Principles of Care and Practice Guidance

The Bureau of Substance Addiction Services actively promotes practice improvement in prevention, treatment and recovery systems of care

The Practice Guidance papers describe best practices as well as why and how practice in specific areas can be improved. These are intended to be used by BSAS substance abuse service providers in assessing and improving programs and services, and by consumers in understanding what best practice should look like. Each guidance contains summaries, with embedded links, of research and resources, as well as a link to provide feedback to BSAS.

Strategic Plan: Principles of Care and Practice Guidance l (DOC)
The Bureau of Substance Addiction Services’ Strategic Plan describes BSAS’s authority and its purpose in articulating Principles of Care and Practice Guidance papers.  The Plan also describes the process by which Practice Guidance papers are developed and issued, including the mechanism for providing feedback to BSAS.

Principles of Care in Prevention, Treatment and Recovery l (DOC)
The Bureau of Substance Addiction Services Principles of Care are built on its Mission Statement and on national standards of care.  The Principles are intended as foundation reference points in program and service design and implementation.

Practice Guidance Modules

Medication Assisted Treatment for Adolescents and Young Adults l (DOC)
The prevalence of opioid misuse and addiction among adolescents and young adults continues to increase across the United States.  Specific to opioid use disorders (OUD), the Bureau of Substance Addiction Services (BSAS) recognizes and supports Medication Assisted Treatment (MAT) combined with behavioral interventions as an effective practice that can support adolescents and young adults to achieve sobriety and engage in long-term recovery. This Practice Guidance was developed with a focus on youth ages 16 to 24 with identified OUD. The aim is to enable service providers (including but not limited to BSAS licensed and/or contracted treatment providers) to better engage, retain, and support this population’s treatment process.

Infectious Diseases and Substance Use: Integrated Risk Assessments | (DOC)
The prevalence of opioid misuse and addiction continues to increase across the United States and has become a contributing factor in the rise of infectious diseases and related conditions as a result of injection drug use (IDU). The Bureau of Substance Addiction Services (BSAS) is committed to ensuring better coordinated and more integrated approaches to address the intersection between addiction and infectious diseases. This Practice Guidance is intended to support capacity development of substance use treatment providers to understand and integrate behavioral risk assessments and appropriate service referral for infectious diseases among individuals accessing substance use disorder (SUD) services.

Integration of Tobacco and Nicotine Into Substance Use Treatment Services l (DOC)
Tobacco and nicotine products are significant co-occurring addictive substances used by the majority of individuals entering treatment services for substance use disorders (SUD).  On the whole, tobacco-related diseases are the leading cause of death among persons treated for a substance use-related disorder.  To address the significant impact tobacco and nicotine products have in terms of health effects and lives lost to tobacco-related diseases among the BSAS treatment population and its workforce, it is imperative to employ a multi-tiered proactive approach for systems change, de-normalizing the use of tobacco/nicotine within the SUD treatment system. This Practice Guidance describes the risks individuals with a substance use disorder who smoke or use tobacco-related products face, and integrating best practices in addressing use and dependency as part of the comprehensive system for treating addictive disorders.

Effective Treatment for Persons with Co-Occurring Disorders l (DOC)
BSAS is committed to promoting integrated treatment of persons with both substance related and mental health disorders. Approximately 50% of individuals with a known diagnosis of one form of disorder also have a co-occurring disorder. Yet, research documents that less than 7% of individuals with co-occurring disorders receive treatment for both conditions, thus increasing risks of relapse, hospitalization, homelessness and incarceration. This Practice Guidance summarizes essential elements of care, and provides guidance so that treatment programs can respond fully and effectively to persons with co-occurring disorders.

Serving LGBTQ Youth and Young Adults and Their Families l (DOC)
Youth and young adults, a priority for the Bureau of Substance Addiction Services, are a population at high risk for substance related disorders. Lesbian, Gay, Bisexual, Transgender and Queer/Questioning youth and young adults face exacerbated risks arising from harrassment, threats, violence and rejection. BSAS is committed to ensuring that LGBTQ youth and young adults, and their families, have equal access to quality services. This Practice Guidance describes the risks this population face, and best practices in engaging these youth and young adults, and their families.

Integrating Opioid Overdose Prevention Strategies into Treatment l (DOC)
Preventing opioid overdose is a priority for the Bureau, and addressing opioid overdose prevention in treatment can reduce risk and increase safety.  This Practice Guidance describes the growing incidence of opioid overdose and provides information and resources for organizational readiness and staff training as well as for ensuring that overdose prevention, recognition and response are included in all stages of treatment.

Integrating Medication in Behavioral Treatment l (DOC)
Each person’s individual health is affected upon their life experiences and environment. The Bureau of Substance Addiction Services believes that treatment should respond to this complexity by treating the whole person. This practice guidance supports capacity of behavioral treatment providers to understand and integrate properly prescribed medication as effective components of treatment plans.

Drug Screening as a Treatment Tool l (DOC)
This Practice Guidance explores use of drug screening in substance abuse treatment, with particular attention to evidence of effectiveness and to tailoring care to the needs of the individual. It includes summaries of current research as well as guidance focused on ensuring that drug screening supports engagement in treatment and recovery.

Partnerships with DCF l (DOC)
Cooperation among providers, a priority for the Bureau of Substance Addiction Services, is critical when substance abuse undermines parents’ ability to care for their children.  This guidance describes actions providers, staff, and DCF can take to build and maintain productive partnerships to promote family recovery and child safety.

Pregnancy and Medication-Assisted Treatment – Information and Support for Pregnant Women in Recovery l (DOC)

Pregnancy and Medication-Assisted Treatment – Information and Support for Pregnant Women in Recovery - Spanish l (DOC)

Making Treatment Culturally Competent l (DOC)
This Practice Guidance describes how to integrate cultural competence into substance abuse treatment. Cultural competence reduces disparities, supports best practices and improves outcomes. It is critical to ensuring equitable access to and engagement in treatment and recovery – a fundamental BSAS Principle of Care.

Treatment Services for Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Adults l (DOC)
The Bureau of Substance Addiction Services is committed to providing access to quality treatment for all those with substance use disorders. This should not vary due to an individual’s gender identity or sexual orientation. This module describes the range of treatment considerations, and best practices in treatment for Lesbian, Gay, Bisexual, Transgender and Queer adults.

Treatment Services for Older Adults l (DOC)
The Bureau of Substance Addiction Services is committed to promoting excellent, effective treatment across the life span. This practice guidance helps to create an outline of how best to provide treatment for older adults.

Engaging Veterans in Treatment l (DOC
Engaging Veterans in Treatment Slide Presentation (PPTX)
This Practice Guidance highlights the importance of understanding the experiences, strengths and needs of those who have served in the U.S. Military, in order for treatment providers to more effectively engage these men and women in treatment, and support recovery for them and for their families.

Treatment Services for Pregnant and Postpartum Women l (DOC)
Pregnant substance using women are a priority population for the Bureau of Substance Addiction Services.  This guidance describes the needs and vulnerabilities of pregnant and postpartum women, as well as administrative actions and clinical expertise needed to successfully engage and treat pregnant women, and their families.  A broad array of resources are listed, with web links.

Access for Persons with Disabilities l (DOC)   
The Bureau of Substance Addiction Services is committed to ensuring access to and participation in substance abuse prevention, treatment and recovery for persons with disabilities. This Practice Guidance: describes the key role of the Access Coordinator in achieving these goals in treatment programs; includes a summary of research and best practices; and contains links to a broad array of useful resources. 

Responding to Relapse l (DOC)
BSAS supports efforts to respond to relapse in ways that support continued participation in treatment.  This module describes practices that aim to keep individuals engaged in treatment while they work toward abstinence and recovery.

Treatment Services For Youth and Their Families l (DOC)
The Bureau of Substance Addiction Services is committed to building a comprehensive and effective system of care for youth and their families. This practice guidance helps to create an outline of how best to respond to specific issues effecting youth and their families.

Engaging Young Adults and Their Families in Treatment l (DOC)
The Bureau of Substance Addiction Services is committed to building a comprehensive and developmentally appropriate system of care for young adults and their families. This practice guidance explores some of the developmental and social behaviors of young adults and helps to create an outline of how best to engage young adults and their families in treatment.

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