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13 TFAH • WBT • PaininTheNation.org and Rescue, 81 is a tool that can assist healthcare systems with opioid misuse prevention. Search and Rescue provides a one-minute opioid risk assessment, continuing education courses on opioid prescribing and helps providers find local opioid treatment programs where they can refer patients. Other resources include the AHA, Catholic Health Association and America's Essential Hospitals, which have all issued guidance to help hospitals and emergency departments respond to the opioid crisis and integrate and support mental health. 82,83,84 CDC and AHA have also developed a prescription opioid handout to facilitate communication between providers and patients about the risks and side effects of opioids, and what patients should do when prescribed opioids. 85 Healthcare systems are also implementing risk-reduction practices such as requiring patients to show identification prior to dispensing opioids, prohibiting dispensing of certain medication in the office setting (i.e., requiring pick up at a separate pharmacy), and requiring patients with high patterns of receiving prescriptions from multiple providers to be "locked-in" to using a single pharmacy to monitor and coordinate the safety of their prescriptions. To prevent the diversion of opioids for illicit use, healthcare systems are also working to ensure that onsite or partner pharmacies have appropriate control processes in place to ensure all medications are secure. 86 NATIONAL PRINCIPLES OF CARE FOR SUBSTANCE USE In 2017, the public-private Substance Use Treatment Task Force, which was created by the organization Shatterproof to ensure all Americans with a substance use disorder have access to treatment based on proven research, issued National Principles of Care for Substance Use. 87 Based on core concepts from the Surgeon General's Report on Alcohol, Drugs, and Health, the task force advocates for: 1. Routine screening in every medical setting 2. A personal plan for every patient 3. Fast access to treatment 4. Disease management that includes long-term outpatient care 5. Coordinated care for every illness 6. Behavioral health care from legitimate providers 7. Medication-assisted treatment 8. Support for recovery outside the doctor's office 88 These principles have been endorsed by more than 300 experts in the field, as well as by the federal agencies with primary responsibility for addiction policy: SAMHSA, the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), CDC, FDA, and the Centers for Medicare and Medicaid Services (CMS). 89

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