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Substance Use Warmline
Peer-to-Peer Consultation and Decision Support
10 am – 6 pm EST Monday - Friday
855-300-3595

Free and confidential consultation for clinicians from the Clinician Consultation Center at San Francisco General Hospital focusing on substance use in primary care

 

Objectives of the Substance Use Warmline:

  • Support primary care providers in managing complex patients with addiction, chronic pain, and behavioral health issues
  • Improve the safety of medication regimens to decrease the risk of overdose
  • Enhance the treatment, care and support for people living with or at risk for HIV
  • Discuss useful strategies for clinicians in managing their patients living with substance use, addiction and chronic pain.

Consultation topics include:

  • Assessment and treatment of opioid, alcohol, and other substance use disorders
  • Approaches to suspected misuse, abuse, or diversion of prescribed opioids
  • Methods to simplify opioid-based pain regimens to reduce risk of misuse and toxicity
  • Urine toxicology testing- when to use it and what it means
  • Use of buprenorphine and the role of methadone maintenance
  • Withdrawal management for opioids, alcohol, and other CNS depressants
  • Harm reduction strategies and overdose prevention
  • Managing substance use in special populations (pregnancy, HIV, hepatitis)
  • Productive ways of discussing (known or suspected) addiction with patients.

The CCC’s multi-disciplinary team of expert physicians, clinical pharmacists and nurses provides consultation to help clinicians manage complex patient needs, medication safety, and a rapidly evolving regulatory environment.

Learn more at http://nccc.ucsf.edu/clinician-consultation/substance-use-management

Family Psychosocial Screening also assesses a number of other risk factors for developmental and behavior problems. These include frequent household moves, single parenting, three or more children in the home, less than a high school education, and unemployment. Four or more such risk factors including mental health problems and an authoritarian parenting style (observed when parents use commands excessively or are negative and less than responsive to child initiated interests) is associated with a substantial drop in children's intelligence and subsequent school achievement . In such cases, children should also be referred for early stimulation programs such as Head Start or a quality day care or preschool program. 

PCMH Standard 2, Element C: Comprehensive Health Assessment, Factor 2: Practice conducts and documents a health assessment including family, social, cultural characteristics.

A depression diagnosis that warrants treatment or treatment change, needs at least one of the first two questions endorse as positive (little pleasure, feeling depressed) indicating the symptom has been present more than half the time in the past two weeks.

 

In addition the tenth question about difficulty at work or home or getting along with others should be answered at least "somewhat difficult".

 

When a depression diagnosis has been made patient preferences should be considered, especially when choosing between treatment recommendations of antidepressant treatment and psychotherapy.

A depression diagnosis that warrants treatment or treatment change, needs at least one of the first two questions endorse as positive (little pleasure, feeling depressed) indicating the symptom has been present more than half the time in the past two weeks.

 

In addition the tenth question about difficulty at work or home or getting along with others should be answered at least "somewhat difficult".

 

When a depression diagnosis has been made patient preferences should be considered, especially when choosing between treatment recommendations of antidepressant treatment and psychotherapy.

The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past two weeks. The PHQ-2 includes the first two items of the PHQ-9.

 

The purose of the PHQ-2 is not to establish a final diagnosis or to monitor depression severity, but rather to screen for depression in a "first step" approach.

 

Patients who screen positive should be further evaluated with the PHQ-9 to determine whether they meet criteria for a depressive disorder.