University of California, Los Angeles Integrated Substance Abuse Programs, 11075 Santa Monica Blvd., #200, Los Angeles, CA 90025, United States of America; David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd., #200, Los Angeles, CA 90025, United States of America.
Stanford University School of Medicine, 1520 Page Mill Road, MC 5265, Palo Alto, CA 94304, United States of America.
J Subst Abuse Treat. 2020 Jan;108:20-25. doi: 10.1016/j.jsat.2019.07.013. Epub 2019 Jul 27.
As part of the State Targeted Response to the opioid epidemic, California has adopted the Hub and Spoke model to expand access to medications for opioid use disorder, particularly buprenorphine, throughout the state. By aligning opioid treatment programs as hubs with primary care, office-based practitioners, and other health care settings as spokes, a broader treatment model can reach more people with opioid use disorder, improve access to medications for opioid use disorders, and decrease overdose deaths. Expanding access requires expanding knowledge and intensive implementation support of new practices. This paper describes the rationale, specific activities and anticipated impact of the implementation plan in California's Hub and Spoke system. Training and technical assistance are designed to: increase the number and capacity of waivered prescribers; enhance skills of prescribers and multidisciplinary teams; and create systems change. Activities include buprenorphine waiver trainings and provider support, a practice facilitator program, Project ECHO sessions, webinars, clinical skills trainings, and regional learning collaboratives. This overview highlights the steps California is taking to build treatment capacity to address the opioid epidemic.
作为国家应对阿片类药物流行的一部分，加利福尼亚州已采用中心辐射模型，以扩大全州范围内阿片类药物使用障碍（尤其是丁丙诺啡）的药物获取渠道。通过将阿片类药物治疗项目作为中心，将初级保健、以办公室为基础的从业者和其他医疗保健环境作为辐射点，更广泛的治疗模式可以覆盖更多的阿片类药物使用障碍患者，改善阿片类药物使用障碍的药物获取渠道，并减少过量死亡人数。扩大获取渠道需要扩大新知识，并为新实践提供深入的实施支持。本文介绍了加利福尼亚州中心辐射系统中实施计划的基本原理、具体活动和预期影响。培训和技术援助旨在：增加有豁免权的处方医生的数量和能力；提高处方医生和多学科团队的技能；并进行系统变革。活动包括丁丙诺啡豁免培训和提供者支持、实践促进者计划、ECHO 项目会议、网络研讨会、临床技能培训和区域学习合作。本文概述了加利福尼亚州为建立治疗能力以应对阿片类药物流行而采取的措施。
