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Substance Use Disorder Treatment

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Essay
A Promising New Program Treats Co-Occurring Mental Health and Opioid Use Disorders
People who have an opioid use disorder and either clinical depression or PTSD are hard to reach, hard to treat, and hard to hold onto. A new collaborative care model called CLARO aims to help patients who otherwise might disappear into the cracks of the U.S. health care system.
Jul 3, 2023
Essay
America's Opioid Crisis: Adopting an Ecosystem Approach
The opioid crisis is metastasizing throughout society, reaching across public health and public safety, but also education, employment, and the child welfare system. Without profound change and new approaches to the crisis, hundreds of thousands of people could die in the coming years.
Jun 30, 2023

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Tool
CLARO Implementation Manual: Strategies and Supports for Successful Implementation of the CLARO Intervention
This manual describes how to implement the Collaboration Leading to Addiction Treatment and Recovery from Other Stresses (CLARO) intervention, which adapts the Collaborative Care Model for adults with opioid use disorder and depression and/or PTSD.
Nov 13, 2023
Journal Article
Comparing Organization-Focused and State-Focused Financing Strategies on Provider-Level Reach of a Youth Substance Use Treatment Model: A Mixed-Method Study
This study compared two US federal grant mechanisms, organization-focused and state-focused grants, on organization-level implementation outcomes for the Adolescent Community Reinforcement Approach, an evidence-based practice for youth substance use.
Oct 16, 2023
Journal Article
US State Laws Relevant to Incentives for Health Behavior: A Qualitative Analysis
The research team conducted a systematic NexisUni legal database review of state statutes and regulations effective during 2022 to identify laws relevant to contingency management.
Oct 5, 2023
Journal Article
How Are State Telehealth Policies Associated with Services Offered by Substance Use Disorder Treatment Facilities? Evidence from 2019-2022
An examination of the effect of state policies on the offering of telehealth at substance use disorder treatment facilities.
Sep 11, 2023
Commentary
Strategies to Prevent Clinically Unnecessary Opioid Use
Guidance on how to direct opioid-related settlement funds has focused on reducing deaths and improving treatment for substance use disorders. What's also needed are strategies to reduce opioid initiation, particularly through effective pain management with nonopioid alternatives.
Aug 29, 2023
Journal Article
Findings from an Organizational Context Survey to Inform the Implementation of a Collaborative Care Study for Co-occurring Disorders
This study surveyed primary care and behavioral health staff from 13 clinics implementing a collaborative care intervention for opioid use disorders co-occurring with PTSD and/or depression as part of a multisite randomized controlled trial.
Aug 17, 2023
Journal Article
Design of CLARO+ (Collaboration Leading to Addiction Treatment and Recovery from Other Stresses, Plus): A Randomized Trial of Collaborative Care to Decrease Overdose and Suicide Risk Among Patients with Co-Occurring Disorders
We build upon a model of collaborative care in which care coordinators deliver preventative measures to high-risk patients and coordinate care with the patients' care team, to increase MOUD retention and decrease risk of suicide and overdose.
Aug 17, 2023
Journal Article
Sexual Identity Differences in Tobacco (Re)Uptake: Testing Mediation by Internalizing and Externalizing Symptoms
We examined whether internalizing and externalizing psychological symptoms serve as mediators of tobacco (re)uptake among sexual minority individuals using data from Waves 4 and 5 of the Population Assessment of Tobacco and Health study.
Aug 11, 2023
Journal Article
An Experimental Evaluation of the Effects of Banning the Sale of Flavored Tobacco Products on Adolescents' and Young Adults' Future Nicotine Vaping Intentions
Experimentally removing flavored tobacco products from a model convenience store display did not change teens' intentions to vape flavored products but increased intentions to use tobacco-flavored vaping products among teens who had previously vaped.
Aug 10, 2023
Report
Psychiatric and Substance Use Disorder Bed Capacity, Need, and Shortage Estimates in Santa Clara County, California
Santa Clara County sought to understand where gaps exist between psychiatric and substance use disorder treatment bed capacity and needs — at different levels of care. The authors use various sources to identify such gaps and hard-to-place populations.
Aug 3, 2023
Journal Article
Investigating the Complexity of Naloxone Distribution: Which Policies Matter for Pharmacies and Potential Recipients
In this paper, we estimate the effects on naloxone pharmacy distribution of two types of laws: laws authorizing non-patient-specific prescription distribution of naloxone and laws granting pharmacists prescriptive authority for naloxone.
Jul 31, 2023
Journal Article
A Bridge Too Far? Distance to Waivered Physicians and Utilization of Buprenorphine Treatment for Opioid Use Disorder in West Virginia Medicaid
Longer travel distance to buprenorphine treatment is associated with a shorter duration of care that is likely to be clinically meaningful.
Jul 19, 2023
Journal Article
Sociodemographic Differences in Quality of Treatment to Medicaid Enrollees Receiving Buprenorphine
Buprenorphine is a key medication to treat opioid use disorder, but little is known about how treatment quality varies across sociodemographic groups. We examined measures of treatment quality and explored variation by sociodemographic factors.
Jul 14, 2023
Journal Article
Differences in Buprenorphine Treatment Quality Across Physician Provider Specialties
Our findings highlight the need for models that can better integrate physical and behavioral health services for opioid use disorder treatment.
Jul 14, 2023
Journal Article
National Trends in Buprenorphine Treatment for Opioid Use Disorder From 2007 to 2018
This study characterizes buprenorphine treatment episodes during 2007-2018 with respect to payer, provider specialty, and patient demographics. We find clear growth in buprenorphine treatment-particularly for older adults and Medicaid beneficiaries.
Jul 14, 2023
Journal Article
Exploring the Association of State Policies and the Trajectories of Buprenorphine Prescriber Patient Caseloads
Researchers conducted a retrospective cohort study to examine the relationship between state buprenorphine policies and clinician prescribing trajectories.
Jul 11, 2023
Journal Article
Integrating Traditional Practices and Social Network Visualization to Prevent Substance Use: Study Protocol for a Randomized Controlled Trial Among Urban Native American Emerging Adults
A community-informed and culturally grounded opioid prevention intervention can be developed for urban AI/AN emerging adults and can help to build resilience and hopefully decrease opioid use among this underserved population.
Jun 21, 2023
Journal Article
Social Networks of Clients in First-Time DUI Programs
Individuals convicted of driving under the influence (DUI) having networks with more substance use individuals had greater substance use and drinking and driving behaviors. Network support was associated with lower drinking and driving.
Jun 15, 2023
Journal Article
State Policy and the Breadth of Buprenorphine-Prescriber Networks in Medicaid Managed Care
Researchers used a diff-in-diff approach to compare three Medicaid Managed Care networks for buprenorphine providers across specialties and market segments within the same state.
Jun 14, 2023
Journal Article
Prevalence of Buprenorphine Providers Requiring Cash Payment From Insured Women Seeking Opioid Use Disorder Treatment
Researchers used an audit (simulated patient) study methodology to examine appointment-granting behavior by buprenorphine prescribers in ten different U.S. states.
Jun 14, 2023

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RAND Topic:
Substance Use Disorder Treatment

Research conducted by

Researcher Spotlight

Megan S. Schuler

Policy Researcher

Megan Schuler is an applied statistician at the RAND Corporation. Her research focuses on substance use and mental health disorders and methodologically on causal inference methods which facilitate rigorous analysis of observational health data. As a co-investigator affiliated with the RAND…
Alex Sizemore

Ph.D. Student, Pardee RAND Graduate School, and Assistant Policy Researcher, RAND

Alex Sizemore (she/they) is a Ph.D. student in the Community-Partnered Policy and Action stream at Pardee RAND Graduate School and an assistant policy analyst at RAND. She has an M.A. in urban planning from the University of Southern California, an M.A. in curatorial studies from the University…

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