Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System

Bertha K. Madras; N. Jia Ahmad; Jenny Wen; Joshua Sharfstein

doi:10.31478/202004b

journal article Apr 27, 2020

Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System

Bertha K. Madras N. Jia Ahmad Jenny Wen Joshua Sharfstein

NAM Perspectives · National Academy of Medicine

View at Publisher Save 10.31478/202004b

Topics

No keywords indexed for this article. Browse by subject →

References

154

[1]

1. U.S. Centers for Disease Control and Prevention. 2018. Evidence-based strategies for preventing opioid overdose: What’s working in the United States. http://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf (accessed January 23, 2020).

[2]

2. Substance Abuse and Mental Health Services Administration. 2018. Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report (accessed January 23, 2020). 10.1037/e501902006-001

[3]

3. Hser, Y. I., L. J. Mooney, A. J. Saxon, K. Miotto, D. S. Bell, Y. Zhu, D. Liang, and D. Huang. 2017. High mortality among patients with opioid use disorder in a large healthcare system. Journal of Addiction Medicine 11(4):315-319. https://doi.org/10.1097/ADM.0000000000000312. 10.1097/adm.0000000000000312

[4]

4. Hser, Y. I., A. J. Saxon, L. J. Mooney, K. Miotto, Y. Zhu, C. K. Yoo, D. Liang, D. Huang, and D. S. Bell. 2019. Escalating opioid dose is associated with mortality: A comparison of patients with and without opioid use disorder. Journal of Addiction Medicine 13(1):41-46. https://doi.org/10.1097/ADM.0000000000000458. 10.1097/adm.0000000000000458

[5]

5. National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press. https://doi.org/10.17226/25310. 10.17226/25310

[6]

6. Connery, H. S. 2015. Medication-assisted treatment of opioid use disorder: Review of the evidence and future directions. Harvard Review of Psychiatry 23(2):63-75. https://doi.org/10.1097/HRP.0000000000000075. 10.1097/hrp.0000000000000075

[7]

7. Sordo, L., G. Barrio, M. J. Bravo, B. I. Indave, L. Degenhardt, L. Wiessing, M. Ferri, and R. Pastor-Barriuso. 2017. Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. British Medical Journal 357:j1550. https://doi.org/10.1136/bmj.j1550. 10.1136/bmj.j1550

[8]

8. Krupitsky, E., E. V. Nunes, W. Ling, A. Illeperuma, D. R. Gastfriend, and B. L. Silverman. 2011. Injectable extended-release naltrexone for opioid dependence: A double-blind, placebo-controlled, multicentre randomised trial. The Lancet 377:1506-1513. https://doi.org/10.1016/S0140-6736(11)60358-9. 10.1016/s0140-6736(11)60358-9

[9]

9. Mojtabai, R., C. Mauro, M. M. Wall, C. L. Barry, and M. Olfson. 2019. Medication treatment for opioid use disorders in substance use treatment facilities. Health Affairs 38(1):14-23. https://doi.org/10.1377/hlthaff.2018.05162. 10.1377/hlthaff.2018.05162

[10]

10. Jones, C. M., D. J. Byrd, T. J. Clarke, T. B. Campbell, C. Ohuoha, and E. F. McCance-Katz. 2019. Characteristics and current clinical practices of opioid treatment programs in the United States. Drug and Alcohol Dependence 205:107616. https://doi.org/10.1016/j.drugalcdep.2019.107616. 10.1016/j.drugalcdep.2019.107616

[11]

11. Clemans-Cope, L., V. Lynch, E. Winiski, and M. Epstein. 2019. State variation in Medicaid prescriptions for opioid use disorder from 2011 to 2018. Urban Institute. https://www.urban.org/sites/default/files/publication/100817/2019.08.19_av_state_medicaid_rx_oud_final_v3_4.pdf (accessed January 16, 2020).

[12]

12. Kennedy-Hendricks, A., C. L. Barry, S. E. Gollust, M. E. Ensminger, M. S. Chisolm, and E. E. McGinty. 2017. Social stigma toward persons with prescription opioid use disorder: Associations with public support for punitive and public health-oriented policies. Psychiatric Services 68(5):462-469. https://doi.org/10.1176/appi.ps.201600056. 10.1176/appi.ps.201600056

[13]

13. Sattler, S., A. Escande, E. Racine, and A. S. Göritz. 2017. Public stigma toward people with drug addiction: A factorial survey. Journal of Studies on Alcohol and Drugs 78(3):415-425. https://doi.org/10.15288/jsad.2017.78.415. 10.15288/jsad.2017.78.415

[14]

14. Hammarlund, R., K. A. Crapanzano, L. Luce, L. Mulligan, and K. M. Ward. 2018. Review of the effects of self-stigma and perceived social stigma on the treatment-seeking decisions of individuals with drug- and alcohol-use disorders. Substance Abuse and Rehabilitation 9:115-136. https://doi.org/10.2147/SAR.S183256. 10.2147/sar.s183256

[15]

15. van Boekel, L.C., E. P. Brouwers, J. van Weeghel, and H. F. Garretsen. 2013. Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence 131:23-35. https://doi.org/10.1016/j.drugalcdep.2013.02.018. 10.1016/j.drugalcdep.2013.02.018

[16]

16. Wakeman, S. E., G. Pham-Kanter, and K. Donelan. 2016. Attitudes, practices, and preparedness to care for patients with substance use disorder: Results from a survey of general internists. Substance Abuse 37(4):635-641. https://doi.org/10.1080/08897077.2016.1187240. 10.1080/08897077.2016.1187240

[17]

17. Haffajee, R. L., A. S. B. Bohner, and P. A. Lagisetty. 2018. Policy pathways to address provider workforce: Barriers to buprenorphine treatment. American Journal of Preventive Medicine 54:S230-S242. https://doi.org/10.1016/j.amepre.2017.12.022. 10.1016/j.amepre.2017.12.022

[18]

Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma

Valerie Earnshaw, Laramie Smith, Michael Copenhaver

International Journal of Mental Health and Addicti... 10.1007/s11469-012-9402-5

[19]

19. Brondani, M. A., R. Alan, and L. Donnelly. 2017. Stigma of addiction and mental illness in healthcare: The case of patients' experiences in dental settings. PLOS ONE 12(5):e0177388. https://doi.org/10.1371/journal.pone.0177388. 10.1371/journal.pone.0177388

[20]

20. Sharfstein, J. M., and Y. Olsen. 2019. Making amends for the opioid epidemic. JAMA 321(15):1446-1447. https://doi.org/10.1001/jama.2019.3505. 10.1001/jama.2019.3505

[21]

21. Albright, J., R. Ciaverelli, A. Essex, J. Tkacz, and C. Ruetsch. 2010. Psychiatrist characteristics that influence use of buprenorphine medication-assisted treatment. Journal of Addiction Medicine 4(4):197-203. https://doi.org/10.1097/ADM.0b013e3181c816f3. 10.1097/adm.0b013e3181c816f3

[22]

22. Arfken, C. L., C. E. Johanson, S. Di Menza, and C. Roberts Schuster. 2010. Expanding treatment capacity for opioid dependence with office-based treatment with buprenorphine: National surveys of physicians. Journal of Substance Abuse Treatment 39(2):96-104. https://doi.org/10.1016/j.jsat.2010.05.004. 10.1016/j.jsat.2010.05.004

[23]

23. Huhn, A. S., and K. E. Dunn. 2017. Why aren’t physicians prescribing more buprenorphine? Journal of Substance Abuse Treatment 78:1-7. https://doi.org/10.1016/j.jsat.2017.04.005. 10.1016/j.jsat.2017.04.005

[24]

24. Lowenstein, M., A. Kilaru, J. Perrone, J. Hemmons, D. Abdel-Rahman, Z. F. Meisel, and M. K. Delgado. 2019. Barriers and facilitators for emergency department initiation of buprenorphine: A physician survey. American Journal of Emergency Medicine 37(9):1787-1790. https://doi.org/10.1016/j.ajem.2019.02.02. 10.1016/j.ajem.2019.02.025

[25]

25. Madden, E. F. 2019. Intervention stigma: How medication-assisted treatment marginalizes patients and providers. Social Science & Medicine 232:324-331. https://doi.org/10.1016/j.socscimed.2019.05.027. 10.1016/j.socscimed.2019.05.027

[26]

26. Olsen, A., B. Lawton, R. Dwyer, M. W. Taing, K. L. J. Chun, S. Hollingworth, and S. Nielsen. 2019. Why aren’t Australian pharmacists supplying naloxone? Findings from a qualitative study. International Journal of Drug Policy 69:46-52. https://doi.org/ 10.1016/j.drugpo.2019.03.020. 10.1016/j.drugpo.2019.03.020

[27]

27. Thompson, E. L., P. S. S. Rao, C. Hayes, and C. Purtill. 2019. Dispensing naloxone without a prescription: Survey evaluation of Ohio pharmacists. Journal of Pharmacy Practice 32(4):412-421. https://doi.org/10.1177/0897190018759225. 10.1177/0897190018759225

[28]

28. Bagley, S. M., S. E. Hadland, B. L. Carney, and R. Saitz. 2017. Addressing stigma in medication treatment of adolescents with opioid use disorder. Journal of Addiction Medicine 11(6):415-416. https://doi.org/10.1097/adm.0000000000000348. 10.1097/adm.0000000000000348

[29]

29. Hadland, S. E., T. W. Park, and S. M. Bagley. 2018. Stigma associated with medication treatment for young adults with opioid use disorder: A case series. Addiction Science & Clinical Practice 13(1):15. https://doi.org/10.1186/s13722-018-0116-2. 10.1186/s13722-018-0116-2

[30]

30. Hadland, S. E., S. M. Bagley, J. Rodean, M. Silverstein, S. Levy, M. R. Larochelle, J. H. Samet, and B. T. Zima. 2018. Receipt of timely addiction treatment and association of early medication treatment with retention in care among youths with opioid use disorder. JAMA Pediatrics 172(11):1029-1037. https://doi.org/10.1001/jamapediatrics.2018.2143. 10.1001/jamapediatrics.2018.2143

[31]

31. Livingston, J. D., T. Milne, M. L. Fang, and E. Amari. 2012. The effectiveness of interventions for reducing stigma related to substance use disorders: A systematic review. Addiction 107(1):39-50. https://doi.org/10.1111/j.1360-0443.2011.03601.x. 10.1111/j.1360-0443.2011.03601.x

[32]

32. McGinty, E. E., H. H. Goldman, B. Pescosolido, and C. L. Barry. 2015. Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination. Social Science & Medicine 126:73-85. https://doi.org/10.1016/j.socscimed.2014.12.010. 10.1016/j.socscimed.2014.12.010

[33]

33. Yoast, R. A., W. J. Filstead, B. B. Wilford, S. Hayashi, J. Reenan, and J. Epstein. 2008. Teaching about substance abuse. Virtual Mentor 10(1):21-9. https://doi.org/10.1001/virtualmentor.2008.10.1.medu1-0801. 10.1001/virtualmentor.2008.10.1.medu1-0801

[34]

34. Accreditation Council for Graduate Medical Education. ACGME common program requirements. https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements (accessed January 23, 2020).

[35]

35. Mendoz, S., A. S. Rivera-Cabrero, and H. Hansen. 2016. Shifting blame: Buprenorphine prescribers, addiction treatment, and prescription monitoring in middle-class America. Transcult Psychiatry 53(4):465-487. https://doi.org/10.1177/1363461516660884. 10.1177/1363461516660884

[36]

36. Suzuki, J., H. S. Connery, T. V. Ellison, and J. A. Renner. 2014. Preliminary survey of office-based opioid treatment practices and attitudes among psychiatrists never receiving buprenorphine training to those who received training during residency. American Journal on Addictions 23:618-622. https://doi.org/10.1111/j.1521-0391.2014.12143.x. 10.1111/j.1521-0391.2014.12143.x

[37]

37. U.S. Preventive Services Task Force. 2019. Draft recommendation statement: Illicit drug use, including nonmedical use of prescription drugs: Screening. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/drug-use-in-adolescents-and-adults-including-pregnant-women-screening (accessed January 23, 2020). 10.7326/m14-0334

[38]

Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later

Bertha K. Madras, Wilson M. Compton, Deepa Avula et al.

Drug and Alcohol Dependence 10.1016/j.drugalcdep.2008.08.003

[39]

39. Ram, A., and M. S. Chisolm. 2016. The time is now: Improving substance abuse training in medical schools. Academic Psychiatry 40(3):454-460. https://doi.org/10.1007/s40596-015-0314-0. 10.1007/s40596-015-0314-0

[40]

40. Suzuki, J., T. V. Ellison, H. S. Connery, C. Surber, and J. A. Renner. 2016. Training in buprenorphine and office-based opioid treatment: A survey of psychiatry residency training programs. Academic Psychiatry 40(3):498-502. https://doi.org/10.1007/s40596-015-0313-1. 10.1007/s40596-015-0313-1

[41]

41. Hoge, M. A., G. W. Stuart, J. Morris, M. T. Flaherty, M. Paris, and E. Golperud. 2013. Mental health and addiction workforce development: Federal leadership is needed to address the growing crisis. Health Affairs 32(11):2005-2012. https://doi.org/10.1377/hlthaff.2013.0541. 10.1377/hlthaff.2013.0541

[42]

42. Fleischauer, A. T., L. Ruhl, S. Rhea, and E. Barnes. 2017. Hospitalizations for endocarditis and associated health care costs among persons with diagnosed drug dependence—North Carolina, 2010-2015. Morbidity and Mortality Weekly Report 66(22):569-573. http://dx.doi.org/10.15585/mmwr.mm6622a1external icon. 10.15585/mmwr.mm6622a1

[43]

43. Substance Abuse and Mental Health Services Administration. 2019. Common comorbidities. https://www.samhsa.gov/medication-assisted-treatment/treatment/common-comorbidities (accessed January 23, 2020).

[44]

44. National Institute on Drug Abuse. 2012. Adoption of NIDA’s evidence-based treatments in real world settings—A National Advisory Council on Drug Abuse Workgroup report. Available at: https://www.drugabuse.gov/sites/default/files/files/evidence-based_treatments_in_real_world_settings_workgroup_report.pdf (accessed January 23, 2020).

[45]

45. Madras, B. K., and H. Connery. 2019. Psychiatry and the opioid overdose crisis. Focus 17:128-133. https://doi.org/10.1176/appi.focus.20190003. 10.1176/appi.focus.20190003

[46]

46. Ling, W., V. R. Nadipelli, N. A. Ronquest, V. A. Albright, A. P. Aldridge, S. M. Learned, V. Mehra, and C. Heidbreder. 2018. Remission from chronic opioid use—Studying environmental and socio-economic factors on recovery (RECOVER): Study design and participant characteristics. Contemporary Clinical Trials 76:93-103. https://doi.org/10.1016/j.cct.2018.11.015. 10.1016/j.cct.2018.11.015

[47]

47. Barnett, M. L., L. Dennis, and R. G. Frank. 2019. In rural areas, buprenorphine waiver adoption since 2017 driven by nurse practitioners and physician assistants. Health Affairs 38(12):2048-2056. https:// 10.1377/hlthaff.2019.00859. 10.1377/hlthaff.2019.00859

[48]

48. Pathman, D. E., T. R. Konrad, T. S. King, D. H. Taylor, and G. G. Koch. 2004. Outcomes of states’ scholarships, loan repayment, and related programs for physicians. Medical Care 42(6):560-569. https://doi.org/10.1097/01.mlr.0000128003.81622.ef. 10.1097/01.mlr.0000128003.81622.ef

[49]

49. Krawczyk, N., K. A. Feder, M. I. Fingerhood, and B. Saloner. 2017. Racial and ethnic differences in opioid agonist treatment for opioid use disorder in a U. S. national sample. Drug and Alcohol Dependence 178:512-518. https://doi.org/10.1016/j.drugalcdep.2017.06.009. 10.1016/j.drugalcdep.2017.06.009

[50]

50. Beetham, T., B. Saloner, S. E. Wakeman, M. Gaye, and M. L. Barnett. 2019. Access to office-based buprenorphine treatment in areas with high rates of opioid-related mortality: An audit study. Annals of Internal Medicine 171(1):1-9. https://doi.org/10.7326/M18-3457. 10.7326/m18-3457

Showing 50 of 154 references

Cited By

146

Qualitative Assessment of Barriers to Buprenorphine Access: The Role of Pharmacies

Siara I. Sitar, Courtney R. Yarbrough · 2024

Substance Use & Misuse

Linkage facilitation for opioid use disorder in criminal legal system contexts: a primer for researchers, clinicians, and legal practitioners

Milan F. Satcher, Steven Belenko · 2024

Health & Justice

Community-Based Cluster-Randomized Trial to Reduce Opioid Overdose Deaths

· 2024

New England Journal of Medicine

Reducing overdose deaths among persons with opioid use disorder in connecticut

Joy D. Scheidell, Tarlise N. Townsend · 2024

Harm Reduction Journal

Metrics

146

Citations

154

References

Details

Published: Apr 27, 2020

Authors

B

Bertha K. Madras

McLean Hospital and Harvard Medical School

N

N. Jia Ahmad

Johns Hopkins Bloomberg School of Public Health

J

Jenny Wen

Johns Hopkins University School of Medicine

J

Joshua Sharfstein

Johns Hopkins Bloomberg School of Public Health

Cite This Article

Bertha K. Madras, N. Jia Ahmad, Jenny Wen, et al. (2020). Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System. NAM Perspectives. https://doi.org/10.31478/202004b

Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System

You May Also Like