Testimony presented before the House Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies on April 5, 2017.
Following three possible recommendations for medical care for people with an opioid addiction may cut deaths among such patients by as much as one-third. Deaths were much lower among patients who were not prescribed opioids or common types of anxiety medications, those who received psychosocial counseling, and those who had quarterly visits with a physician.
When patients are prescribed opioids in risky ways, their chance of dying increases, and their odds of death go higher as the number of risky opioid prescriptions increases.
To date, the stigma associated with opioid dependence has had the untoward effect of discouraging treatment-seeking behavior before the occurrence of an adverse event.
This issue features research on preventing child abuse and neglect and improving outcomes for children in the U.S. child-welfare system; a look back on RAND's 70 years of innovation; and an exploration of the human side of artificial intelligence.
Reflecting a comprehensive VA effort to improve pain management, in 2007 fewer veterans received high doses of opioids and more veterans received non-opioid pain therapies, naloxone, and treatment for substance use disorders.
Motivational interviewing is used extensively to improve health and substance use-related outcomes, but therapists may need more training in strategic use of the approach.
Homeless young adults were less likely to complete an alcohol and other drug and risky sex prevention program if they had slept outside or received the program in an urban setting.
Abundant supply of opioids was one of the major causes of the opioid crisis. Broader supply-side policies that consider the full market, if coupled with effective treatment, are likely to be effective and resistant to substitution effects.
This paper describes the process of planning and developing an intervention for delivering treatment for opioid and alcohol use disorders in primary care.
Outpatient guidelines can help hospitalists evaluate inpatients on long-term opioid therapy, but more work is needed to help providers make decisions for inpatients that balance effective pain treatment and opioid risk reduction.
An organizational readiness intervention improved some implementation outcomes related to integrating treatment for opioid and alcohol use disorders in primary care, but not all.
The association between medical marijuana and lower levels of opioid overdose deaths—identified previously in several studies—is more complex than previously described. It appears to be changing as both medical marijuana laws and the opioid crisis evolve.
RAND research, analysis, and expertise provide context for the issues discussed in the president's first State of the Union address, including infrastructure, North Korea, and opioids.
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.
Decreasing the reliance of VA providers on opioid prescribing for chronic pain requires local availability of nonpharmacologic pain therapies (NPTs) as well as provider efficacy in prescribing NPTs.
Patients of community health clinics who screen positive for alcohol or opioid misuse have a high probability of an alcohol- or substance-use disorder and a slightly higher prevalence of mental illness than the overall clinic population.
The methods of contacting respondents and the technology for questioning respondents in household surveys complicate cross-country comparisons of drug prevalence.
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.
