The National Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic produces many different types of publications to advance the field and accelerate the translation of the most promising opportunities to reverse the opioid crisis. Read the publications below to gain insight into the strategies members of the Action Collaborative have identified to address the U.S. opioid crisis and improve care for patients who experience pain.
Guide for Future Directions for the Addiction and OUD Treatment Ecosystem
April 5, 2021
Identifying, addressing, and closing existing gaps in the addiction and opioid use disorder treatment ecosystem is a vital step in addressing America’s epidemic of drug overdose and death.
Authors of a new individually-authored discussion paper outline major gaps in the treatment ecosystem through the framework of “the 4 Cs”: capacity, competency, consistency, and compensation. Under each major header, the authors identify areas that could benefit from sustained investment, further research, or applied expertise, including naloxone distribution, ensuring payment parity, identifying successes in telemedicine during COVID-19, and ensuring consistency of high-quality care.
Combatting the Stigma of Addiction – The Need for a Comprehensive Health System Approach
November 9, 2020
The COVID-19 pandemic has increased stress on the health system, which in turn exposed and exacerbated the barriers to care often faced by individuals with opioid use disorder (OUD). Creating robust efforts to call attention to stigma and build individual and structural competency is necessary to drive change. The authors of a new individually-authored commentary call for a cohesive, evidence-driven effort to eliminate stigma against OUD.
The American Opioid Epidemic in Special Populations: Five Examples
October 26, 2020
The United States is in the midst of an unprecedented crisis of prescription and illicit opioid misuse, use disorder, and overdose. Although the crisis has affected large swaths of the U.S. population, it has impacted certain segments of the population with an extra level of intensity—justice-involved populations, rural populations, veterans, adolescents and young adults, and people who inject drugs. Research has clearly shown that solutions for the opioid overdose epidemic are not one size fits all, and special attention should be paid to these populations that may be suffering unduly.
The discussion paper “The American Opioid Epidemic in Special Populations: Five Examples” focuses on these five identified populations and, for each, reviews why the population warrants focused attention, current barriers encountered in accessing care, promising approaches in supporting this population, and high-impact research and action priorities.
Best Practices, Research Gaps, and Future Priorities to Support Tapering Patients on Long-Term Opioid Therapy for Chronic Non-Cancer Pain in Outpatient Settings
August 10, 2020
Ensuring high-quality, respectful, and appropriate management of chronic non-cancer pain (CNCP) in the context of the U.S. opioid crisis is a critical and complex endeavor. Unfortunately, data regarding the best way to proceed with care for these patients in terms of opioid maintenance or tapering are lacking. The evidence supporting the use of opioids in managing CNCP is weak, and there is now strong evidence that chronic opioid use among CNCP patients can be detrimental, particularly at high doses.
The discussion paper “Best Practices, Research Gaps, and Future Priorities to Support Tapering Patients on Long-Term Opioid Therapy for Chronic Non-Cancer Pain in Outpatient Settings” focuses on key decision points and available evidence to support tapering strategies for specific patient populations of long-term opioid use being treated for CNCP in the out-patient setting. This document summarizes the key messages from the discussion paper, as well as identified priorities for future research. It must be reiterated that the needs of each patient are unique and should be approached on a case-by-case basis. Clinicians should review the risks and benefits of tapering for each patient and proceed in a way that is informed by individual circumstances.
Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System
April 27, 2020
Though medications for opioid use disorder are effective and approved by the FDA, almost four in five Americans with opioid use disorder (OUD) do not receive treatment with these medications. The gap in access to evidence-based care, including treatment with these medications, stems in part from barriers to change within the health care system. An individually authored discussion paper by members of the National Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic identifies nine key barriers to access, use, and delivery of evidence-based treatment and focuses on strategies that can be employed by providers, researchers, payers, institutions, educational and accrediting bodies, and regulators to overcome barriers and move toward a more functional treatment system for all. The barriers are divided into five categories: provider barriers, institutional barriers, regulatory barriers, financial barriers, and barriers to engagement within the treatment system.
The paper’s authors present 25 potential strategies to address these barriers. Some are achievable immediately, and some will need to be executed over a longer term. All the strategies work toward the end goal of improving access to evidence-based medical treatment and better care for those with OUD.
Dismantling Buprenorphine Policy Can Provide More Comprehensive Addiction Treatment
September 9, 2019
Reversing the trends of the opioid epidemic will require as many qualified practitioners as possible, willing to provide their patients the care they need. Every health care provider should be empowered to give their patients the care they need if it is safe and reasonable, but they need education and clinical support. Restrictions on clinicians, along with stigma around addiction treatment, are impeding the abilities of health care providers to adequately treat opioid use disorder. This individually authored commentary includes potential solutions to broadening access to care, and how the health system can support clinicians to provide this care.