Legal Requirements and Recommendations to Prescribe Naloxone 2020
We conducted a systematic legal review of state laws that mandate or recommend that healthcare providers prescribe naloxone to patients with indicators for opioid overdose risk.
OPTIC Staff Publications
Key Takeaways
Key Takeaways are OPTIC-created, one-page summaries of published research findings tailored for policymakers.
- Access to Office-Based Buprenorphine Treatment in Areas With High Rates of Opioid-Related Mortality
- Association Among County-Level Economic Factors, Clinician Supply, Metropolitan or Rural Location, and Neonatal Abstinence Syndrome
- Association Between State Laws Facilitating Pharmacy Distribution of Naloxone and Risk of Fatal Overdose
- Association of Punitive and Reporting State Policies Related to Substance Use in Pregnancy with Rates of Neonatal Abstinence Syndrome
- A Population-Based Examination of Trends and Disparities in Medication Treatment for Opioid Use Disorders Among Medicaid Enrollees
- Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017
- High-Risk Prescribing to Medicaid Enrollees Receiving Opioid Analgesics: Individual- and County-Level Factors
- Impact of Prescription Drug Monitoring Programs (PDMPs) on Opioid Utilization Among Medicare Beneficiaries in 10 U.S. States
- Prescribing Patterns of Buprenorphine Waivered Physicians
- Who Receives Naloxone from Emergency Medical Services? Characteristics of Calls and Recent Trends
Policy Effects
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We Need a Taxonomy of State-Level Opioid Policies 2020
Developing and using a state-level opioid policy can facilitate the design and implementation of more effective state-level policies-an essential tool in addressing the opioid crisis.
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Association of Punitive and Reporting State Policies Related to Substance Use in Pregnancy With Rates of Neonatal Abstinence Syndrome 2019
State policies that impose punitive action against pregnant women who use illicit substances are associated with higher rates of infants being born with opioid withdrawal.
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Who Receives Naloxone from Emergency Medical Services? Characteristics of Calls and Recent Trends 2019
Administration of naloxone by emergency medical services personnel is increasing faster than opioid-related deaths.
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Association Between State Laws Facilitating Pharmacy Distribution of Naloxone and Risk of Fatal Overdose 2019
Although many states have passed some type of law affecting naloxone availability, only laws allowing direct dispensing by pharmacists appear to be useful. Communities in which access to naloxone is improved should prepare for increases in nonfatal overdoses and link these individuals to effective treatment.
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Impact of Prescription Drug Monitoring Programs (PDMPs) on Opioid Utilization Among Medicare Beneficiaries in 10 U.S. States 2017
Implementation of a prescription drug monitoring program in 10 states was associated with a reduction in overall volume of opioid drugs prescribed.
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The Affordable Care Act in The Heart of the Opioid Crisis: Evidence from West Virginia 2019
The growing use of medication treatment for opioid use disorder in the West Virginia Medicaid expansion population provides an opportunity to reduce overdose deaths.
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Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers? 2018
States that provide legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medication.
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Did the Dependent Coverage Expansion Increase Risky Substance Use Among Young Adults? 2017
This analysis of the dependent coverage expansion under the ACA suggests that historical trends rather than the insurance expansion itself account for increases in substance use among people ages 19-25 since 2010.
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Funding Considerations in the Fight Against the Opioid Epidemic: What the Science Tells Us 2017
Testimony presented before the House Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies on April 5, 2017.
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How Increasing Medical Access to Opioids Contributes to the Opioid Epidemic: Evidence from Medicare Part D 2016
Uses the introduction of the Medicare Prescription Drug Benefit Program (Part D) to explore how increasing medical access to opioids contributes to the opioid epidemic.
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Policies to Support a Better Treatment for Heroin and Prescription Opioid Abuse: Unlike Methadone, Buprenorphine Can Be Taken at Home, but Greater Access is Key 2015
Increasing the number of physicians who can prescribe buprenorphine for opioid abuse and supporting their ability to treat more patients may be the fastest approach to enhancing capacity for treatment, particularly in less populated counties.
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Policies Related to Opioid Agonist Therapy for Opioid Use Disorders: The Evolution of State Policies from 2004 to 2013 2015
This study examines the evolution of states' coverage and policies with respect to opioid agonist therapy and present an overview of the Medicaid policy environment from 2004 to 2013.
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Supply of Buprenorphine Waivered Physicians: The Influence of State Policies 2014
The authors calculated the number of buprenorphine-waivered physicians and used multivariate regression models to predict number of buprenorphine-waivered physicians/100,000 residents as a function of county characteristics, state policies and efforts to promote buprenorphine use.
Healthcare Implications of Opioid Use
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Five-Year Outcomes Among Medicaid-Enrolled Children With In Utero Opioid Exposure 2020
Children with in utero opioid exposure had a predicted probability of being diagnosed with a pediatric complex chronic condition similar to that among children with tobacco exposure and those with neither exposure (20.4%,18.7%, and 20.2%, respectively). Our findings were consistent when we examined a subgroup of opioid-exposed children identified as having neonatal opioid withdrawal symptoms.
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An Observational Study of Retail Pharmacy Naloxone Prescriptions: Differences Across Provider Specialties and Patient Populations 2019
This article explores variation in pharmacy-dispensed naloxone by prescriber specialty and patient characteristics.
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Strengths and Weaknesses of Existing Data Sources to Support Research to Address the Opioids Crisis 2019
We conducted a scoping study to identify data sources and linking strategies commonly used in opioid studies, describe data source strengths and limitations, and highlight opportunities to use data to address public health research questions.
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Association Among County-Level Economic Factors, Clinician Supply, Metropolitan or Rural Location, and Neonatal Abstinence Syndrome 2019
This analysis found a significant association among higher long-term unemployment, higher mental health clinician shortage areas, and higher county-level rates of neonatal abstinence syndrome.
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Association Between State Laws Facilitating Pharmacy Distribution of Naloxone and Risk of Fatal Overdose 2019
Although many states have passed some type of law affecting naloxone availability, only laws allowing direct dispensing by pharmacists appear to be useful. Communities in which access to naloxone is improved should prepare for increases in nonfatal overdoses and link these individuals to effective treatment.
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Who Receives Naloxone from Emergency Medical Services? Characteristics of Calls and Recent Trends 2019
Administration of naloxone by emergency medical services personnel is increasing faster than opioid-related deaths.
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Did the Dependent Coverage Expansion Increase Risky Substance Use Among Young Adults? 2017
This analysis of the dependent coverage expansion under the ACA suggests that historical trends rather than the insurance expansion itself account for increases in substance use among people ages 19-25 since 2010.
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Physician Prescribing of Opioids to Patients at Increased Risk of Overdose From Benzodiazepine Use in the United States 2019
New opioid prescriptions decreased among higher-risk patients who used benzodiazepines from 2010 to 2015, suggesting that the rapid increase in opioid-related deaths is primarily associated with factors other than physicians writing new opioid prescriptions.
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Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015 2019
Older age was the strongest predictor of undergoing potentially inappropriate prescribing (PIP) among individuals who were prescribed opioids. PIP was also associated with risk of adverse outcomes in both older and younger adults.
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Potentially Inappropriate Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011-2015 2018
While any opioid prescription carries some risk, a subset of prescriptions is particularly risky: identifying potentially inappropriate prescribing (PIP) through state-level online prescription monitoring programs could help reduce PIP.
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High-Risk Prescribing to Medicaid Enrollees Receiving Opioid Analgesics: Individual- and County-Level Factors 2018
Among Medicaid recipients, high-risk prescribing of opioids occurred in 39.4% of episodes. Four characteristics -- older age, rural county of residence, white race, and major depression diagnosis -- were associated with higher rates of all types of high-risk prescribing.
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How Increasing Medical Access to Opioids Contributes to the Opioid Epidemic: Evidence from Medicare Part D 2016
Uses the introduction of the Medicare Prescription Drug Benefit Program (Part D) to explore how increasing medical access to opioids contributes to the opioid epidemic.
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Simulation of County Neonatal Abstinence Syndrome (NAS) Rates Tool 2019
This web-based tool aims to inform policymakers about the rates of neonatal abstinence syndrome by county across eight states from 2009 to 2015. This analysis is displayed via maps and interactive charts.
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The Ecology of Neonatal Abstinence Syndrome 2019
Newborns exposed to opioids before birth can experience withdrawal symptoms known as neonatal abstinence syndrome (NAS). From 2009 to 2015, the average NAS rate per 1,000 hospital births across eight states rose from about six to more than 25.
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Association Among County-Level Economic Factors, Clinician Supply, Metropolitan or Rural Location, and Neonatal Abstinence Syndrome 2019
This analysis found a significant association among higher long-term unemployment, higher mental health clinician shortage areas, and higher county-level rates of neonatal abstinence syndrome.
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Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015 2019
Older age was the strongest predictor of undergoing potentially inappropriate prescribing (PIP) among individuals who were prescribed opioids. PIP was also associated with risk of adverse outcomes in both older and younger adults.
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Prescribing Patterns of Buprenorphine Waivered Physicians 2017
Most buprenorphine prescribers treat many fewer patients than allowed by the current patient limit. Increasing the limit above 100 would likely improve access only for patients of a few high prescribers.
Markets and Illicit Drugs
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Strengths and Weaknesses of Existing Data Sources to Support Research to Address the Opioids Crisis 2019
We conducted a scoping study to identify data sources and linking strategies commonly used in opioid studies, describe data source strengths and limitations, and highlight opportunities to use data to address public health research questions.
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Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids 2018
Results suggest that a substantial share of the dramatic increase in heroin deaths since 2010 can be attributed to the reformulation of OxyContin.
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A Supply-Side Perspective on the Opioid Crisis 2018
In dealing with the opioid crisis, supply-side policies that consider the full market (both prescription opioids as well as heroin and fentanyl), if coupled with effective treatment, are likely to be the most effective.
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The Price Elasticity of Demand for Heroin: Matched Longitudinal and Experimental Evidence 2015
This paper reports estimates of the price elasticity of demand for heroin based on a newly constructed dataset.
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A Search-Theoretic Model of the Retail Market for Illicit Drugs 2012
How legalizing marijuana would affect consumption and tax revenues will depend on many design choices including tax level, incentives for a continued black market, whether advertising is restricted, and how the regulatory system is designed and adjusted.
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A Transitioning Epidemic: How The Opioid Crisis Is Driving The Rise In Hepatitis C 2019
The 2010 reformulation of Oxycontin to prevent abuse of the drug (by making it crush-proof and therefore impossible to dissolve in liquid) had the unintended effect of driving some users to switch to heroin, which contributed to a dramatic rise in Hepatitis C.
Opioid Pain Medication Prescribing
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Legal Requirements and Recommendations to Prescribe Naloxone 2020
We conducted a systematic legal review of state laws that mandate or recommend that healthcare providers prescribe naloxone to patients with indicators for opioid overdose risk.
-
An Observational Study of Retail Pharmacy Naloxone Prescriptions: Differences Across Provider Specialties and Patient Populations 2019
This article explores variation in pharmacy-dispensed naloxone by prescriber specialty and patient characteristics.
-
Strengths and Weaknesses of Existing Data Sources to Support Research to Address the Opioids Crisis 2019
We conducted a scoping study to identify data sources and linking strategies commonly used in opioid studies, describe data source strengths and limitations, and highlight opportunities to use data to address public health research questions.
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High-Risk Prescribing to Medicaid Enrollees Receiving Opioid Analgesics: Individual- and County-Level Factors 2018
Among Medicaid recipients, high-risk prescribing of opioids occurred in 39.4% of episodes. Four characteristics -- older age, rural county of residence, white race, and major depression diagnosis -- were associated with higher rates of all types of high-risk prescribing.
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Impact of Prescription Drug Monitoring Programs (PDMPs) on Opioid Utilization Among Medicare Beneficiaries in 10 U.S. States 2017
Implementation of a prescription drug monitoring program in 10 states was associated with a reduction in overall volume of opioid drugs prescribed.
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Reducing High-Dose Opioid Prescribing: State-Level Morphine Equivalent Daily Dose Policies, 2007-2017
Morphine equivalent daily dose thresholds are a promising policy tool, but there is a lack of consensus about how to use the thresholds and what the threshold level should be.
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Physician Prescribing of Opioids to Patients at Increased Risk of Overdose From Benzodiazepine Use in the United States
New opioid prescriptions decreased among higher-risk patients who used benzodiazepines from 2010 to 2015, suggesting that the rapid increase in opioid-related deaths is primarily associated with factors other than physicians writing new opioid prescriptions.
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Data Sources and Data-Linking Strategies to Support Research to Address the Opioid Crisis: Final Report
This report highlights key research questions and identifies opportunities to use existing data sources and implement data-linking strategies that can support the HHS five point strategy to combat the opioid crisis.
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Effect of Age on Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011 to 2015
Older age was the strongest predictor of undergoing potentially inappropriate prescribing (PIP) among individuals who were prescribed opioids. PIP was also associated with risk of adverse outcomes in both older and younger adults.
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Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?
States that provide legal access to marijuana through dispensaries experience lower treatment admissions for addiction to pain medication.
-
Potentially Inappropriate Opioid Prescribing, Overdose, and Mortality in Massachusetts, 2011-2015
While any opioid prescription carries some risk, a subset of prescriptions is particularly risky: identifying potentially inappropriate prescribing (PIP) through state-level online prescription monitoring programs could help reduce PIP.
-
High-Risk Prescribing to Medicaid Enrollees Receiving Opioid Analgesics: Individual- and County-Level Factors
Among Medicaid recipients, high-risk prescribing of opioids occurred in 39.4% of episodes. Four characteristics -- older age, rural county of residence, white race, and major depression diagnosis -- were associated with higher rates of all types of high-risk prescribing.
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Opioid Analgesic and Benzodiazepine Prescribing Among Medicaid-enrollees with Opioid Use Disorders: The Influence of Provider Communities
A substantial number of Medicaid enrollees were able to fill prescriptions for opioid analgesics, benzodiazepines, or both in the year following diagnosis for an opioid use disorder.
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How Increasing Medical Access to Opioids Contributes to the Opioid Epidemic: Evidence from Medicare Part D
Uses the introduction of the Medicare Prescription Drug Benefit Program (Part D) to explore how increasing medical access to opioids contributes to the opioid epidemic.
Treatment
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Growth and Distribution of Buprenorphine-Waivered Providers in the United States, 2007–2017 2020
This study sheds light on the distribution of buprenorphine-waivered prescribers over the past decade. Growth has been rapid in communities affected by the opioid crisis, but slower in rural communities, and those with lower levels of education.
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Strengths and Weaknesses of Existing Data Sources to Support Research to Address the Opioids Crisis 2019
We conducted a scoping study to identify data sources and linking strategies commonly used in opioid studies, describe data source strengths and limitations, and highlight opportunities to use data to address public health research questions.
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Association of Punitive and Reporting State Policies Related to Substance Use in Pregnancy With Rates of Neonatal Abstinence Syndrome 2019
State policies that impose punitive action against pregnant women who use illicit substances are associated with higher rates of infants being born with opioid withdrawal.
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Access to Office-Based Buprenorphine Treatment in Areas With High Rates of Opioid-Related Mortality: An Audit Study 2019
In the six jurisdictions with the highest rate of opioid-related mortality in 2016, the most prominent barrier to accessing buprenorphine treatment was the difficulty of finding clinicians.
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A Population-Based Examination of Trends and Disparities in Medication Treatment for Opioid Use Disorders Among Medicaid Enrollees 2018
The number of Medicaid recipients receiving medication to treat opioid abuse increased sharply in the years after approval of a new drug, but the increase was smaller in poorer counties and areas with larger populations of black and Hispanic residents.
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Prescribing Patterns of Buprenorphine Waivered Physicians 2017
Most buprenorphine prescribers treat many fewer patients than allowed by the current patient limit. Increasing the limit above 100 would likely improve access only for patients of a few high prescribers.
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The Affordable Care Act in The Heart of the Opioid Crisis: Evidence from West Virginia 2019
The growing use of medication treatment for opioid use disorder in the West Virginia Medicaid expansion population provides an opportunity to reduce overdose deaths.
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Changes in Outpatient Services and Medication Use Following a Non-fatal Opioid Overdose in the West Virginia Medicaid Program 2019
Fewer than 10% of West Virginia Medicaid enrollees received medication for opioid use disorder after a non-fatal overdose, making it an opportunity to increase treatment for opioid use disorder and co-occurring mental health conditions.
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A Population-Based Examination of Trends and Disparities in Medication Treatment for Opioid Use Disorders Among Medicaid Enrollees 2018
The number of Medicaid recipients receiving medication to treat opioid abuse increased sharply in the years after approval of a new drug, but the increase was smaller in poorer counties and areas with larger populations of black and Hispanic residents.
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Prescribing Patterns of Buprenorphine Waivered Physicians 2017
Most buprenorphine prescribers treat many fewer patients than allowed by the current patient limit. Increasing the limit above 100 would likely improve access only for patients of a few high prescribers.
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Association Between Process Measures and Mortality in Individuals with Opioid Use Disorders 2017
Three possible measures for quality of care may help reduce deaths from opioid addiction by one-third.
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Physician Capacity to Treat Opioid Use Disorder with Buprenorphine-Assisted Treatment 2016
Many physicians who prescribe buprenorphine are prescribing below the patient limits historically allowed under U.S. law.
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Policies to Support a Better Treatment for Heroin and Prescription Opioid Abuse: Unlike Methadone, Buprenorphine Can Be Taken at Home, but Greater Access is Key 2015
Increasing the number of physicians who can prescribe buprenorphine for opioid abuse and supporting their ability to treat more patients may be the fastest approach to enhancing capacity for treatment, particularly in less populated counties.
-
Policies Related to Opioid Agonist Therapy for Opioid Use Disorders: The Evolution of State Policies from 2004 to 2013 2015
This study examines the evolution of states' coverage and policies with respect to opioid agonist therapy and present an overview of the Medicaid policy environment from 2004 to 2013.
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Where Is Buprenorphine Dispensed to Treat Opioid Use Disorders? The Role of Private Offices, Opioid Treatment Programs, and Substance Abuse Treatment Facilities in Urban and Rural Counties 2015
Opioid use disorders are a significant public health problem.
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Growth in Buprenorphine Waivers for Physicians Increased Potential Access to Opioid Agonist Treatment, 2002-11 2015
Policy makers should focus their efforts on further increasing the number and geographical distribution of physicians, particularly in more rural counties, where prescription opioid misuse is rapidly growing.
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Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process 2015
The authors developed an updated and expanded set of buprenorphine treatment guidelines; this additional guidance may increase credentialed physicians' comfort with prescribing buprenorphine to patients with opioid use disorders.
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Supply of Buprenorphine Waivered Physicians: The Influence of State Policies 2014
The authors calculated the number of buprenorphine-waivered physicians and used multivariate regression models to predict number of buprenorphine-waivered physicians/100,000 residents as a function of county characteristics, state policies and efforts to promote buprenorphine use.
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A Systematic Review of the Prevention and Treatment of Prescription Drug Misuse 2016
Guidance on how to prevent or treat the misuse of prescription drugs in the U.S. Department of Defense and Veterans Administration is similar to directives outside the military system, and tends to focus on opioids.
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Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members 2017
This report presents the framework of an analytic tool that can help the military predict future trends in PDM based on current demographics of active-duty service members and rates of injury and prescribing of prescription drugs.