PCSS Topics and Design
The PCSS is designed to offer support to clinicians
on the following topics:
1. Patient Assessment
Selection for office-based opioid treatment
Considerations of appropriateness for opioid maintenance
Considerations of appropriateness for opioid withdrawal
The use of DSM-IV checklists and opioid withdrawal scales
Pharmacologic withdrawal follow-up procedures
2. Induction
Induction methods
Physician or nurse availability during induction and early stabilization
3. Dosing and patient monitoring
Buprenorphine dosing
Appropriate use of ancillary medications
Frequency of monitoring
Complications and treatment of complications
Timing and processes of referrals to higher levels of care
4. Treatment of poly-substance dependence or co-morbid conditions, including
Psychiatric conditions
Medical conditions, especially Hepatitis C
5. Issues related to treatment of special populations
Adolescents
Pregnant patients
Elderly
HIV/AIDS, including HIV and HCV screening, counseling, and referrals
Pain
6. Development of support and referral networks
Involvement of nurse, non-physician health professionals, pharmacists, and certified alcohol and other drug abuse counselors
Collaboration with opioid treatment programs
Integrating counseling and urine toxicology testing into the treatment regimen
Involvement of family members and significant others
Patient and family education for appropriate expectations on symptom decrease and treatment outcomes
7. Use of non-pharmacologic strategies
Motivational counseling
Limit setting
Appropriate use of contingencies
Use of 12-step and other self-help programs
8. Patient tracking
Tracking procedures
Recommended visit schedules
9. Office logistics
Staff education
Paper work:
Screening and initial follow-up visit forms
Coding with proper CPT codes, and billing
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