Medication-Assisted Treatment for Opioid Use Disorder Proceedings of a Workshop–in Brief (2018) / Chapter Skim
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Medication-Assisted Treatment for Opioid Use Disorder: Proceedings of a Workshop - in Brief
Medication-Assisted Treatment for Opioid Use Disorder: Proceedings of a Workshop - in Brief
Pages 1-10
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Medications are irrefutably the most effective way to treat OUD -- reducing the likelihood of overdose death by up to three-fold -- but fewer than half of patients receive them due to stigma and structural barriers, and treatment retention is poor, she said. NIDA is focusing on implementation science and service delivery research to expand access to MAT in the health care and criminal justice systems.
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Judith Steinberg explained that HRSA supports health centers in implementing a patient-centered medical home model of care for OUD that integrates behavioral and psychosocial health interventions. The agency also supports workforce development and rural service delivery through telehealth modalities and is working to integrate treatment for OUD into primary care.
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In Vermont, the per capita rate of health care expenditures (excluding OUD treatment costs) for people on MAT has declined steadily over the past decade and the expansion of access to MAT has helped stabilize overdose rates.
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Medical students today tend to be committed to social justice issues and eager to take on the task of ending the OUD epidemic, she said, and making education on addiction care a core requirement would bolster those efforts. Stephen Patrick, Vanderbilt University, discussed ways to improve outcomes for pregnant women, babies, and adolescents.
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Health Care Delivery, Payment Approaches, and Economics Measures The second panel explored the opportunities and barriers related to health care delivery, payment approaches, and economics measures to improve the treatment of OUD. The objectives were to discuss how health care access and delivery impact patient access to medications to treat OUD; consider regulations around hospital capacity, administrative burdens, and the tight regulation of medical products; explore the cost, reimbursement, and coverage of medications to treat OUD and discuss measures to help facilitate quality improvement and access; and examine the regulatory differences of for-profit versus nonprofit treatment providers.
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The model aims to reimburse appropriately through a one-time initial payment to cover treatment initiation followed by ongoing monthly payments for medical, psychological, and social support services. She explained that some providers offer fully integrated care under one roof, while others join formal collaborative care arrangements.
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KNOWLEDGE GAPS, FUTURE RESEARCH, AND POTENTIAL POLICY CHANGES The fourth session focused on knowledge gaps, future research, and next steps. As in previous sessions, speakers addressed a mix of interconnected topics, speaking both of the need to take immediate action to help those now suffering from OUD, as well as the need to advance understanding of how best to deliver and increase access to MAT.
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She added that evidence should be used to eliminate the policies and practices that do not work -- for example, detoxification without medication and barriers to buprenorphine delivery. Nickel suggested using multidisciplinary approaches to investigate various combinations of medications and psychosocial interventions to treat OUD of different severity levels.
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1997. Treatment retention and follow-up outcomes in the drug abuse treatment outcome study (datos)
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REVIEWERS: To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Workshop -- in Brief was reviewed by Gavin Bart, University of Minnesota; Anand Kumar, University of Illinois at Chicago; Maia Szalavitz, American reporter and author; and Stephen Patrick, Vanderbilt University. Lauren Shern, National Academies of Sciences, Engineering, and Medicine, served as the review coordinator.
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