Substance Use/Opioid - VA Homeless Programs
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Substance Use/Opioid

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Substance Use/Opioid

drug abuse word collageSubstance Use Disorders:

  • are one of the five the most common mental health diagnoses impacting homeless Veterans
  • impact all sectors of society including individuals experiencing homelessness
  • are a source of significant premature death and disability within our society

Effective treatments are available for Substance Use Disorders and people can and do recover.

Access challenges and stigma can create barriers to receiving needed care, this can be particularly true for homeless individuals.

Expanding awareness, education and the availability of resources are all vital to reducing the toll of substance use disorders.

Mental and Substance Use Disorder Treatment for People with Physical and Cognitive Disabilities

Mental and Substance Use Disorder Treatment for People with Physical and Cognitive Disabilities

September 2019

Substance Abuse and Homelessness (2017)

Substance Abuse and Homelessness (2017)

Opioid Use Disorders and Homelessness

Opioid Use Disorders and Homelessness

Proceedings from VA National Center on Homelessness Among Veterans Homeless Evidence and Research Synthesis Roundtable Series (February 2017)

Opiod Use Disorder Among Justice-Involved Veterans Fact Sheet

Screenshot of 1-page Fact Sheet on Opioid Use Disorder Among Justice-Involved Veterans Fact Sheet

Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006–2017

Trends in Opioids Prescribed at Discharge From Emergency Departments Among Adults: United States, 2006–2017

Source: Centers for Disease Control and Prevention (CDC). Published: 1/8/2020. This 12-page report describes trends in opioid prescribing at emergency department (ED) discharge among adults from 2006–2007 through 2016–2017, by selected patient and hospital characteristics and the type of opioids prescribed.

 

Rationale, design and methods of VA-BRAVE: a randomized comparative effectiveness trial of two formulations of buprenorphine for treatment of opioid use disorder in Veterans. Petrakis I, Springer SA, Davis C, Ralevski E, Gu L, Lew R, Hermos J, Nuite M, Gordon AJ, Kosten TR, Nunes EV, Rosenheck R, Saxon AJ, Swift R, Goldberg A, Ringer R, Ferguson R. Addict Sci Clin Pract. 2022 Jan 31;17(1):6. doi: 10.1186/s13722-022-00286-6.

Simulated opioid choice linked to opioid use disorder severity among Veterans with chronic pain: initial validation of a novel paradigm. Parikh A, Moeller SJ, Garland EL. Am J Drug Alcohol Abuse. 2022 Jan 31:1-10. doi: 10.1080/00952990.2021.2007258. Epub ahead of print.

Trends in comorbid opioid and stimulant use disorders among Veterans receiving care from the Veterans Health Administration, 2005-2019. Warfield SC, Bharat C, Bossarte RM, DePhilippis D, Farrell M, Hoover M Jr, Larney S, Marshalek P, McKetin R, Degenhardt L. Drug Alcohol Depend. 2022 Jan 19;232:109310. doi: 10.1016/j.drugalcdep.2022.109310. Epub ahead of print.

Intranasal Oxytocin for Stimulant Use Disorder Among Male Veterans Enrolled in an Opioid Treatment Program: A Randomized Controlled Trial. Stauffer CS, Samson S, Hickok A, Hoffman WF, Batki SL. Front Psychiatry. 2022 Jan 17;12:804997. doi: 10.3389/fpsyt.2021.804997.

Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD): An Implementation Trial in Eight Veterans Health Administration Facilities. Hagedorn HJ, Gustavson AM, Ackland PE, Bangerter A, Bounthavong M, Clothier B, Harris AHS, Kenny ME, Noorbaloochi S, Salameh HA, Gordon AJ. J Gen Intern Med. 2022 Jan 3:1–9. doi: 10.1007/s11606-021-07274-7. Epub ahead of print.

Opioid Use Disorder with Chronic Pain Increases Disease Burden and Service Use. MacLean RR, Sofuoglu M, Stefanovics E, Rosenheck R. Psychol Serv. 2021 Dec 30. doi: 10.1037/ser0000607. Epub ahead of print.

Therapeutic Relationships between Veterans and Buprenorphine Providers and Effects on Treatment Retention. Vakkalanka JP, Lund BC, Arndt S, Field W, Charlton M, Ward MM, Carnahan RM. Health Serv Res. 2021 Dec 1. doi: 10.1111/1475-6773.13919. Epub ahead of print.

Alcohol-Involved Overdose Deaths in US Veterans. Lin LA, Bonar EE, Zhang L, Girard R, Coughlin LN. Drug Alcohol Depend. 2022 Jan 1;230:109196. doi: 10.1016/j.drugalcdep.2021.109196. Epub 2021 Nov 26.

Advancing our Understanding of the Intersection Between Emotion Regulation and Alcohol and Drug Use Problems: Dyadic Analysis in Couples with Intimate Partner Violence and Alcohol Use Disorder. Weiss NH, Hogan J, Brem M, Massa AA, Kirby CM, Flanagan JC. Drug Alcohol Depend. 2021 Nov 1;228:109066. doi: 10.1016/j.drugalcdep.2021.109066. Epub 2021 Sep 24.

Opioid use as a predictor of pain outcomes in Iraq and Afghanistan Veterans with chronic pain: Analysis of a randomized controlled trial. Bushey MA, Wu J, Outcalt SD, Krebs EE, Ang D, Kline M, Yu Z, Bair MJ. Pain Med. 2021 Aug 19:pnab237. doi: 10.1093/pm/pnab237

Substance Use Relapse Among Veterans at Termination of Treatment for Substance Use Disorders.
 Betancourt CA, Kitsantas P, Goldberg DG, Hawks BA. Mil Med. 2021 Jul 17:usab280. doi: 10.1093/milmed/usab280

Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014-2018. Medicaid Outcomes Distributed Research Network (MODRN), Donohue JM, Jarlenski MP, Kim JY, Tang L, Ahrens K, Allen L, Austin A, Barnes AJ, Burns M, Chang CH, Clark S, Cole E, Crane D, Cunningham P, Idala D, Junker S, Lanier P, Mauk R, McDuffie MJ, Mohamoud S, Pauly N, Sheets L, Talbert J, Zivin K, Gordon AJ, Kennedy S. JAMA. 2021 Jul 13;326(2):154-164. doi: 10.1001/jama.2021.7374

Treatment Outcomes Among Black Adults Receiving Medication for Opioid Use Disorder. Parlier-Ahmad AB, Pugh M Jr, Martin CE. J Racial Ethn Health Disparities. 2021 Jul 12:1-11. doi: 10.1007/s40615-021-01095-4

Medication-assisted treatment and self-help group participation among military Veterans with opioid or alcohol use disorder. Albright DL, McDaniel JT, Suntai Z, Laha-Walsh MK, Frick K, Weatherly T, McIntosh S. BMJ Mil Health. 2021 Jul 12:bmjmilitary-2021-001845. doi: 10.1136/bmjmilitary-2021-001845

Moving Beyond Narcan: A Police, Social Service, and Researcher Collaborative Response to the Opioid Crisis. White MD, Perrone D, Watts S, Malm A. Am J Crim Justice. 2021 Jul 3:1-18. doi: 10.1007/s12103-021-09625-w

Severity of substance use as an indicator of suicide risk among U.S. military Veterans.
 Na PJ, Nichter B, Hill ML, Kim B, Norman SB, Pietrzak RH. Addict Behav. 2021 Jul 2;122:107035. doi: 10.1016/j.addbeh.2021.107035

Economic Evaluations of Pharmacologic Treatment for Opioid Use Disorder: A Systematic Literature Review. Onuoha EN, Leff JA, Schackman BR, McCollister KE, Polsky D, Murphy SM. Value Health. 2021 Jul;24(7):1068-1083. doi: 10.1016/j.jval.2020.12.023

Cannabis use disorder, anger, and violence in Iraq/Afghanistan-era Veterans. Dillon KH, Van Voorhees EE, Elbogen EB, Beckham JC; VA Mid-Atlantic MIRECC Workgroup, Calhoun PS. J Psychiatr Res. 2021 Jun;138:375-379. Epub 2021 Apr 22. doi: 10.1016/j.jpsychires.2021.04.018

Psychological Distress and Alcohol Use Disorder During the COVID-19 Era Among Middle- and Low-Income U.S. Adults. Tsai J, Elbogen EB, Huang M, North CS, Pietrzak RH. J Affect Disord. 2021 Jun 1;288:41-49. doi: 10.1016/j.jad.2021.03.085. Epub 2021 Apr 4. PMID: 33839557.

The Association of opioid use disorder and homelessness nationally in the Veterans health administration.
 Manhapra A, Stefanovics E, Rosenheck R. Drug Alcohol Depend. 2021 Jun 1;223:108714. doi: 10.1016/j.drugalcdep.2021.108714

Meeting at the crossroads of pain and addiction: An ethical analysis of pain management with palliative care for individuals with substance use disorders. Flaherty A, Hossain F, Vercelli A. J Opioid Manag. 2021 May-Jun;17(3):207-214. doi: 10.5055/jom.2021.0631

National Trends in Substance Use Treatment Admissions for Opioid Use Disorder among Adults Experiencing Homelessness. Han BH, Doran KM, Krawczyk N. J Subst Abuse Treat. 2021 May 29;132:108504. doi: 10.1016/j.jsat.2021.108504

Sex Differences in Opioid Use Disorder Prevalence and Multimorbidity Nationally in the Veterans Health Administration. Peltier MR, Sofuoglu M, Petrakis IL, Stefanovics E, Rosenheck RA. J Dual Diagn. 2021 May 13:1-11. doi: 10.1080/15504263.2021.1904162

Ending the Chase: Experiences of Rural Individuals with Opioid Use Disorder. Scorsone KL, Haozous EA, Hayes L, Cox KJ. Subst Use Misuse. 2021 Apr 19:1-8. doi: 10.1080/10826084.2021.1914109

Opioid Prescribing in the U.S Military Health System, 2014-2018: fewer prescriptions, fewer pills, and shorter treatment duration. Goldman LAH, Johnson LDD, Griffis LCE, Land EV, Balazs CGC. Pain. 2021 Apr 16. doi: 10.1097/j.pain.0000000000002313

Growing Racial/Ethnic Disparities in Buprenorphine Distribution in the United States, 2007-2017. Schuler MS, Dick AW, Stein BD. Drug Alcohol Depend. 2021 Apr 16;223:108710. doi: 10.1016/j.drugalcdep.2021.108710

Engaging Vulnerable Populations in Drug Treatment Court: Six Month Outcomes from a Co-Occurring Disorder Wraparound Intervention. Shaffer PM, Rodriguez CP, Gaba A, Byrne T, Casey SC, Harter J, Smelson D. Int J Law Psychiatry. 2021 Apr 14;76:101700. doi: 10.1016/j.ijlp.2021.101700

The Association of Opioid Use Disorder and Homelessness Nationally in the Veterans Health Administration. Manhapra A, Stefanovics E, Rosenheck R. Drug Alcohol Depend. 2021 Apr 14;223:108714. doi: 10.1016/j.drugalcdep.2021.108714

The Pharmacology of Buprenorphine Microinduction for Opioid Use Disorder. De Aquino JP, Parida S, Sofuoglu M. Clin Drug Investig. 2021 Apr 5:1-12. doi: 10.1007/s40261-021-01032-7

Perceptions of nonopioid treatment for pain in a homeless population. Fraser KA, Nguyen H, Kim S, Park F, Bernal J, Westberg AD, Podawiltz A. J Osteopath Med. 2021 Apr 2. doi: 10.1515/jom-2020-0239

Homelessness and Veteran Status in Relation to Nonfatal and Fatal Opioid Overdose in Massachusetts. Jasuja GK, Bettano A, Smelson D, Bernson D, Rose AJ, Byrne T, Berlowitz DR, McCullough MB, Miller DR. Med Care. 2021 Apr 1;59(Suppl 2):S165-S169. doi: 10.1097/MLR.0000000000001437

Cost-effectiveness of Treatments for Opioid Use Disorder. Fairley M, Humphreys K, Joyce VR, Bounthavong M, Trafton J, Combs A, Oliva EM, Goldhaber-Fiebert JD, Asch SM, Brandeau ML, Owens DK. JAMA Psychiatry. 2021 Mar 31. doi: 10.1001/jamapsychiatry.2021.0247

Naloxone prescriptions following emergency department encounters for opioid use disorder, overdose, or withdrawal. Kilaru AS, Liu M, Gupta R, Perrone J, Delgado MK, Meisel ZF, Lowenstein M. Am J Emerg Med. 2021 Mar 24;47:154-157. doi: 10.1016/j.ajem.2021.03.056

An Initiative to Increase Opioid Overdose Education and Naloxone Distribution for Homeless Veterans Residing in Contracted Housing Facilities. Rife T, Tat C, Jones J, Pennington DL. J Am Assoc Nurse Pract. 2021 Mar 12. doi: 10.1097/JXX.0000000000000577

Case report: Increasing the frequency of intramuscular naltrexone administration in a high risk patient with opioid use disorder. Wright M, De Aquino JP, Bystrak T. Subst Abus. 2021 Mar 9:1-7. doi: 10.1080/08897077.2021.1876811

Trends in Opioid Use Disorder Among Older Adults: Analyzing Medicare Data, 2013-2018. Shoff C, Yang TC, Shaw BA. Am J Prev Med. 2021 Mar 4:S0749-3797(21)00092-1. doi: 10.1016/j.amepre.2021.01.010

Strategies to Improve Implementation of Medications for Opioid Use Disorder Reported by Veterans Involved in The Legal System: A Qualitative Study. Morse E, Binswanger IA, Taylor E, Gray C, Stimmel M, Timko C, Harris AHS, Smelson D, Finlay AK. J Subst Abuse Treat. 2021 Mar 4;129:108353. doi: 10.1016/j.jsat.2021.108353

Opioid Prescribing and Opioid Risk Mitigation Strategies in the Veterans Health Administration. Sandbrink F, Oliva EM, McMullen TL, Aylor AR, Harvey MA, Christopher ML, Cunningham F, Minegishi T, Emmendorfer T, Perry JM. J Gen Intern Med. 2020 Nov 16. doi: 10.1007/s11606-020-06258-3

Beyond Buprenorphine: Models of Follow-up Care for Opioid Use Disorder in the Emergeny Department. Martin A, Butler K, Chavez T, Herring A, Wakeman S, Hayes BD, Raja A. West J Emerg Med. 2020 Nov 2;21(6):257-263. doi: 10.5811/westjem.2020.7.46079

Differences in Opioid Overdose Mortality Rates Among Middle-Aged Adults by Race/Ethnicity and Sex, 1999-2018. Hoopsick RA, Homish GG, Leonard KE. Public Health Rep. 2020 Nov 19:33354920968806. doi: 10.1177/0033354920968806

A Research Agenda for Advancing Strategies to Improve Opioid Safety: Findings from a VHA State of the Art Conference. Becker WC, Krebs EE, Edmond SN, Lin LA, Sullivan MD, Weiss RD, Gordon AJ. J Gen Intern Med. 2020 Nov 3. doi: 10.1007/s11606-020-06260-9

Barriers and Facilitators to the Use of Medications for Opioid Use Disorder: a Rapid Review. Mackey K, Veazie S, Anderson J, Bourne D, Peterson K. J Gen Intern Med. 2020 Nov 3. doi: 10.1007/s11606-020-06257-4

Assessment of Co-Occurring Substance Use During Opiate Treatment Programs in the United States. Gormley MA, Blondino CT, Taylor DSDH, Lowery E, Clifford JS, Burkart B, Graves WC, Prom-Wormley EC, Lu J. Epidemiol Rev. 2020 Oct 16:mxaa009. doi: 10.1093/epirev/mxaa009

The Association Between Prescribed Opioid Receipt and Community-Acquired Pneumonia in Adults: a Systematic Review and Meta-analysis. Steffens C, Sung M, Bastian LA, Edelman EJ, Brackett A, Gunderson CG. J Gen Intern Med. 2020 Sep 3. doi: 10.1007/s11606-020-06155-9

A systematic review of patients' and providers' perspectives of medications for treatment of opioid use disorder. Cioe K, Biondi BE, Easly R, Simard A, Zheng X, Springer SA. J Subst Abuse Treat. 2020 Dec;119:108146. doi: 10.1016/j.jsat.2020.108146. Epub 2020 Sep 22

Disparities in Access to Medications for Opioid Use Disorder in the Veterans Health Administration. Finlay AK, Harris AHS, Timko C, Yu M, Smelson D, Stimmel M, Binswanger IA. J Addict Med. 2020 Aug 18. doi: 10.1097/ADM.0000000000000719

Mental health and substance use patterns associated with lifetime suicide attempt, incarceration, and homelessness: A latent class analysis of a nationally representative sample of U.S. veterans.
Edwards ER, Barnes S, Govindarajulu U, Geraci J, Tsai J. Psychol Serv. 2020 Aug 27. doi: 10.1037/ser0000488

Heightened healthcare utilization & risk of mental disorders among Veterans with comorbid opioid use disorder & posttraumatic stress disorder. Mahoney CT, Moshier SJ, Keane TM, Marx BP. Addict Behav. 2020 Jul 24;112:106572. doi: 10.1016/j.addbeh.2020.106572

Screening for Unhealthy Drug Use: US Preventive Services Task Force Recommendation Statement. US Preventive Services Task Force, Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, Curry SJ, Donahue K, Doubeni CA, Epling JW Jr, Kubik M, Ogedegbe G, Pbert L, Silverstein M, Simon MA, Tseng CW, Wong JB. JAMA. 2020 Jun 9;323(22):2301-2309. doi: 10.1001/jama.2020.8020.

Effects of Medication-Assisted Treatment (MAT) for Opioid Use Disorder on Functional Outcomes: A Systematic Review. Maglione MA, et al. Rand Health Q. 2020. PMID: 32582471 Free PMC article. 

Treating Opioid Use Disorder and Related Infectious Diseases in the Criminal Justice System. Winetsky D, Fox A, Nijhawan A, Rich JD. Infect Dis Clin North Am. 2020 Sep;34(3):585-603. doi: 10.1016/j.idc.2020.06.012.

Individualized approach to primary prevention of substance use disorder: age-related risks. Afuseh E, Pike CA, Oruche UM. Subst Abuse Treat Prev Policy. 2020 Aug 14;15(1):58. doi: 10.1186/s13011-020-00300-7. (this is a review of the literature)

Veterans at Higher Risk of Overdose/Suicide Death After Stopping Opioid Treatment; Increasing Risk with Duration on Opioids Oliva E, Bowe T, Manhapra A. Associations between Stopping Prescriptions for Opioids, Length of Opioid Treatment, and Overdose or Suicide Deaths in US Veterans: Observational Evaluation. British Medical Journal. March 4, 2020

Barriers to Medications for Opioid Use Disorder Among Veterans Involved in the Legal System: a Qualitative Study. Finlay AK, Morse E, Stimmel M, Taylor E, Timko C, Harris AHS, Smelson D, Yu M, Blue-Howells J, Binswanger IA.Finlay AK, et al. J Gen Intern Med. 2020 Jun 24. doi: 10.1007/s11606-020-05944-6.

The Effects of Prolonged Exposure on Substance Use in Patients with Posttraumatic Stress Disorder and Substance Use Disorders. Peirce JM, Schacht RL, Brooner RK.Peirce JM, et al. J Trauma Stress. 2020 Jun 29. doi: 10.1002/jts.22546.

Mobile, Community-Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study. Iheanacho T, Payne K, Tsai J. Am J Addict. 2020 May 4. doi: 10.1111/ajad.13055. [Epub ahead of print]

Primary care experiences of veterans with opioid use disorder in the Veterans Health Administration. Jones AL, Kertesz SG, Hausmann LRM, Mor MK, Suo Y, Pettey WBP, Schaefer JH Jr, Gundlapalli AV, Gordon AJ. J Subst Abuse Treat. 2020 Jun;113:107996. doi: 10.1016/j.jsat.2020.02.013. Epub 2020 Feb 29.

Polysubstance Use: A Broader Understanding of Substance Use During the Opioid Crisis. Cicero TJ, Ellis MS, Kasper ZA.Am J Public Health. 2020 Feb;110(2):244-250. doi: 10.2105/AJPH.2019.305412

Opioid use and schizophrenia. Li KJ, Chen A, DeLisi LE. Curr Opin Psychiatry. 2020 Feb 18. doi: 10.1097/YCO.0000000000000593. [Epub ahead of print]

Increasing buprenorphine access for veterans with opioid use disorder in rural clinics using telemedicine. Brunet N, Moore DT, Lendvai Wischik D, Mattocks KM, Rosen MI. Subst Abus. 2020 Feb 20:1-8. doi: 10.1080/08897077.2020.1728466. [Epub ahead of print]

The Effects of Co-Occurring Interpersonal Trauma and Gender on Opioid Use and Misuse. Williams JR, Girdler S, Williams W, Cromeens MG. J Interpers Violence. 2020 Feb 13:886260519900309. doi: 10.1177/0886260519900309. [Epub ahead of print]

Interventions for incarcerated adults with opioid use disorder in the United States: A systematic review with a focus on social determinants of health. Sugarman OK, Bachhuber MA, Wennerstrom A, Bruno T, Springgate BF. PLoS One. 2020 Jan 21;15(1):e0227968. doi: 10.1371/journal.pone.0227968. eCollection 2020.

Prescription opioid misuse among heterosexual versus lesbian, gay, and bisexual military veterans: Evidence from the 2015-2017 national survey of drug use and health. Anderson-Carpenter KD, Rutledge JD, Mitchell K. Drug Alcohol Depend. 2020 Feb 1;207:107794. doi: 10.1016/j.drugalcdep.2019.107794. Epub 2019 Dec 10.

Rapid Transition From Methadone to Buprenorphine Utilizing a Micro-dosing Protocol in the Outpatient Veteran Affairs Setting. De Aquino JP, Fairgrieve C, Klaire S, Garcia-Vassallo G. J Addict Med. 2020 Jan 31. doi: 10.1097/ADM.0000000000000618. [Epub ahead of print]

Inhibitory-control training for cocaine use disorder and contingency management for clinic attendance: A randomized pilot study of feasibility, acceptability and initial efficacy. Rush CR, Strickland JC, Pike E, Studts CR, Stoops WW. Drug Alcohol Depend. 2020 Feb 1;207:107803. doi: 10.1016/j.drugalcdep.2019.107803. Epub 2019 Dec 16.

Rural Community Action Guide: Building Stronger, Healthy, Drug-Free Rural Communities (January 2020)

Effects of medication-assisted treatment on mortality among opioids users: a systematic review and meta-analysis. Ma J, Bao YP, Wang RJ, Su MF, Liu MX, Li JQ, Degenhardt L, Farrell M, Blow FC, Ilgen M, Shi J, Lu L.Ma J, et al. Mol Psychiatry. 2019 Dec;24(12):1868-1883. doi: 10.1038/s41380-018-0094-5. Epub 2018 Jun 22.Mol Psychiatry . 2019. PMID: 29934549

Geographic Disparities Affect Access to Buprenorphine Services for Opioid Use Disorder OIG used data from the Substance Abuse and Mental Health Services Administration (SAMHSA) to determine the number and nation-wide patient capacity of providers who had received waivers to prescribe buprenorphine for MAT as of April 2018. We also used these data to identify U.S. counties with low patient capacity rates.

Opioid use and receipt of medication-assisted treatment and overdose reversal medication

The Opioid Epidemic In Veterans Who Were Homeless Or Unstably Housed. Midboe AM, Byrne T, Smelson D, Jasuja G, McInnes K, Troszak LK.Health Aff (Millwood). 2019 Aug;38(8):1289-1297. doi: 10.1377/hlthaff.2019.00281.

Homeless Veterans in Nursing Homes: Care for Complex Medical, Substance Use, and Social Needs. Jutkowitz E, Halladay C, McGeary J, O'Toole T, Rudolph JL.J Am Geriatr Soc. 2019 Aug;67(8):1707-1712. doi: 10.1111/jgs.15993. Epub 2019 Jun 17.

Predictive Validity of Outpatient Follow-up After Detoxification as a Quality Measure. Schmidt EM, Gupta S, Bowe T, Ellerbe LS, Phelps TE, Finney JW, Humphreys K, Trafton J, Vanneman ME, Harris AHS. J Addict Med. 2017 May/Jun;11(3):205-210. doi: 10.1097/ADM.0000000000000298.

Opioid overdose education and naloxone distribution: Development of the Veterans Health Administration's national program (2017)

Characteristics and service utilization of homeless veterans entering VA substance use treatment. Cox KB, Malte CA, Saxon AJ. Psychol Serv. 2017 May;14(2):208-213. doi: 10.1037/ser0000133.

Receipt of pharmacotherapy for opioid use disorder by justice-involved U.S. Veterans Health Administration patients. Finlay AK, Harris AH, Rosenthal J, Blue-Howells J, Clark S, McGuire J, Timko C, Frayne SM, Smelson D, Oliva E, Binswanger I. Drug Alcohol Depend. 2016 Mar 1;160:222-6. doi: 10.1016/j.drugalcdep.2016.01.013. Epub 2016 Jan 24.

Predictive validity of a quality measure for intensive substance use disorder treatment.
Schmidt EM, Gupta S, Bowe T, Ellerbe LS, Phelps TE, Finney JW, Asch SM, Humphreys K, Trafton J, Vanneman M, Harris AHS. Subst Abus. 2017 Jul-Sep;38(3):317-323. doi: 10.1080/08897077.2016.1212779. Epub 2016 Jul 19.

Predictive validity of two process-of-care quality measures for residential substance use disorder treatment. Harris AH, Gupta S, Bowe T, Ellerbe LS, Phelps TE, Rubinsky AD, Finney JW, Asch SM, Humphreys K, Trafton J. Addict Sci Clin Pract. 2015 Oct 31;10:22. doi: 10.1186/s13722-015-0042-5.

Screening for homelessness among individuals initiating medication-assisted treatment for opioid use disorder in the Veterans Health Administration.  Bachhuber MA, Roberts CB, Metraux S, Montgomery AE. J Opioid Manag. 2015 Nov-Dec;11(6):459-62. doi: 10.5055/jom.2015.0298.

Impact of opioid dose escalation on the development of substance use disorders, accidents, self-inflicted injuries, opioid overdoses and alcohol and non-opioid drug-related overdoses: a retrospective cohort study. Hayes CJ, Krebs EE, Hudson T, Brown J, Li C, Martin BC. Addiction. 2020 Jan 15. doi: 10.1111/add.14940. [Epub ahead of print]
 
The effectiveness of substance use interventions for homeless and vulnerably housed persons:  A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder. Magwood O, Salvalaggio G, Beder M, Kendall C, Kpade V, Daghmach W, Habonimana G, Marshall Z, Snyder E, O'Shea T, Lennox R, Hsu H, Tugwell P, Pottie K. PLoS One. 2020 Jan 16;15(1):e0227298. doi: 10.1371/journal.pone.0227298. eCollection 2020.

Use of urinary naloxone levels in a single provider practice: a case study. Warrington JS, Booth K, Warrington GS, Francis-Fath S. Addict Sci Clin Pract. 2020 Jan 15;15(1):3. doi: 10.1186/s13722-020-0178-9.

Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach. Rozylo J, Mitchell K, Nikoo M, Durante SE, Barbic SP, Lin D, Mathias S, Azar P. Addict Sci Clin Pract. 2020 Jan 15;15(1):2. doi: 10.1186/s13722-020-0177-x.

Gender differences in diversion among non-medical users of prescription opioids and sedatives. Milani SA, Lloyd SL, Serdarevic M, Cottler LB, Striley CW. Am J Drug Alcohol Abuse. 2020 Jan 14:1-8. doi: 10.1080/00952990.2019.1708086. [Epub ahead of print]

Opioids: Past-Year Misuse Associated with Suicide Attempt Past-year opioid misuse was associated with past-year suicide attempt in high suicide-risk Veterans: 82% of opioid misusers had attempted suicide in the past year versus 56% of those who misused other substances...[more]

Case Managers and Community Efforts to Impact the Opioid Crisis. Treiger TM. Prof Case Manag. 2020 Mar/Apr;25(2):94-95. doi: 10.1097/NCM.0000000000000420. No abstract available.

Outcomes of prescription opioid dose escalation for chronic pain: results from a prospective cohort study. Morasco BJ, Smith N, Dobscha SK, Deyo RA, Hyde S, Yarborough BJH. Pain. 2020 Jan 24. doi: 10.1097/j.pain.0000000000001817. [Epub ahead of print]

Opioid Prescribing Behaviors — Prescription Behavior Surveillance System, 11 States, 2010–2016. MMWR Surveill Summ 2020;69(No. SS-1):1–14. DOI: http://dx.doi.org/10.15585/mmwr.ss6901a1external icon.

Most Patients With Opioid-Related Hospitalizations Have Chronic Conditions , Neurology Advisor, January 2020

Rural Veterans Less Likely to Get Medication for Opioid Use Disorder. Rubin R. JAMA. 2020 Jan 28;323(4):300. doi: 10.1001/jama.2019.21856. No abstract available.

Implementation evaluation of academic detailing on naloxone prescribing trends at the United States Veterans Health Administration. Bounthavong M, Devine EB, Christopher MLD, Harvey MA, Veenstra DL, Basu A. Health Serv Res. 2019 Oct;54(5):1055-1064. doi: 10.1111/1475-6773.13194. Epub 2019 Jul 17.

Opioid Prescribing After Opioid-related Inpatient Hospitalizations by Diagnosis: A Cohort Study. Lagisetty PA, Lin LA, Ganoczy D, Haffajee RL, Iwashyna TJ, Bohnert ASB. Med Care. 2019 Oct;57(10):815-821. doi: 10.1097/MLR.0000000000001182.

Counteracting the Effect of Stigma on Education for Substance Use Disorders.
Renner JA Jr. Focus (Am Psychiatr Publ). 2019 Apr;17(2):134-140. doi: 10.1176/appi.focus.20180039. Epub 2019 Apr 10.

Behavioral and Accumbal Responses During an Affective Go/No-Go Task Predict Adherence to Injectable Naltrexone Treatment in Opioid Use Disorder. Shi Z, Jagannathan K, Wang AL, Fairchild VP, Lynch KG, Suh JJ, Childress AR, Langleben DD. Int J Neuropsychopharmacol. 2019 Mar 1;22(3):180-185. doi: 10.1093/ijnp/pyz002.

Impact of opioid dose escalation on the development of substance use disorders, accidents, self-inflicted injuries, opioid overdoses and alcohol and non-opioid drug-related overdoses: a retrospective cohort study. Hayes CJ, Krebs EE, Hudson T, Brown J, Li C, Martin BC. Addiction. 2020 Jan 15. doi: 10.1111/add.14940. [Epub ahead of print]

The effectiveness of substance use interventions for homeless and vulnerably housed persons:  A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder. Magwood O, Salvalaggio G, Beder M, Kendall C, Kpade V, Daghmach W, Habonimana G, Marshall Z, Snyder E, O'Shea T, Lennox R, Hsu H, Tugwell P, Pottie K. PLoS One. 2020 Jan 16;15(1):e0227298. doi: 10.1371/journal.pone.0227298. eCollection 2020.

Use of urinary naloxone levels in a single provider practice: a case study. Warrington JS, Booth K, Warrington GS, Francis-Fath S. Addict Sci Clin Pract. 2020 Jan 15;15(1):3. doi: 10.1186/s13722-020-0178-9.

Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach. Rozylo J, Mitchell K, Nikoo M, Durante SE, Barbic SP, Lin D, Mathias S, Azar P. Addict Sci Clin Pract. 2020 Jan 15;15(1):2. doi: 10.1186/s13722-020-0177-x.

Gender differences in diversion among non-medical users of prescription opioids and sedatives. Milani SA, Lloyd SL, Serdarevic M, Cottler LB, Striley CW. Am J Drug Alcohol Abuse. 2020 Jan 14:1-8. doi: 10.1080/00952990.2019.1708086. [Epub ahead of print]

Opioids: Past-Year Misuse Associated with Suicide Attempt Past-year opioid misuse was associated with past-year suicide attempt in high suicide-risk Veterans: 82% of opioid misusers had attempted suicide in the past year versus 56% of those who misused other substances...[more]

Comprehensive Addiction and Recovery Act of 2016: To authorize the Attorney General and Secretary of Health and Human Services to award grants to address the prescription opioid abuse and heroin use crisis, and for other purposes.

Under Public Law 114-113, Title V section 520, Federal agencies are permitted to use Federal funds to support comprehensive syringe service programs, however Federal agencies cannot use those funds to purchase sterile needles or syringes. (http://www.cdc.gov/hiv/risk/ssps.html

Public Law No: 115-271 Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act (10/24/2018)

 

The Center is not responsible for the content or privacy policies of these Web sites and linking to these sites does not constitute endorsement by the Center of the sites' sponsors or the information, products, or services they provide.

Alcoholics Anonymous (AA): AA is an international fellowship of men and women who have had a drinking problem. It is nonprofessional, self-supporting, multiracial, apolitical, and available almost everywhere. There are no age or education requirements. Membership is open to anyone who wants to do something about his or her drinking problem.

Al-Anon: Al-Anon is a is a fellowship group designed to help people who are affected by a loved one's drinking behavior. The support group is also commonly referred to as the Al-Anon Family Group

American Academy of Child & Adolescent Psychology: Substance Use Resources Center

Cannabis Substance Abuse among Homeless and Runaway Youths – What Can You Do & How to Find Help – Stay Honest: A guide on assisting homeless and runaway youths who suffer from substance abuse, with a comprehensive section of additional resources.

Certification of Opioid Treatment Programs

Curated Library about Opioid Use for Decision-Makers (CLOUD) Source: Milbank Memorial Fund. Published: 1/2020. This web page provides an online source for curated, actionable, evidence-based resources on opioids and the opioid crisis in the United States. It offers resources on a broad range of topics, including addiction treatment, harm reduction, prevention, recovery, and alternative treatments for pain. The materials include downloadable documents, such as policy reports, implementation guides, government documents such as relevant legislation, infographics, videos, and website links.

Locating Treatment Facilities for Veterans Find Facilities for Veterans


Narcotics Anonymous (NA): NA is a nonprofit fellowship or society of men and women for whom drugs had become a major problem. Members are recovering addicts who meet regularly to help each other stay clean. This is a program of complete abstinence from all drugs. There is only one requirement for membership, the desire to stop using.

National Institute on Drug Abuse (NIDA) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)
 – January 2018

National Treatment Plan for Substance Use Disorder (2020) – download

OEND Implementation SharePoint

Opioid Overdose Prevention Toolkit: This SAMHSA guide is for health care professionals, communities, patients, and families to prevent and manage opioid overdoses.

Opioid Safety Initiative Dashboard ACCESS LINK  (VA access only)

Opioid Therapy Guidelines: The guideline describes the critical decision points in the Management of Opioid Therapy (OT) for Chronic Pain and provides clear and comprehensive evidence-based recommendations incorporating current information and practices for practitioners throughout the DoD and VA Health Care systems. The workgroup consensus statements are provided to minimize harm and increase patient safety in patients requiring opioid therapy.

Disclaimer:This Clinical Practice Guideline is intended for use only as a tool to assist a clinician/healthcare professional and should not be used to replace clinical judgment.

Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic Source: National Academies Press (NAP). Published: 1/2020. Opioid use and infectious diseases are intertwined epidemics. This 182-page report examines current efforts to integrate care and describes barriers, such as inadequate workforce and training; lack of data integration and sharing; and stigma among people who use drugs and have also been diagnosed with an infectious disease. 

Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder
(April 2021)

Prescribing Safety: Program Evaluation & Resource Center (PERC)

Public Health Emergency: State Efforts to Curb the Opioid Crisis
Source: U.S. House of Representatives, Committee on Energy and Commerce. Published: 1/14/2020. This two-hour, 41-minute Congressional hearing provides five key states (Massachusetts, North Carolina, Pennsylvania, Rhode Island, and West Virginia) with an opportunity to discuss ongoing efforts to curb the opioid epidemic, as well as areas of additional support Congress can consider. The hearing also explores whether federal funds have enabled states to expand evidence-based treatment, and whether states have adequate flexibility to respond to this ever-evolving crisis. (Video or Multimedia)

SAMSHA Naloxone Website

SAMSHA National Helpline

SMART Recovery  Self-Management And Recovery Training (SMART) is a global community of mutual-support groups. At meetings, participants help one another resolve problems with any addiction (to drugs or alcohol or to activities such as gambling or over-eating).

Statutes, Regulations, and Guidelines

Stratification Tool for Opioid Risk Mitigation (STORM) Frequently Asked Questions

Substance Use Resource for Young Adults & Adolescents

Understanding Naloxone

The Ultimate Guide to Helping Those in Need of Addiction Recovery from Cannabis and Other Substances – Stay Honest

POC

Michal Wilson, MD Michal.wilson@va.gov

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