Restricted accessResearch articleFirst published online 2024-08
Implementation of Medications for Alcohol and Opioid Use Disorders in a Value-Based Organization-Unlocking Value by Addressing Unmet Needs for Medicaid and Dually-Eligible Beneficiaries
The authors describe a rapid implementation of medication treatment for substance use disorders in a value-based organization, delivered in the community-based, interdisciplinary primary care of Medicaid and dual-eligible members. The determinants of increased need are reviewed, as well as the growing opportunity to improve access to treatments, and a template for implementation is shared.
EdinoffAN, Martinez GarzaD, ViningSP, et al.New synthetic opioids: Clinical considerations and dangers. Pain Ther, 2023; 12(2):399–421; doi: 10.1007/s40122-023-00481-6
4.
O’DonnellJ, GladdenRM, MattsonCL, HunterCT, DavisNL. Vital signs: Characteristics of drug overdose deaths involving opioids and stimulants—24 States and the District of Columbia, January–June 2019. MMWR Morb Mortal Wkly Rep, 2020; 69(35):1189–1197; doi: 10.1558/5/mmwr.mm6935a1
5.
JeffersA, MeehanAA, BarkerJ, et al.Impact of social isolation during the COVID-19 pandemic on mental health, substance use, and homelessness: Qualitative interviews with behavioral health providers. Int J Environ Res Public Health, 2022; 19(19):12120; doi: 10.3390/ijerph191912120
HawkM, CoulterRWS, EganJE, et al.Harm reduction principles for healthcare settings. Harm Reduct J, 2017; 14(1):70; doi: 10.1186/s12954-017-0196-4
8.
Sanchez-RoigeS, KemberRL, AgrawalA. Substance use and common contributors to morbidity: A genetics perspective. eBioMedicine, 2022; 83:104212; doi: 10.1016/j.ebiom.2022.104212
9.
GonzalezA, BarinasJ, O’CleirighC. Substance use: Impact on adherence and HIV medical treatment. Curr HIV/AIDS Rep, 2011; 8(4):223–234; doi: 10.1007/s11904-011-0093-5
10.
VolkowND, FriedenTR, HydePS, ChaSS. Medication-assisted therapies—tackling the opioid-overdose epidemic. N Engl J Med, 2014; 370(22):2063–2066; doi: 10.1056/NEJMp1402780
11.
KampmanK, JarvisM. American Society of Addiction Medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use. J Addict Med, 2015; 9(5):358–367; doi: 10.1097/ADM.0000000000000166
12.
WatkinsKE, OberAJ, LampK, et al.Collaborative care for opioid and alcohol use disorders in primary care: The SUMMIT randomized clinical trial. JAMA Intern Med, 2017; 177(10):1480–1488; doi: 10.1001/jamainternmed.2017.3947
13.
AntonRF, O’MalleySS, CirauloDA, et al.COMBINE Study Research Group. Combined pharmacotherapies and behavioral interventions for alcohol dependence: The COMBINE study: A randomized controlled trial. JAMA, 2006; 295(17):2003–2017; doi: 10.1001/jama.295.17.2003
14.
Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder | Psychiatry and Behavioral Health | JAMA Network Open | JAMA Network. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760032 [Last accessed: November30, 2023].
15.
WangL, WeissJ, RyanEB, WaldmanJ, RubinS, GriffinJL. Telemedicine increases access to buprenorphine initiation during the COVID-19 pandemic. J Subst Abuse Treat, 2021; 124:108272; doi: 10.1016/j.jsat.2020.108272
US Department of Health and Human Services. Office of Inspector General. Geographic disparities affect access to buprenorphine services for opioid use disorder. OEI-12-17-00240. 2020. Available from: https://oig.hhs.gov/oei…; [Last accessed: March17, 2022].
18.
YearbyR, ClarkB, FigueroaJF. Structural racism in historical and modern US health care policy. Health Aff (Millwood), 2022; 41(2):187–194; doi: 10.1377/hlthaff.2021.01466
19.
MadrasBK, AhmadNJ, WenJ, SharfsteinJS. Improving access to evidence-based medical treatment for opioid use disorder: Strategies to address key barriers within the treatment system. NAM Perspect, 2020; 2020; doi: 10.3147/8/202004b10.31478/202004b
MohlmanMK, TanzmanB, FinisonK, PinetteM, JonesC. Impact of medication-assisted treatment for opioid addiction on medicaid expenditures and health services utilization rates in Vermont. J Subst Abuse Treat, 2016; 67:9–14; doi: 10.1016/j.jsat.2016.05.002
22.
SohlerNL, LiX, KuninsHV, et al.Home- versus office-based buprenorphine inductions for opioid-dependent patients. J Subst Abuse Treat, 2010; 38(2):153–159; doi: 10.1016/j.jsat.2009.08.001
23.
McKnightC, WengCA, ReynosoM, KimballS, ThompsonLM, JarlaisDD. Understanding intentionality of fentanyl use and drug overdose risk: Findings from a mixed methods study of people who inject drugs in New York City. Int J Drug Policy, 2023; 118:104063; doi: 10.1016/j.drugpo.2023.104063
24.
HämmigR, KemterA, StrasserJ, et al.Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: The Bernese method. Subst Abuse Rehabil, 2016; 7:99–105; doi: 10.2147/SAR.S109919
25.
León-BarrieraR, ZwiebelSJ, Modesto-LoweV. A practical guide for buprenorphine initiation in the primary care setting. Cleve Clin J Med, 2023; 90(9):557–564; doi: 10.3949/ccjm.90a.23022
26.
AhmedS, BhivandkarS, LonerganBB, SuzukiJ. Microinduction of buprenorphine/naloxone: A review of the literature. Am J Addict, 2021; 30(4):305–315; doi: 10.1111/ajad.13135
27.
ProchaskaJO, DiClementeCC. The transtheoretical approach: Crossing traditional boundaries of therapy. No Title. Published online 1984.
28.
Training courses archive—providers clinical support system-medications for opioid use disorders. Available from: https://pcssnow.org/courses/ [Last accessed: February6, 2024].
29.
KelloggSH, TatarskyA. Re-envisioning addiction treatment: A six-point plan. Alcohol Treat Q, 2012; 30(1):109–128; doi: 10.1080/07347324.2012.635544
30.
TimkoC, SchultzNR, CucciareMA, VittorioL, Garrison-DiehnC. Retention in medication-assisted treatment for opiate dependence: A systematic review. J Addict Dis, 2016; 35(1):22–35; doi: 10.1080/10550887.2016.1100960
31.
KinskyS, HouckPR, MayesK, LovelandD, DaleyD, SchusterJM. A comparison of adherence, outcomes, and costs among opioid use disorder Medicaid patients treated with buprenorphine and methadone: A view from the payer perspective. J Subst Abuse Treat, 2019; 104:15–21; doi: 10.1016/j.jsat.2019.05.015
32.
RonquestNA, WillsonTM, MontejanoLB, NadipelliVR, WollschlaegerBA. Relationship between buprenorphine adherence and relapse, health care utilization and costs in privately and publicly insured patients with opioid use disorder. Subst Abuse Rehabil, 2018; 9:59–78; doi: 10.2147/SAR.S150253
33.
GopaldasM, WenzelK, CampbellANC, et al.Impact of medication-based treatment on health care utilization among individuals with opioid use disorder. Psychiatr Serv, 2023; 74(12):1227–1233; doi: 10.1176/appi.ps.20220549
34.
FairleyM, HumphreysK, JoyceVR, et al.Cost-effectiveness of treatments for opioid use disorder. JAMA Psychiatry, 2021; 78(7):767–777; doi: 10.1001/jamapsychiatry.2021.0247
35.
MooreG, RobichaudC, LearyK, JongAJD. Reducing harm—overdose prevention in Philadelphia - The opioid crisis in Philadelphia. Published online April 9, 2021. Available from: https://policycommons.net/artifacts/2329688/reducing-harm/3090313/ [Last accessed: January1, 2024].
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