research Archives

SAj Flashback: Research priorities for expanding access to methadone treatment for opioid use disorder in the United States: A National Institute on Drug Abuse Center for Clinical Trials Network Task Force report

Oct 11, 2022 by AMERSA

In this SAj Flashback, we look back to “A National Institute on Drug Abuse Center for Clinical Trials Network Task Force report” from SAj Volume 42, Issue 3. This commentary comes from authors Paul J. Joudrey, MD, MPH; Gavin Bart, MD, PhD; Robert K. Brooner, PhD; Lawrence Brown, MD, MPH; Julie Dickson-Gomez, PhD; Adam Gordon, MD, MPH; Sarah S. Kawasaki, MD; Jane M. Liebschutz, MD MPH; Edward Nunes, MD; Dennis McCarty, PhD; Robert P. Schwartz, MD; José Szapocnik, PhD; Madhukar Trivedi, MD; Judith I. Tsui, MD MPH; Arthur Williams, MD; Li-Tzy Wu, DSc; and David A. Fiellin, MD.

In the US, methadone treatment can only be provided to patients with opioid use disorder (OUD) through federal and state-regulated opioid treatment programs (OTPs). There is a shortage of OTPs, and racial and geographic inequities exist in access to methadone treatment. The National Institute on Drug Abuse Clinical Trials Network convened the Methadone Access Research Task Force to develop a research agenda to expand and create more equitable access to methadone treatment for OUD. This research agenda included mechanisms that are available within and outside the current regulations. The task force identified 6 areas where research is needed: (1) access to methadone in general medical and other outpatient settings; (2) the impact of methadone treatment setting on patient outcomes; (3) impact of treatment structure on outcomes in patients receiving methadone; (4) comparative effectiveness of different medications to treat OUD; (5) optimal educational and support structure for provision of methadone by medical providers; and (6) benefits and harms of expanded methadone access. In addition to outlining these research priorities, the task force identified important cross-cutting issues, including the impact of patient characteristics, treatment, and treatment system characteristics such as methadone formulation and dose, concurrent behavioral treatment, frequency of dispensing, urine or oral fluid testing, and methods of measuring clinical outcomes. Together, the research priorities and cross-cutting issues represent a compelling research agenda to expand access to methadone in the US.

Read this commentary now in SAj Volume 42, Issue 3 or online.

The Authors’ Own Words: Implementation of a nationwide health economic consultation service to assist substance use researchers: Lessons learned

Jan 3, 2020 by AMERSA

The Authors’ Own Words:

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.

Implementation of a nationwide health economic consultation service to assist substance use researchers: Lessons learned

Sean M. Murphy PhD; Jared A. Leff MS; Benjamin P. Linas MD, MPH; Jake R. Morgan PhD; Kathryn McCollister PhD; & Bruce R. Schackman PhD

Substance Abuse Vol. 39, Iss. 2, 2018

“Both effectiveness and costs must be taken into consideration to successfully reach the greatest number of individuals and match them with the best interventions; however, health-economic researchers with expertise in substance use disorders and related conditions can be difficult to find. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) designed a free consultation service for investigators whose work aligns with CHERISH’s mission of developing and disseminating health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances. The Consultation Service serves as a resource to ensure that economic analyses are appropriately designed, methodologically sound, and feasible, and that outcomes are correctly interpreted.”

The Authors’ Own Words: Development and evaluation of a standardized research definition for opioid overdose outcomes

Nov 10, 2019 by AMERSA

The Authors’ Own Words:

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.

Development and evaluation of a standardized research definition for opioid overdose outcomes

Ingrid A. Binswanger, MD, MPH, MS; Komal J. Narwaney, PhD; Edward M. Gardner, MD; Barbara A. Gabella, MSPH; Susan L. Calcaterra, MD, MPH; Jason M. Glanz, PhD

Substance Abuse Vol. 40, Iss. 1, 2019

“There is little consensus on how to verify opioid overdose outcomes for research purposes. To ensure reproducibility, minimize misclassification, and permit data harmonization across studies, standardized and consistent overdose definitions are needed. Thus, Binswanger and colleagues developed and evaluated a case criteria classification scheme for pharmaceutical opioid and heroin overdoses in two distinct health systems, using information commonly available in electronic health records. This scheme was compared with clinician impression and encounter documentation. This novel case criteria classification scheme for opioid overdose represents a potential option for a consistent and reproducible definition of overdose in multi-site research.“