Opioid Use Disorder

 Centers of Excellence (COE) and Other Resources

Ending the Stigma

  • Prevalence: Over 5.7 million people aged 12+ in the U.S. have OUD. As a primary care provider (PCP), you are likely already caring for patients with OUD.
  • Role of PCPs: PCPs are essential in managing OUD—both by treating comorbid physical conditions and by initiating or facilitating access to FDA-approved medications (buprenorphine, naltrexone, methadone).
  • Stigma & Barriers: Stigma, misconceptions (e.g., "replacing one addiction with another"), cost, and lack of training hinder treatment access. Many PCPs report discomfort with diagnosing and treating OUD.

Prescribing Guidelines

Pennsylvania has taken significant steps to improve prescribing practices for pain and related conditions. Visit the Commonwealth of PA for both state and federal prescribing guidelines.

Treating OUD

For the most up-to-date information on preferred agents for treatment of OUD, including coverage criteria and prior authorization requirements, please refer to the Preferred Drug List (PDL).

  • Regulatory Update: The DATA-Waiver (X-waiver) is no longer required. Any DEA-registered clinician with authority to prescribe controlled substances can now prescribe buprenorphine for OUD.
Medetomidine Crisis

Medetomidine, a powerful veterinary sedative, was first detected in Philadelphia’s street opioid supply in May 2024. It produces long-lasting sedation and severe withdrawal symptoms, often leaving individuals unresponsive even after naloxone is administered. Withdrawal can begin rapidly, causing dangerously high heart rates and blood pressure, and frequently requires intensive care. Providers are urged to stay informed as hospital admissions for medetomidine withdrawal have more than doubled since its appearance in the illicit drug supply.

Tip:

Although your patient can visit a COE without talking to you, your involvement helps increase the success of his or her recovery from opioid addiction.

Jefferson Health Plans Everwell members can learn about opioids and OUD by visiting the Opioid Use Disorder page.

COE Designation Process and PROMISE Enrollment

DHS issued a “Specialty Designation” MA bulletin that details a process for how providers interested in receiving a Center of Excellence designation can apply.

MCOs will only pay the G9012 procedure code for COE care management services to providers who are enrolled in the PROMISE system with the Opioid COE specialty designation.

The bulletin is available on the PA DHS Centers of Excellence website.

Prescription Drug Take-Back Program

If a medication is expired or no longer needed, it’s important to protect the safety of others by disposing of it properly.

Members can visit the PA Department of Drug and Alcohol Programs' Prescription Drug Take-Back Program page and enter their ZIP code or county to find a local prescription drop-off location.

Resources

Opioid Use Disorder

For assistance, members can call us at 1-888-477-9800. They can also call the Federal Substance Abuse and Mental Health Service Hotline at 1-800-662-4357 or visit the Commonwealth of Pennsylvania’s Opioid Use Disorder web page for more information.

Pennsylvania's Prescription Drug Monitoring Program (PDMP) tracks all dispensed controlled substance prescriptions to prevent drug abuse and ensure community health and safety. It supports healthcare providers in prescribing safely and helps patients receive appropriate care.

The PA Department of Health has information and resources devoted to opioid awareness on its website.

Information about preventing Opioid Abuse and Addiction can also be found on the US Department of Health and Human Services website.

Naloxone is a medication that can reverse an overdose that is caused by an opioid drug. Consider offering Naloxone for overdose reversal to all patients with OUD and their household members/significant others.

Medetomidine Crisis

The Philadelphia Department of Public Health has provided updated guidance on responding to medetomidine overdose and withdrawal.

What you need to know about Medetomidine, the new street drug taking over Philly.

References