Program Overview

February 14, 2025

Better Prescribing, Better Treatment Podcast: New Podcast Episode Available

Better Prescribing, Better Treatment is WSMA's physician-led, peer-to-peer, non-punitive initiative aimed at encouraging safe opioid prescribing. Starting in 2024, the initiative expanded to include safe prescribing recommendations for benzodiazepines and sedatives and getting started with appropriate buprenorphine prescribing for treatment of opioid use disorder. To complement these new best practices, the popular Better Prescribing, Better Treatment CME podcast is now back online, with a new episode and more on the way.

Nathan Schlicher, MD, JD, chief clinical officer for Better Prescribing, Better Treatment, is your host for the podcast. Each episode features conversations with guest physician leaders from across specialties and systems on how we reduce the dependence on opioids for pain management where appropriate, help those suffering with chronic conditions safely, and help those with addiction. Each episode supports the goals of the Better Prescribing, Better Treatment safe-prescribing program.

Episode 18: Buprenorphine Guidelines and Fentanyl

In this new episode, Dr. Schlicher talks with Callan Fockele, MD, a board-certified internal medicine physician specializing in emergency medicine, to discuss the benefits of prescribing buprenorphine and the challenges of treating opioid use disorder due to fentanyl. Dr. Fockele strives to center harm reduction in the treatment of patients experiencing mental health and substance use disorders.

Access the new episode and previous episodes on the WSMA website or from our podcast channel, WSMA Podcasts, available through Apple Podcasts and Spotify. Each podcast is approved for AMA PRA Category 1 Creditâ„¢.

Now available: Coaching services on improving opioid prescribing and treatment protocols in clinics

The WSMA is pleased to offer coaching services on improving opioid prescribing and treatment protocols in clinics. Examples of past projects include developing an opioid curriculum for a residency program and updating clinic opioid prescribing policies. As part of WSMA's current grant funding for the Better Prescribing, Better Treatment program, we are excited to offer a stipend for clinics that engage with us. You will also get consulting time with the program's chief clinical officer, Nathan Schlicher, MD, JD. Contact Monica Salgaonkar at monica@wsma.org for more information.

Oct. 11, 2024

Call for Feedback on Draft OUD Treatment Guidelines from Bree Collaborative

The Dr. Robert Bree Collaborative is accepting public comment on its draft Treatment for Opioid Use Disorder Report and Guidelines 2024. In partnership with the Washington Society of Addiction Medicine, the WSMA supports updating the guidelines to reflect current clinical practice and patient care in the era of fentanyl.

Some of the updated guidelines include encouraging practitioners to:

• Become educated on the latest evidence-based guidelines.
• Universally screen in primary care at least annually for substance use disorders including opioid use disorder using a validated instrument (see NIDA Screening and Assessment Tools) following the United States Preventative Task Force recommendations. Physicians and practitioners not in primary care settings should also routinely screen for substance use disorders using validated instruments.
• If a patient screens positive, or independently brings up concerns about their opioid use, ask about frequency, amount, and route of opioid use, perform comprehensive assessment, and discuss medications for opioid use disorder.

A complete list of the updated guidelines is available on pages 9-11 of the report.

Once completed, the guidelines will be submitted to the Legislature and may be the foundation of future legislation. We encourage WSMA members to review and provide feedback on the draft report and guidelines before the deadline on Thursday, Oct. 24 at 11:59 p.m.. All comments will be presented anonymously and reviewed at the November work group meeting.

June 14, 2024

ScalaNW Program Provides ER Physicians Support for Opioid Use Treatment

Despite the success of medications for opioid use disorder like methadone and buprenorphine, less than 9% of overdose-related emergency room visits result in a prescription for MOUD. A new program from the state Health Care Authority, introduced this month, aims to bring that number up by equipping emergency room clinicians with tools to treat patients for opioid use disorder and connect them to community-based care.

MOUD have been underprescribed in the ER for a reason: Before 2023, the U.S. Drug Enforcement Administration required clinicians to complete special training to prescribe certain medications for OUD. These requirements were removed at the end of 2022. Now that the medications are easier to prescribe, clinicians and hospital systems can standardize treatment protocols and consistently get medication to ER patients with OUD.

The new Health Care Authority program, ScalaNW, is a bridge program with tools to close the gap between emergency initiation of MOUD and the ongoing, outpatient clinical care they needed to keep patients on medication long-term. The program gives acute care physicians and practitioners a direct link to evidence-based clinical support and provides hospital systems with 24/7 scheduling services to make it easier to initiate medications for opioid use disorder. ScalaNW is endorsed by the WSMA, the Washington Chapter of the American College of Emergency Physicians, and the Washington Hospital Association.

The program website, ScalaNW.org, offers evidence-backed protocols for clinicians to determine how and when to provide MOUD and collaborates with the University of Washington Psychiatry Consultation Line to offer 24/7 live clinical support. ScalaNW also works with the Washington Recovery Helpline to provide 24/7 scheduling that allows follow-up appointments to be made before ER discharge.