Opioid Use Disorder News—January 2018 Update

The following items highlight important news and publications about medication-assisted treatment (MAT) and opioid use disorder (OUD):

Department of Health and Human Services News and Publications

• Strategies To Address the Opioid Epidemic (Centers for Medicare & Medicaid Services)—this letter announces that CMS will take a new approach in working with States on section 1115(a) demonstrations, which give States additional flexibility to design and improve their programs for Medicaid beneficiaries.
• The Underestimated Cost of the Opioid Crisis (Council of Economic Advisers)—this report estimates the economic cost of deaths from drug overdoses involving opioids to be $504 billion in 2015, or 2.8 percent of the Nation’s gross domestic product.
• Rural America in Crisis: The Changing Opioid Overdose Epidemic (Centers for Disease Control and Prevention)—this blog discusses how rural communities have been effected by the opioid epidemic and how public health programs can prevent overdose deaths in rural America.
• Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700—10 States, July-December 2016 (Centers for Disease Control and Prevention)—this report uses toxicologic and death scene evidence to characterize opioid overdose deaths and estimate those that involve synthetic opioids, including fentanyl and fentanyl analogs.
• Illicit Drug Use, Illicit Drug Use Disorders, and Drug Overdose Deaths in Metropolitan and Nonmetropolitan Areas—United States (Centers for Disease Control and Prevention)—this study finds the rate of drug overdose deaths in rural areas is increasing and has surpassed rates in urban areas.

Peer-Reviewed Literature

• Comparative Effectiveness of Extended-Release Naltrexone Versus Buprenorphine-Naloxone for Opioid Relapse Prevention: A Multicentre, Open-Label, Randomised Controlled Trial (The Lancet)—this study finds that both extended-release naltrexone and sublingual buprenorphine-naloxone were equally safe and effective, but it was more difficult to initiate patients with extended-release naltrexone.
• Experiences of Three States Implementing the Medicaid Health Home Model To Address Opioid Use Disorder (Journal of Substance Abuse Treatment)—this study concludes that opioid health homes may be an effective model to treat the complex needs of individuals with opioid use disorder. 
• Service Use Preceding Opioid-Related Fatality (American Journal of Psychiatry)—this study examines health service patterns of individuals who died of opioid-related causes and finds that they commonly used services related to behavioral health disorders in their last year of life yet often lacked formal opioid use disorder diagnoses near the time of death.
• Underlying Factors in Drug Overdose Deaths (JAMA)—this opinion piece discusses the role of illicitly manufactured fentanyl in the increase in drug overdose deaths in recent years.

Other News

• Pharmacy Benefit Management of Opioid Prescribing: The Role of Employers and Insurers (Health Affairs)—this blog discusses how pharmacy benefit managers may use utilization management techniques to guide physician prescribing of opioids.
• Value-Based Payment as Part of a Broader Strategy To Address Opioid Addiction Crisis (Health Affairs)—this blog explains how value-based payment models could improve the quality and lower the costs of care for patients with opioid use disorder.
• In Focus: Expanding Access to Addiction Treatment Through Primary Care (The Commonwealth Fund)—this article discusses how integrating treatment into primary care presents an opportunity to increase access to addiction services.
• New Leaders Use Telehealth—and Teamwork—To Tackle Opioid Use (Robert Wood Johnson Foundation)—this blog explains how programs can leverage telehealth technologies to increase access to treatment for patients with opioid use disorders who live in rural areas.