We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Adherence to Buprenorphine Treatment Guidelines in a Medicaid Program
Jeffrey D. Baxter , Robin E. Clark , Mihail Samnaliev , Gideon Aweh , Elizabeth O’Connell
Substance Abuse
Vol. 36, Iss. 2, 2015

This is the first study to investigate the structure of buprenorphine treatment on a large scale across multiple providers and clinical practice sites. Our findings suggest there is significant variation in practice patterns, and that many patients receive care outside of the levels recommended by current treatment guidelines.

Now after more than 10 years experience with office-based buprenorphine treatment, providers and policy makers are at a crossroads. With opioid abuse and overdose rates increasing, federal agencies are weighing expanding the buprenorphine prescribing limits to try to improve access. At the same time, states and private payers are imposing restrictions on treatment without understanding the potential impact of limiting access on patients’ lives and on healthcare costs.

In order to sustain and expand this modality, it is critically important create policies that ensure buprenorphine treatment is provided in the highest quality, most cost effective manner. We hope that our findings support work on updating treatment guidelines and developing quality metrics that will encourage both providers and payers to invest further in providing high quality treatments for opioid addiction.

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Defining Nonmedical Use of Prescription Opioids Within Health Care Claims: A Systematic Review
Gerald Cochran, Bongki Woo, Wei-Hsuan Lo-Ciganic, Adam J. Gordon,  Julie M. Donohue, Walid F. Gellad
Substance Abuse
Vol. 36, Iss. 2, 2015

Health insurance claims data may play an important role for healthcare systems and payers in monitoring the non-medical use of prescription opioids (NMPO) among patients. We conducted a systematic review of publications that defined and measured NMPO within health insurance claims databases in order to describe definitions of NMPO and identify areas for improvement. Findings showed substantial variation in: conceptual and operational definitions of NMPO, efforts to validate these definitions, and rates of NMPO. Future research should prospectively test and validate a construct of NMPO to disseminate to payers and health officials.

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Breastfeeding and Methadone Therapy: The Maternal Experience
Jill R. Demirci , Debra L. Bogen , Yael Klionsky
Substance Abuse
Vol. 36, Iss. 2, 2015

The breastfeeding challenges faced by women prescribed methadone are often inferred, but these assertions have not been substantiated from the maternal perspective. In this study, we found that women taking methadone and intending to breastfeed face additional barriers to breastfeeding establishment compared to the general population (e.g., poor support, concern about methadone transfer through breast milk); yet, awareness of the protective effects of breastfeeding against neonatal abstinence syndrome is a highly motivating factor to persevere through these challenges. Our research exposes the shortcomings of the healthcare community in educating women about the safety and benefits of breastfeeding while taking methadone, but also highlights the opportunities clinicians and researchers have to correct misinformation, promote maternal breastfeeding confidence, and develop support systems to improve breastfeeding outcomes in this population.