Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. A. Introduction


Opioid overdoses claim 17,000 American lives annually (ASAM 2015). Deaths by opioid overdose have nearly quadrupled from 1999 to 2013 (CDC 2015). Nearly 2.5 million Americans are currently at risk for overdoses -- 1.9 million are opioid-dependent, and 517,000 are addicted to heroin (ASAM 2015). In response to the growing opioid epidemic, the U.S. Department of Health and Human Services (HHS) announced a three-pronged initiative in March 2015 to: (1) improve opioid prescribing practices; (2) increase access to naloxone for overdose management; and (3) expand medication-assisted treatment (MAT) to reduce opioid dependence (ASPE 2015). MAT is a treatment that combines medication with psychosocial treatment to treat substance use disorders (SUDs). In the United States, three medications are HHS Food and Drug Administration (FDA)-approved to treat opioid use disorders: methadone, buprenorphine and naltrexone. In support of the initiative, the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with Mathematica Policy Research to develop a roadmap that identifies concepts for potential quality measures that promote the appropriate use of MAT for opioid use as well as the steps needed to develop those concepts into measures. As a guiding step in roadmap development, we conducted a review of clinical MAT guidelines and existing measures related to MAT. In this report, we briefly summarize the findings from the review.

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