Resources for Medical Providers

In order to participate in the continuing education program, you will need to create an IN-TRAIN account if you do not already have one.

Currently, there are no Continuing Education Courses offered by the IDOH Oral Health Program; however, there are 4 Non-CE Courses provided by the Oral Health Program.

Continuing Education Courses on IN-TRAIN

Health Equity: the pursuit of an equal opportunity for all people to achieve their best possible health.

• Introduction to Health Equity & Racial Justice - Course ID 1100784
• Achieving Health Equity - Course ID 1100159
• Addressing Health Equity: A Public Health Essential - Course ID 1041931

Disparities in Oral Health by community: the inequalities that occur in the provision of healthcare and access to healthcare across different racial, ethnic and socioeconomic groups.

• Measuring Health Disparities - Course ID 1087494
• Rural Health: Exploring The Growing Disparities - Course ID 1078208
• Serving Diverse Communities: Finding Data on Health Disparities - Course 1079670

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What is medication-assisted treatment?

• Medication-assisted treatment (MAT) is the use of FDA-approved medications, along with appropriate counseling and behavioral therapy, to treat substance use disorder and sustain recovery.

Physician training and education on MAT

• For a physician to be eligible to prescribe or dispense buprenorphine for the purpose of MAT, he or she must qualify, apply for a physician waiver, and complete an eight-hour buprenorphine waiver training.
• Residential Substance Abuse Treatment (RSAT) Training Tool: Medication-assisted treatment (MAT) for offender populations provides evidence-based information on the application and effectiveness of MAT among the offender population during incarceration and as they are released and re-enter the community.
• The Addiction Technology Transfer center (ATTC) provides online training designed to enhance professionals’ knowledge and skills related to MAT and increasing the use of MAT.
• Substance Abuse and Mental Health Services Administration’s (SAMHSA) Medication-Assisted Treatment of Opioid Use Disorder Pocket Guide provides physicians with information on approved medications, screening and assessment tools, and best practices for patient care.
• Webinars and educational videos provided by Providers Clinical Support System.

Visit the SAMHSA website or call SAMHSA at 1-866-BUP-CSAT (1-866-287-2728) for more information about physician waiver qualifications, treatment training in your area or to obtain a waiver.

Opioid ECHO Project

• The Opioid ECHO project is a free partnership between local primary care providers and a team of specialists from Indiana University (IU). It aims to improve the treatment of opioid use disorder in rural and underserved areas by educating primary care clinicians through virtual video-conferencing to provide specialty care services.
  • IU will conduct three separate ECHO clinics for the following disciplines: prescribers, behavioral health specialists, and community health workers/peer recovery workers.
  • Each clinic has a curriculum that is 12 sessions long. After the curriculum is completed, the clinic will restart at the beginning with a new cohort of participants.
  • Visit the Opioid ECHO Project website if you are interested in joining.

Additional MAT Resources

• Physicians must confirm that that they will not prescribe buprenorphine to more than 100 patients during the first year of obtaining their buprenorphine waiver. Following the first year, physicians can apply for approval to treat up to 275 patients. Learn more on applying to increase patient limits after the first year.
• Unlike physicians, pharmacists do not need a buprenorphine waiver to dispense buprenorphine. No additional credentials are required for a pharmacist to dispense a schedule III substance, such as buprenorphine. However, when the medication has been prescribed they are required to go to the Buprenorphine Pharmacy Lookup and verify the prescribing physician’s buprenorphine certification. Learn more about verifying physician waivers for pharmacists.
• As of 2020, there are 18 opioid treatment programs (OTPs) in the state of Indiana (demonstrated by the dark blue pins on the map). To find an OTP, visit https://www.in.gov/recovery/.​

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Between 1999 and 2020, drug overdose deaths increased by 319 percent in Indiana. The recent surge in the supply of illicit fentanyl is contributing to the rapid rise of drug overdose deaths. This highlights the need for timely and accurate data to monitor changes in the types of opioids involved in overdose deaths.

The Indiana Department of Health’s (IDOH’s) ability to respond quickly and appropriately to the drug overdose epidemic depends on complete and timely data. Historically, drug overdose deaths have too often been classified on death certificates as resulting from “multi-drug toxicity” or simply “drug overdose” without specifying the drug that caused the fatal overdose. Comprehensive toxicology testing is essential to properly identify which drugs, specifically opioids, are associated with overdose deaths.

IDOH is improving fatal drug overdose reporting by funding standardized toxicology testing on suspected drug overdose deaths. Under Indiana Code 36-2-14-6 (b), all Indiana coroners are required to conduct toxicology screenings to gather information on suspected controlled substances in fatal overdose cases.

Coroners must take the following steps if they reasonably suspect the cause of a person’s death to be an overdose of a controlled substance, whether it was accidental or intentional:

1. Obtain any relevant information about the decedent maintained from the INSPECT program;
2. Extract and test certain bodily fluids of the decedent;
3. Report test results to IDOH; and
4. Provide the department notice of the decedent's death, including any information related to the controlled substances involved, if any.

This legislation has enhanced the state's ability to respond quickly and appropriately to control the drug overdose epidemic by providing more rapid, consistent and extensive data.

As part of this new law, coroners will also be required to create an account to access the INSPECT records of a person who has died of a suspected drug overdose. An INSPECT report summarizes the controlled substances a patient has been prescribed, the practitioner who prescribed them, and the dispensing pharmacy where the patient obtained them. To read more about INSPECT, visit the website and scroll down to the section on Law Enforcement utilizing INSPECT to review the policies regarding coroners and law enforcement.

If you have questions about the toxicology program, please email indianatrauma@health.in.gov or contact the Trauma and Injury Prevention Division director, Brian Busching, at BBusching@health.in.gov or 317-234-2865.

Toxicology Reports

The reports below have been created by partners at the Wayne State University Center for Behavioral Health and Justice.

2019 Multi-Drug Toxicology Report
2020 Multi-Drug Toxicology Report

Overview

To more rapidly detect overdose outbreaks or sharp increases in overdose deaths, IDOH will be partnering with coroners to collect preliminary data on suspected overdose deaths (i.e., deaths suspected to involve substances before receipt of forensic toxicology data). Awarded coroners have been asked to provide information on the decedent within a month of the date of death. The data requested includes background on the drug overdose scene and minimal identifiable information on the decedent. IDOH will collect this information using the Coroner Case Management System (CCMS), a repository in which coroners can manage their cases.

Suspected Drug Overdose Case Definition

A fatal drug overdose is confirmed by positive toxicology results and is certified by a coroner/medical examiner as such. In order to quickly identify possible overdoses before confirmed toxicology results, we ask that coroners report cases if they meet the following case definition:

• Drug paraphernalia suggestive of use was found at/around the scene OR
• Clinical evidence suggestive of an opioid overdose including pulmonary/cerebral edema, bladder distension, pinpoint pupils, injections sites, foam cone, etc. OR
• Unexpected death with a diagnosis of substance use disorder OR
• Evidence of stimulant overdose including seizures and multiple organ failures resulting from heatstroke OR
• Any other evidence indicative of a drug overdose/prior overdose.

Within CCMS, IDOH will be using the following variables to track suspected overdose deaths:

Coroners must complete these fields in CCMS when filling out cases for each decedent. Instructions on completing this can be found here.

Death Investigation Guide

Click here for additional guidance on detecting a drug overdose on scene.