Congratulations to our 2024 Bree Collaborative award winner for Best Practices in Opioid Use Disorder Treatment
- Healthpoint
- Community Health Plan of Washington
- UW Medicine & UW Physician
- MultiCare
Opioid Use Disorder Treatment (Revised 2024)
Currently, the Bree does not have a data dashboard for Opioid Use Disorder Treatment metrics. The Washington State Department of Health does host a DASHBOARD that tracks Opioid overdose incidents, including deaths, hospitalizations and EMS services.
The data below is from the Kaiser Family Foundation (KFF) analysis of Substance Abuse and Mental Health Services Administration (SAMHSA)’s restricted online data analysis system (RDAS), National Survey on Drug Use and Health (NSDUH), 2018 and 2019, Substance Abuse and Mental Health Data Archive.
Implementation Tools
Revised 2024 Treatment for Opioid Use Disorder Report and Guidelines
Read our REVISED 2024 Report and Guidelines
(Adopted November 2024)
Opioid use disorder continues to be prevalent in Washington State, with a 10% increase from 2018 to 2019 and 35% for both 2020 and 2021 over the prior year. The Bree Collaborative developed guidelines in 2017, outlining full or partial opioid agonists for treatment (as opposed to treatment without medication). As the number of opioid overdose death rate has continued to climb, the Bree Collaborative members decided to revisit the previous guidelines and report. In the time since the last report, the X waiver requirement has been removed, and the increase in fentanyl in Washington’s drug supply has complicated opioid overdose response. A significant number of methamphetamine overdoses involve opioids, and most people who use drugs use multiple substances. According to the Washington DOH, the stimulant-related overdose death rate has increased 388%. As a result, the response to opioid use and overdose should address strategies that are associated with many drugs not just opioids. Fentanyl and analogues carry a higher overdose risk than other opioids; in 2022, a survey by the UW’s Addiction, Drug & Alcohol Institute (ADAI) found that 18% of respondents had used fentanyl within the past 3 months. There is a need for guidance for providers to improve confidence and competence and for payors on successful and safe initiation, stabilization, and titration of individuals on medication for opioid use disorder in the age of fentanyl with a focus on populations that are or have been underserved.
2024 Workgroup Members
| Name | Title | Organization |
| Charissa Fotinos, MD (Chair) | Deputy Chief Medical Officer | Washington HealthCare Authority |
| Nikki Jones, LCISW, SUDP, CMHS, DDMHS, GMGS | Behavioral Health Addictions Administrator | United Health Community |
| Michael Sayre, MD | Medical Director | Medic One |
| Brad Finegood, MA, LMHC | Strategic Advisor Opioids and Health | King County |
| Everett Maroon, MPH | Executive Director | Blue Mountain Heart 2 Heart |
| Tina Seery, RN, MHA, CPHQ, CPPS, CLSSBB | Senior Director, Quality and Rural Programs | Washington State Hospital Association |
| Tawnya Christiansen, MD | Behavioral Health Medical Director | Community Health Plan of Washington |
| Sue Petersohn, EN, MBA, CARN | Program Manager, Multicare SUD Task Force | MultiCare |
| Mark Murphy, MD | Medical Director Addiction Services | MultiCare |
| Libby Hein, LMHC | Director of Behavioral Health | Molina Healthcare |
| Ryan Caldeiro, MD | Chief Chemical Dependency Services and Consultative Psychiatry |
Kaiser Permanente |
| Herbie Duber, MD | Regional Medical Officer – Northwest WA | Department of Health |
| Bob Lutz, MD, MPH | CHAS Health | |
| Amanda McPeak, PharmD | Pharmacist and Director of Long-term Care | Kelley-Ross/Harborview |
| Jason Fodeman, MD | Associate Medical Director of Innovation and Outreach | L&I |
| Maureen Oscadal, RN, CARN | Registered Nurse | Harborview Medical Center/Addiction Drugs and Alcohol Institute |
| John Olson, MD, MHA | Addiction Medicine Physician | Sound Health |
| Daniel Floyd | Care Coordination and Recovery Section Manager | King County Behavioral Health and Recovery Division |
| Kelly Youngberg, MHA | Assistant Director for Health Care Implementation and Strategy | Addictions, Drug and Alcohol Institute |
| Cris DuVall, PharmD, SUDP, WSPA | Clinical Pharmacist Counselor | Compass Health, Island Drug |
| Tom Hutch, MD, FASAM | Medical Director | We Care Daily Clinic |
| Liz Wolkin, MSN, RN, NPD-BC CEN | Emergency Department Support Program Administrator | Washington HealthCare Authority |
| David Sapienza, MD | Lead Physician | Pathways, Public Health Seattle & King County – Community Health Services Division |
Past Meeting Materials
| Date | Materials |
| January 16th, 2024 | |
| February 20th | February Agenda January Minutes Draft Focus Areas |
| March 19th | March Agenda February Minutes Draft Focus Areas/2017 Report |
| April 16th | April Agenda March Minutes Focus Areas |
| May 21st | May Agenda April Minutes |
| June 18th | June Agenda May Minutes Care System Diagram/HEHub Worksheet/Draft Evidence Table |
| July 16th | July Agenda June Minutes OUD Interventions Worksheet/Nontraditional Models |
| August 20th | August Agenda July Minutes OUD Aug Evidence Table |
| September 17th | September Agenda August Minutes Treatment for OUD Revision Draft Report |
| October 15th | October Agenda September Minutes Evaluation Framework/Evaluation Matrix Provider Checklist/Healthcare Facilities Checklist/Health Plan Checklist |
| November 5th | November Agenda October Minutes Public Comment/Summary Public Comments/Draft Report |
Supporting Materials
Original 2017 Treatment for Opioid Use Disorder
(Adopted November 2017)
Drug overdose is the leading cause of accidental health in the United States, driven by opioid addiction. The majority of people with identified substance use disorders do not receive appropriate care or treatment. Barriers to care lie in lack of access, variation in treatment, and because substance use is highly stigmatized. This workgroup met from December 2016 to November 2017, built on the work of the 2016 Washington State Interagency Opioid Working Plan, and developed the following focus areas:
- Access to evidence-based treatment
- Medication treatment: buprenorphine, methadone, naltrexone (e.g., increase geographic reach, increase number of providers)
- Reduction in stigma associated with treatment
- Referral information
- Providers and patients know where to access care
- Accessible inventory of buprenorphine and methadone prescribers
- Referral infrastructure that supports patients and providers
- Integrated behavioral and physical health to support whole-person care
- Treatment of comorbid conditions including multiple substance use, mental illness, and physical health in line with Behavioral Health Integration Report and Recommendations
Opioid Use Disorder Webinar
Supporting Materials
Letter from the Health Care Authority Accepting the Total Knee and Total Hip Replacement Bundle and Warranty and the Opioid Use Disorder Treatment and Alzheimer’s Disease and Other Dementias Report and Recommendations
Opioid Use Disorder Treatment Charter and Roster
2017 Workgroup Members
| Member | Title | Organization |
|---|---|---|
| Charissa Fotinos, MD (Co-Chair) | Deputy Medical Officer | Health Care Authority |
| Andrew Saxon, MD (Co-Chair) | Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE) | VA Puget Sound Health Care System |
| Jane Ballantyne, MD, FRCA | Professor, Department of Anesthesiology and Pain Medicine | University of Washington School of Medicine |
| Caleb Banta-Green, PhD, MPH, MSW | Senior Scientist | Alcohol and Drug Abuse Institute, University of Washington |
| David Beck, MD | Immediate Past President | Washington Society of Addiction Medicine |
| Ryan Caldeiro, MD | Chief Chemical Dependency Services and Consultative Psychiatry | Kaiser Permanente |
| Mary Catlin, BSN, MPH | Institutional Nurse Consultant | Department of Health |
| Nancy Lawton, MN, ARNP, FNP | President | ARNPs United of Washington State |
| Darin Neven, MD, MS | President and Founder | Consistent Care |
| Richard Ries, MD | Director, Addiction Psychiatry Residency Program | University of Washington |
| John Robinson, MD, SM | Chief Medical Officer | First Choice Health |
| John Roll, PhD | Professor & Vice Dean for Research, Elson S. Floyd College of Medicine | Washington State University |
| Terry Rogers, MD | Medical Director | Lakeside Milam Recovery |
| Vania Rudolf, MD, MPH | Addiction Recovery Services | Swedish Medical Center |
| Mark Stephens | President | Change Management Consulting |
| Milena Stott, LICSW, CDP | Chief Of Inpatient Services | Valley Cities Counseling |
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