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Addictions, Drug & Alcohol Institute > Education on Medications for Opioid and Alcohol Use Disorder & Shared Decision-Making Tools (SB 6228)

Education on Medications for Opioid and Alcohol Use Disorder & Shared Decision-Making Tools (SB 6228)

From the Alcohol Use Disorder Patient Decision Aid

In 2024, the Washington State legislature passed Senate Bill 6228, a law that establishes new standards for substance use disorder treatment.

Those standards include the requirement that behavioral health agencies (BHAs) treating alcohol or opioid use disorder educate patients about all clinically appropriate FDA-approved medication options, support patients’ informed medication choices, and use shared decision-making tools with patients, such as those developed by the UW Addictions, Drug & Alcohol Institute (ADAI).

Read more about SB 6228 requirements

Licensed or certified Behavioral Health Agencies (BHAs) treating patients for opioid use disorder or alcohol use disorder, whether inpatient or outpatient, shall provide:

  • Education on all FDA‑approved medications clinically appropriate for the patient
  • Education that is unbiased and in accordance with shared decision-making and informed consent standards
  • Support for the patient’s chosen medication, either by direct provision or a warm handoff to a provider who can prescribe/dispense

To support this requirement, BHAs may use patient shared decision-making tools for opioid and alcohol use disorders developed by the Addictions, Drug, and Alcohol Institute (ADAI).

Note: BHAs are NOT REQUIRED to use ADAI's shared decision-making tools; they may use their own educational materials as outlined in RCW 71.24.037(10)(a).

Enforcement & Restrictions

According to RCW 71.24.037(10)(b)(c)(d), BHAs that do not meet the education requirement may not treat patients for opioid use disorder or alcohol use disorder, nor advertise that they do so. Failure to meet education requirements may be used as evidence demonstrating breach of duty to secure informed consent and subject to disciplinary action[TW4.1]. Hospital-based BHAs are exempt.

Access ADAI’s Shared Decision Making Tools
Alcohol Use Disorder tools (available now!) | ADAI Opioid Use Disorder tools (coming soon!)

What is shared decision-making and how does it help?

Shared decision-making is a collaborative process in which clients and clinicians make health decisions together. It considers the best available scientific evidence and client preferences so clients can make informed decisions that fit their personal needs and preferences.

Studies show that people who receive treatments that match their personal preferences and values often have better outcomes, like reduced substance use.

Shared decision-making includes the following steps:

  1. Supporting clients so they feel informed and not left to make decisions alone.
  2. Explaining that different options will be reviewed together as a team.
  3. Describing available options based on scientific research; reviewing pros, cons, and which options are equal; and ensuring understanding. Decision aids, like the ADAI tools, can help.
  4. Exploring what matters to clients and helping to align their personal preferences with options.
  5. Agreeing on a plan based on client preferences.
  6. Following up to see how things are going and adjust as needed.

Why use the ADAI tools?

The ADAI tools:

  • Meet SB 6228 requirements
  • Use evidence-based, accurate, plain language information
  • Are informed by researchers, clinical experts, and people with lived experience
  • Are appropriate for clinical and non-clinical BHA staff involved in patient education
  • Are not clinical instruments and do not require licensure
  • Were developed in partnership with WA State Health Care Authority and Department of Health

How to access and use the ADAI tools

Finding your path: Options for thinking about your drinking
Alcohol Use Disorder Patient Decision Aid

The ADAI shared decision-making tools are designed to give BHAs flexibility in how and when to use them, including at intake, during treatment planning, in ongoing medication discussions, and during discharge planning.

The tools include a printable medications handout with a summary and comparison of evidence-based medication options, and an interactive online decision aid that helps clients explore options that best fit their needs and preferences.

Trained non-clinical staff can use the decision aids to help clients understand and compare treatment and support options, identify what matters most to the clients, and connect them with next steps.

Alcohol Use Disorder Tools (available now!)

Opioid Use Disorder Tools (coming in late 2026!)

What trainings and technical assistance will be offered?

ADAI will offer free trainings with continuing education credits through a variety of methods, including live online trainings, in-person trainings, and self-paced recorded online modules.

ADD LINK TO WHERE TRAINING OPPS WILL BE LISTED

Billing and coding

Using shared decision-making tools is not considered a separate billable Medicaid service. The inclusion of these tools and the time it takes to administer them can be billed as part of SUD brief intervention, assessment services, and/or on-going treatment services such as individual therapy sessions.

Have questions or feedback?

If you would like further support and technical assistance after completing a training, or have questions or feedback, reach out to SharedDecisionMaking@uw.edu.