Ideas for Making Treatment Available for All

Here are some ways to think outside the box when substance use providers or treatment programs are not available in the area:

• Utilize substance use and mental health services outside the community:
  • The SAMHSA Web site noted above, which includes a National Helpline, 1-800-662-HELP, which provides free, confidential 24/7 treatment and referral and information services in English and Spanish for individuals and families facing substance use disorders
  • State and county resources
  • Remote resources in other states
• Ask the family or case manager to contact the payer to help locate in-network resources.

When cost/insurance is an issue, consider these ideas:

• Explore telehealth options that enable allied providers to consult with patients remotely.
• Take advantage of state psychiatric consultation services, if available.

• Explore mental health coverage options through Medicaid and private insurance, including an appeal on coverage decisions.
• Locate a sliding scale clinic whose fee is adjusted according to need.
• Seek services offered by the state or local community health department.
• Ask the family or case manager to contact the payer to help find in-network services.
• Explore services made available through the Families First Prevention Services Act, if applicable. This legislation provides federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training.
• Consider lower levels of care such as psychoeducation (providing information about substance use and its management) and brief interventions to assist patient and family in reducing harm. As appropriate, address related issues through mental health/therapy services, which may be a more acceptable and affordable first step. Following are some Web-based psychoeducational services to consider:
  • https://drugfree.org
  • https://teens.drugabuse.gov/
  • https://addictionresource.com/parents-and-educators

When the patient needs medication-based treatment for opioid use disorder, but there is no place to refer them, consider the following:

• Physicians, advanced practice nurses, and physician assistants can receive Medication Administration Training (MAT) and obtain a waiver to prescribe buprenorphine for the treatment of opioid use disorder. Available at no cost at:
  • http://www.aap.org/mat for AAP members (login required)
  • https://pcssnow.org/education-training/mat-training/ for nonmembers
• Become familiar with the AAP policy statement, Medication-Assisted Treatment of Adolescents with Opioid Use Disorders. Available at: https://doi.org/10.1542/peds.2016-1893.