Addressing the U.S. Opioid Crisis: Using an Integrated Systems-Based Approach: Addendum 2020
Document submitted January 21, 2020, as an addendum to testimony before the Senate Judiciary Committee Hearing on Opioids on December 17, 2019.
Reports and Articles - Treatment
Below are the most recent reports and articles from the RAND Drug Policy Research Center. Please visit our RAND Topics pages for a complete research archive on these and other drug policy-related research topics.
RAND Topic Pages: Substance Abuse Treatment2020
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Adoption of Telemedicine Services by Substance Abuse Treatment Facilities in the U.S. 2020
Telemedicine for treating Substance use disorder (SUD) use is growing steadily among treatment facilities; however, uptake is uneven and relatively low. As such, telemedicine may be an under-utilized tool to expand access to care for patients with SUD.
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Association of Pregnancy and Insurance Status With Treatment Access for Opioid Use Disorder 2020
In this cross-sectional study with random assignment of clinicians and simulated-patient callers, many women, especially pregnant women, faced barriers to accessing treatment. Given the high out-of-pocket costs and lack of acceptance of insurance among many clinicians, access to affordable opioid use disorder treatment is a significant concern.
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The Association of State Opioid Misuse Prevention Policies With Patient- and Provider-Related Outcomes: A Scoping Review 2020
This review reveals a growing literature on the effects of certain state opioid misuse prevention policies, but persistent gaps in evidence on other prevalent state policies remain.
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Consensus Guidelines and State Policies: The Gap Between Principle and Practice at the Intersection of Substance Use and Pregnancy 2020
We review the change over time in state-level policy environments around substance use in pregnancy and contrast the policy response with the principles and guidance from professional societies and federal agencies.
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The Dawn of a New Synthetic Opioid Era: The Need for Innovative Interventions 2020
This paper stems from recent research into understanding the past, present and possible futures of synthetic opioids in North America and beyond.
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An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19 2020
The COVID-19 pandemic strikes at a moment when our national response to the opioid crisis was beginning to coalesce. COVID-19 threatens to dramatically overshadow and reverse this progress.
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Ethics Consultations Related to Opioid Use Disorder 2020
The aim of this study was to characterize ethics consult questions among inpatients with opioid use disorder at Massachusetts General Hospital.
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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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Guidance for Organizations That Support the Behavioral Health of Post-9/11 Veterans 2020
This brief highlights important treatment, provider, and system factors that organizations that support the behavioral health needs of veterans with co-occurring substance use disorders and mental health disorders should consider.
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Health Center Implementation of Telemedicine for Opioid Use Disorders: A Qualitative Assessment of Adopters and Nonadopters 2020
Although use of telemedicine for the treatment of opioid use disorders is growing, there is limited research on how it is actually being deployed in treatment. We explored how health centers across the U.S. are using it.
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Improving Substance Use Care: Addressing Barriers to Expanding Integrated Treatment Options for Post-9/11 Veterans 2020
Post-9/11 veterans are at particularly high risk for co-occurring substance use disorders (SUDs) and mental health disorders. Integrated care—in which both SUDs and mental health problems are addressed concurrently—is a recommended form of treatment for these veterans. This report provides guidance and recommendations to support the delivery of quality care for veterans with co-occurring SUDs and mental health disorders.
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Incidence and Treatment Costs of Severe Bacterial Infections Among People Who Inject Heroin: A Cohort Study in South London, England 2020
A study examined the rates of hospitalisation or death related to severe bacteria infections among people who inject heroin in South London, England. The report compared these rates to the general population and calculated the cost of admissions.
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The Law Enforcement Response to Homelessness: Identifying High-Priority Needs to Improve Law Enforcement Strategies for Addressing Homelessness 2020
Police often are the first (and sometimes the only) point of government contact for persons experiencing homelessness (PEH). Police responses have shifted to approaches designed to foster positive relationships with PEH, help assess the individual needs of each person or area, and guide homeless or unsheltered individuals to the services they require. A panel of experts identified ways to address related challenges.
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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. By targeting higher-risk patients during clinical encounters, naloxone prescribing requirements could increase naloxone prescribed, destigmatize naloxone use, and reduce overdose harms.
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Medications for Opioid Use Disorder Among Pregnant Women Referred by Criminal Justice Agencies Before and After Medicaid Expansion: A Retrospective Study of Admissions to Treatment Centers in the United States 2020
Pregnant women with OUD referred by criminal justice agencies between 1992 and 2017 were consistently less likely to receive evidence-based treatment than women referred through other sources.
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Monthly Patient Volumes of Buprenorphine-Waivered Clinicians in the US 2020
This cross-sectional study examines the number of patients prescribed buprenorphine by waivered-clinicians. Evidence shows waivered-clinicians who are able to prescribe buprenorphine treat fewer patients than their limit allows. With so much unmet demand for OUD treatment, this suggests the need for ongoing efforts to address treatment barriers.
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Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY): A Randomized Controlled Trial 2020
Urban Native American teens may benefit from culturally centered programs. No differences found between MICUNAY + Community Wellness Gatherings (CWGs) and CWGs only.
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Oil Spill Disruption and Problem Drinking: Assessing the Impact of Religious Context Among Gulf Coast Residents 2020
This study employs multilevel analysis to examine the impact of religious context on alcohol misuse among individuals impacted by the Deepwater Horizon Oil Spill.
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Opioid Prescribing History Prior to Heroin Overdose Among Commercially Insured Adults 2020
We used insurance claims to examine the prevalence and prescribing patterns of prescription opioids in a national cohort of individuals experiencing a treated heroin-related overdose between 2010 and 2017.