Opioids and Substance Use Disorders: What's New
Validated Screening Tools for Unhealthy Alcohol Use Are Available But Not Regularly Used in Primary Care Settings
An AHRQ-funded study of primary care practices across Virginia found that, while most clinicians (76%) asked patients about alcohol use, only 11% documented using a validated screening tool such as the AUDIT-C. In addition, when comparing EHR documentation to matched patient surveys, far fewer patients were documented as having unhealthy alcohol use than would be expected based on patient self-reported drinking. Refer to The Current State of Alcohol Screening and Management in Virginia Primary Care Practices in the journal Medical Clinics of North America for more information. August 2023.
Persistent Racial Inequities in End-of-Life Care
An AHRQ-funded study found that older Black and Hispanic patients with advanced cancer are less likely to receive opioid medications, and that these inequities are not mediated by socioeconomic variables. "Disparities in Opioid Access and Urine Drug Screening Among Older Patients With Poor-Prognosis Cancer Near the End of Life," June 2023
Health IT functionality and onsite behavioral clinicians linked to increased screening and treatment of OUD
Using a national cross-section database of multi-physician primary care and multispecialty practices, AHRQ-funded researchers found that access to advanced health information technology (IT) and access to onsite behavioral clinicians were associated with a higher extent of physician practices offering the screenings and the medications for opioid use disorder (OUD). More details can be found in Internal and Environmental Predictors of Physician Practice Use of Screening and Medications for Opioid Use Disorders, Medical Care Research and Review. April 2023
MAT and Ongoing Treatment Linked to Lower Costs
Total Cost of Care Associated With Opioid Use Disorder Treatment, a retrospective study among adult patients diagnosed with opioid use disorder (OUD), co-authored by Mohammad Usama Toseef and colleagues, found that patients with OUD who initiated medication treatment but were not linked to ongoing care had the highest healthcare costs, while those who received medication treatment for OUD and were linked to ongoing treatment had the lowest costs. December 2022
AHRQ SUD Presentations at the 15th Annual Conference on the Science of Dissemination and Implementation in Health, December 12-14, 2022
- Implementation of Opioid Prescribing and Management Strategies for Older Adults in Primary Care: Preliminary Findings from the AHRQ Opioids in Older Adults Learning Collaborative.
- Electronic Health Records (EHRs) Used by Small to Medium Primary Care Practices: Do They Include Elements Required to Support Evidence-Based Primary Care for Unhealthy Alcohol Use?
Centers for Disease Control and Prevention Releases the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain
The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022 Clinical Practice Guideline) is now available in the Morbidity and Mortality Weekly Report (MMWR), published on November 3, 2022. The publication updates and replaces the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. CDC also released a suite of tools and resources to help patients and clinicians understand and use the recommendations in the new Guideline in their pain care decision making. November 2022
Analysis of the Impact of ACA Insurance Expansion on Opioid-Related ED Visits
“The Impact of the Affordable Care Act (ACA) Insurance Expansions on Opioid-Related Emergency Department Visits,” co-authored by Sandy Decker, Michael Dworsky (RAND), and Teresa Gibson, Rachel Henke, and Kimberly McDermott (IBM Health) in the American Journal of Health Economics. This study examines the impact of ACA coverage expansions (including Medicaid expansion and Marketplaces) on opioid-related emergency department (ED) visits while accounting for potentially confounding changes in relevant state-level policies. The study found that areas with higher uninsurance rates prior to the ACA saw larger reductions in opioid-related ED visits after the ACA took effect. Effects were also time-varying, with no significant dose-response relationship emerging until the third year of ACA implementation. These estimates suggest that increasing insurance coverage among the uninsured may help mitigate harms of the opioid crisis. October 2022
AHRQ's blog posts, infographics, and announcements on its latest efforts to help end the opioid epidemic.