Pharmacotherapy for Opioid Use Disorder (POD)

The percentage of opioid use disorder (OUD) pharmacotherapy events that lasted at least 180 days among persons 16 years of age and older with a diagnosis of OUD and a new OUD pharmacotherapy event.

Why It Matters

OUD includes recurrent use and desire for opioids despite both functional and clinical interference; it can be mild, moderate or severe, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (2). 

Individuals with OUD are at increased risk of death, opioid-related overdose, ED visits and readmissions and blood-borne infectious disease (3). Opioid-related overdose deaths in the U.S. increased more than five-fold between 1999 and 2016. In 2016, more than 63,600 deaths were due to drug overdose; of those, 66% involved an opioid (4). Total overall costs of substance misuse and substance use disorders in the U.S., including loss of work productivity, direct health care expenditures and crime-related costs, exceed $400B annually (5). 

Use of and adherence to appropriate evidence-based treatment for OUD has been shown to improve outcomes for patients and reduce the burden on the health care system by preventing acute exacerbations and emergencies (6). The benefits of pharmacotherapy for the treatment of individuals with OUD extends beyond the reduction of substance use, overdose and mortality to include reduced crime and recidivism, reduced risk of infectious disease and improved patient function (7). 

*Adapted with permission by NCQA from the “Continuity of Pharmacotherapy for Opioid Use Disorder” measure owned by The RAND Corporation. 

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References

  2. SAMHSA. 2015. Substance Use Disorders. http://www.samhsa.gov/disorders/substance-use
  3. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse; Phillips, J.K., M.A. Ford, R.J. Bonnie, editors. 2017. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington (DC): National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK458661/
  4. Centers for Disease Control and Prevention (CDC). National Center for Injury Prevention and Control. 2017. Understanding the Epidemic. https://www.cdc.gov/drugoverdose/epidemic/index.html
  5. Department of Health and Human Services. 2016. Medicare Coverage of Substance Abuse Services. https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1604.pdf 6. CDC. 2018. Opioid Overdoses Treated in Emergency Departments. https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html
  6. Pew. 2016. Medication-Assisted Treatment Improves Outcomes for Patients with Opioid Use Disorder. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2016/11/medication-assisted-treatment-improves-outcomes-for-patients-with-opioid-use-disorder#1-backgroun

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