists of frequency of use questions to categorize substance use by adolescent patients into different risk categories. The accompanying resources assist clinicians in providing patient feedback and resources for follow-up. Published by: NIDA for Teens, n.d.
Developmentally specific approaches to treatment of adolescents and young adults with opioid use disorders (OUDs);
Use of relapse prevention medication in youth;
The role of families, when and how to involve them;
Confidentiality, use of various levels of care;
The impact of other substance use disorders (primarily cannabis and alcohol);
Delivery models for medications and psychosocial treatment modalities; and others.
Published by: American Society of Addiction Medicine (ASAM), 2018
Two Brief Online Screening Tools – NIDA has launched two brief online screening tools that providers can use to assess for substance use disorder risk among adolescents 12-17 years old. With the American Academy of Pediatrics recommending universal screening in pediatric primary care settings, these tools help providers quickly and easily introduce brief, evidence-based screenings into their clinical practices. [Screening to Brief Intervention (S2BI) and Brief Screener for Alcohol, Tobacco, and other Drugs (BSTAD)] Published by: NIDA, May 2019
Developmentally specific approaches to treatment of adolescents and young adults with opioid use disorders (OUDs);
Use of relapse prevention medication in youth;
The role of families, when and how to involve them;
Confidentiality, use of various levels of care;
The impact of other substance use disorders (primarily cannabis and alcohol);
Delivery models for medications and psychosocial treatment modalities; and others.
Published by: American Society of Addiction Medicine (ASAM), 2018
Ways to Address the Opioid Epidemic in Youth and Youth Adults – This webinar discusses youth-oriented OUD prevention strategies, Motivational Interviewing for youth and Young adults, and MAT for youth and young adults with an OUD. Published by: Relias, 2018
Toolkits – Includes 18-24
Behavioral Health Among College Students Information and Resource Kit – This kit discusses the consequences of substance misuse among college students including the misuse of prescription and over-the-country drugs. It explores various causational factors, such as peer pressure, stress, social norms, and advertising messages. Published by: Substance Abuse and Mental Health Services Administration (SAMHSA), 2018
California’s Public Substance Use Disorder Treatment System for Youth: An Overview – This resource addresses some of the unique needs of youth with a SUD, including Medi-Cal coverage of an SUD, the Consent and the State Only Medi-Cal Minor Consent Program, financing of public SUD services in California, promising practices, and considerations. Published by: California Health Care Foundation, 2017
CIN Toolkit: Three Strategies to Help Primary Care Teams Treat Substance Use Disorders – This document is a guide for primary care organizations and care teams working to integrate substance use disorder (SUD) treatment services. It provides proven strategies, best practices, and tools used by organizations within California to expand the capability of primary care teams in commercial and safety-net sectors to confidently and willingly provide SUD services. Published by: California Improvement Network, January 31, 2019
Medication Assisted Treatment in Residential Treatment Facilities – With support from the California Health Care Foundation, Harbage Consulting created a toolkit for residential treatment facilities to increase access to MAT for clients residing in their facilities, either by providing medication services onsite or through referral and partnerships. The toolkit contains:
A three-part booklet explaining the research supporting MAT, the process for receiving IMS approval, and how providers can become DATA 2000 waivered to prescribe buprenorphine.
An appendix with sample policies and procedures for providing IMS, so that facilities can quickly adopt the necessary measures to safely provide clients medications.
Published by: California Department of Health Care Services (DHCS), 2019
Medication Assisted Treatment Toolkit for Counselors – With support from DHCS, Harbage Consulting created a toolkit for substance use counselors to learn more about MAT and have conversations with their clients about how MAT can help them. The toolkit contains:
A two-part booklet explaining the research supporting MAT, and how counselors can help clients who are receiving MAT as part of their treatment
Two quick guide documents to the FDA-approved medications for opioids and alcohol use disorder
A quick guide to helping clients find a MAT prescriber
An instruction guide to using the overdose reversal drug Narcan
A document from the National Council on Challenging Myths about MAT
SAMHSA’s MAT for Opioid Addiction – Facts for Family and Friends
Published by: California Department of Health Care Services (DHCS), 2019
Opioid Safety Toolkit for Health Plans – This toolkit for health plans implementing opioid safety initiatives. The toolkit showcases best practices and success stories and provides practical tools across five areas:
Leadership and Change Management: How to mobilize your organization to make change
Provider Network: How to ensure your network provides safer pain management and evidence-based addiction treatment
Medical Management: How to coordinate care for high-risk members
Pharmacy Benefit: How to safely reduce new opioid starts and streamline access to buprenorphine and naloxone
Member Services: How to offer resources for members and their families/caregivers to learn about opioid safety and pain management
Published by: California Health Care Foundation and Manatt Health, 2019
SAMHSA Opioid Overdose Prevention TOOKIT – This toolkit provides steps for first responders, information for prescribers, safety advice for patients & family members, and resources for overdose survivors and family members. Published by: SAMHSA, 2018
Stem the Tide: Addressing the Opioid Epidemic – This toolkit includes resources for hospitals and health systems to share with clinicians and patients and to use to enhance partnerships within their communities. The information is categorized into eight topic areas:
Clinician education on prescribing practices
Nonopioid pain management
Addressing stigma
Treatment options for opioid use disorders
Patient, family and caregiver education
Transitions of care
Safeguarding against diversion
Collaborating with communities
Published by: American Hospital Association, 2017
Booklets
Children and Trauma: Update for Mental Health – This booklet provides a brief overview on what is known about post-traumatic stress disorder (PTSD) and trauma in children and adolescents; how providers can help children, adolescents, and their families cope and recovery from trauma; what still needs to learned about the complexities of PTSD and trauma; and other resources. Published by: American Psychological Association (APA), 2008
Fact sheets
Mental Health Issues and Conditions in Children and Youth Exposed to Human-caused Disasters – This is a disaster technical assistance center supplemental research bulletin focusing on mental health and substance use issues and conditions in children and youth after human-caused disasters. Published by: Substance Abuse and Mental Health Services Administration (SAMHSA), July 2019
Suicide Rising Across the U.S.: Vital Signs – This fact sheet features suicide trends and circumstances contributing to suicide. Published by: Centers for Disease Control and Prevention (CDC), June 2018
Webinars
Combating Stigma and Overcoming Barriers to Medication for Opioid Use Disorder – Listen to this webinar to hear an expert discuss how to navigate the difficult conversations surrounding opioid use disorders and discuss strategies to address stigma, dispel myths, and overcome barriers to adherence to medications that assist people in recovery. Published by: American Pharmacists Association, June 20, 2018
Low Barrier Access to Mental Health Services for Youth and Young Adults: What Works With What We’ve Got – This recorded webinar explores low-barrier services for young adults of transition age experiencing or at risk for behavioral health challenges. Presenters discuss how low-barrier services can improve engagement and will identify strategies for integrating low-barrier policies and practices into organizational standards. Throughout the discussion, presenters provide examples of promising approaches that have been adopted by local communities, including the development of drop-in centers and peer-to-peer programs. Published by: Pacific Southwest Mental Health Technology Transfer Center (MHTTC), April 30, 2019
Suicide Prevention in School Part 2: Tools, Resources, and Programming – This recorded webinar focuses on available and easily accessible tools, resources, and programming for suicide prevention in schools. Some highlighted programs include QPR, The American Foundation for Suicide Prevention, The Jason Foundation, and more. Published by: Great Lakes MHTTC, September 4, 2019
Suicide Prevention in School Part 3: Implementing the SOS Program in Middle and High School – SOS educates teens on warning signs of depression and suicide and teaches them how to support themselves or a friend using ACT: Acknowledge, Care, and Tell. SOS includes a vital screening component to help school student services staff identify at-risk youth and link them to needed services. Published by: Great Lakes MHTCC, September 4, 2019
Youth Suicide – Early Detection of Warning Signs and Identifying Risk Factors – Suicide is a complex issue and usually an intimidating topic to talk about. This recorded webinar is an introduction to suicide prevention for school personnel. It will inform participants of recent trends in youth suicide and the potential “red flags” at various age and grade levels. Resources to support youth will be presented and provided. Published by: Northeast and Caribbean MHTCC, August 15, 2019
