Tackling Overdose with Networks (TOWN)

Tackling Overdose with Networks (TOWN) is a clinic-based model promoting an approach that includes multiple strategies to reduce opioid overdose within communities by:

• Increasing access to Medication for Opioid Use Disorder (MOUD) also known as Medication-Assisted Treatment (MAT).
• Increasing community care coordination and prevention efforts.

TOWN Program Strategies

• Designating a care coordinator/navigator to manage the relationship between the health care system and patients.
• Appointing a provider champion to strengthen capacity, expand access within the clinic and neighboring clinics and support long-term sustainability.  
• Delivering continuous technical guidance and support to medical providers considering prescribing medication for opioid use disorder (MOUD).
• Provide short term, low threshold telehealth access for MOUD bridging and comprehensive assessments to patients.
• Creating opportunities to partner with established community task forces that bring together behavioral health professionals, law enforcement, EMS, public health agencies, and a range of non-profit and for-profit organizations.
• Support Naloxone distribution within the clinic and the community.
• Integrate the Prescription Monitoring Program into clinical workflows.
• Implement multidisciplinary care teams focused on the management of controlled substances.  

TOWN Participating Clinics

Map of TOWN Grantees

TOWN Program Resources

• TOWN Evaluation Summary- Model Implementation and Best Practices (PDF)

• TOWN Evaluation Emergent Outcomes (PDF)

• TOWN Manual (PDF)

Contact health.drugodprev@state.mn.us for further information on TOWN.

TOWN Implementation 

Step 1: Build Internal capacity

1. Identify or hire a nurse care coordinator/navigator who serves as the liaison between patients, administrators, providers, and community shareholders.
2. Designate a provider champion who provides education and support, strengthens capacity, and facilitates long-term opioid stewardship and MOUD program sustainability.   
3. Recognize internal administrative champions who can allocate time and funding to initiate and maintain clinic education around tapering, opioid prescribing, and MOUD best practices. 

Step 2: Create and update activities across the clinic and hospital and formation of partnerships

1. Convene a controlled substance care team (CSCT) to review and monitor opioid prescribing practices and ensure patient safety.
2. Provide education and training for clinic staff to adopt safe opioid prescribing practices and opioid stewardship initiatives.
3. Disseminate education and resources to primary care providers, emergency department, obstetrics, mental health, and surgical services staff to ensure continuity of care and promote safe initiation and management of MOUD.  
4. Provide continuing education multimodally to facilitate and promote communication with internally designated MOUD champions.

Step 3: Combine processes for a reliable system change

1. Identify opportunities to coordinate prevention and referral efforts including but not limited to naloxone distribution.
2. Develop strategies for community outreach and education, such as an opioid focused community coalition to foster relationships with key community shareholders to transition patients to ongoing care and support services available in the community.