Substance Use Disorder Workforce Issue Brief
Ellen Bouchery, Mathematica Policy Research
Judith Dey, U.S. Department of Health and Human Services
Printer Friendly Version in PDF Format (5 PDF pages)
Substance Use Disorder Workforce Issue Brief
Many barriers to accessing evidence-based treatment for substance use disorder (SUD), particularly medication assisted treatment, are related to the workforce. Barriers include workforce shortages for certain providers, insufficient training, education and experience, lack of institutional and clinician peer support, provider stigma and inadequate
ExamSUDib.pdf
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The Use of 1915(i) Medicaid Plan Option for Individuals with Mental Health and Substance Use Disorders
Stan Dorn, Rebecca Peters and Morgan Cheeks
Urban Institute
Pat Casanova and Gina Eckart
Health Management Associates
Ted Lutterman
National Association of State Mental Health Program Directors Research Institute, Inc.
Printer Friendly Version in PDF Format (37 PDF pages)
The Use of 1915(i) Medicaid Plan Option for Individuals with Mental Health and Substance Use Disorders
Created by the Deficit Reduction Act of 2005 and amended by the Patient Protection and Affordable Care Act (ACA), Section 1915(i) of the Social Security Act gives state Medicaid programs the flexibility to cover home and community-based services (HCBS) through a Medicaid state plan amendment (SPA) without the need to seek a federal waiver. This re
1915iSPA.pdf
Adolescent Well-Being after Experiencing Family Homelessness
New analysis of data from HUD's Family Options Study of adolescents’ experiences in shelter with their families and 20 months later shows that most adolescents continued to live with their families, and some continued to experience housing instability or live in overcrowded situations. These adolescents were more likely to have changed schools o
adolescents.pdf
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Project Information and Additional Reports
DEVELOPMENT AND TESTING OF BEHAVIORAL HEALTH QUALITY MEASURES
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. References
American Society of Addiction Medicine (ASAM). "Opioid Addiction Disease 2015 Facts and Figures." Available at http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf .
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. F. Summary
The guidelines provide recommendations on the use of MAT across treatment phases with an emphasis on the maintenance phase. Most of the guidelines were developed based upon expert opinion and scientific literature. Some guidelines focus on special populations and over half mention psychosocial treatment. The strength of the recommendation varies f
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. E. Summary of Medication-assisted Treatment Quality Measures
TABLE 3 . MAT for Opioid Use Measures
Measure
Denominator
Numerator
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. D. Variation in Key Features of Medication-assisted Treatment Clinical Guidelines
Stages of Treatment . Both opioid and alcohol use MAT guidelines tend to focus on stages of treatment -- assessment, withdrawal management (also referred to as detoxification), and maintenance -- whereby the recommended dosage of medication and frequency and intensity of MAT vary with the stage of treatment and the client's needs.
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. C. Summary of Medication-assisted Treatment
TABLE 1 . Summary of MAT Guidelines for Opioid Use
Guideline Name
(publication year)
(appendix table #)
Setting
Stage(s) of
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. B. Approach to Review
Even though the roadmap focuses on MAT for opioid use, we recognize that clinical guidelines and measures related to MAT for alcohol and other SUDs could be useful to guide the approach to developing and implementing MAT measures for opioid use. As such, we searched for and reviewed clinical guidelines that include MAT for opioid and alcohol use p
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.
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Acronyms
The following acronyms are mentioned in this report and/or appendices.
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Appendix C. Alcohol Use: Medication-assisted Treatment and Other Related Measures
TABLE C.1 . Alcohol Use: MAT and Other Related Measures
Measure
Denominator
Numerator
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Appendix B. Medication-assisted Treatment for Alcohol Use Clinical Guidelines: Verbatium Excerpts From Relevant Guideline Sections
LIST OF TABLES
TABLE B.1 : SAMHSA and NIAAA: Brief Guide to Medication for the Treatment of Alcohol Use Disorder
TABLE B.2 : NICE: Technology Appraisal Guidance of Nalmefene for Reducing Alcohol Consumption in People with Alcohol Dependence
TABLE B.3 : WHO: Guidelines for the Identification and Management of Substance Use and SUD in Preg
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Appendix D. Substance Use: Medication-assisted Treatment and Other Related Measures
TABLE D.1. Substance Use: MAT and Other Related Measures
Measure
Denominator
Numerator
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Appendix A. Medication-assisted Treatment for Opioid Use Clinical Guidelines: Excerpts From Relevant Sections
LIST OF TABLES
TABLE A.1 : Practice Guidance for Buprenorphine for the Treatment of Opioid Use Disorders: Results of an Expert Panel Process
TABLE A.2 : Institute of Obstetricians and Gynecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Care Health Service Executive: Methadone Prescribing and Admini
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Abstract
Summary : 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.
Review of Medication-Assisted Treatment Guidelines and Measures for Opioid and Alcohol Use. Acknowledgments
Mathematica Policy Research prepared this review under contract to the Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services (HHS) (HHSP23320100019WI/HHSP23337001T). Additional funding was provided by the HHS Substance Abuse and Mental Health Services Administration (SAMHSA). The authors
