Objective: Few studies examine how payers address the need for improved access to pharmacotherapy for opioid use disorders and the influence of environmental variables on access to opioid agonist and antagonist medications.
Method: The 52 Ohio Addiction Drug Abuse and Mental Health Services (ADAMHS) Boards that disburse funds for treatment services for the uninsured and underinsured were surveyed to assess coverage for opioid agonist and antagonist treatment medications. Analyses examined public health data on regional opioid addiction patterns, characteristics of the local health insurance market, and their associations with coverage for opioid addiction pharmacotherapy.
Results: Most (70%) of the 44 participating ADAMHS Boards paid for opioid treatment medications. For payment policy, all Boards required behavioral therapy to be provided in conjunction with opioid agonist or opioid antagonist therapy, and 27% of the Boards limited length of a buprenorphine therapy regimen. Higher local opioid treatment admission rates were associated with higher rates of Board funding for opioid treatment pharmacotherapy. Environmental variables (eg, overdose fatality rates or the behaviors of private insurance payers) were not associated with ADAMHS support for opioid agonist or antagonist medication.
Conclusions: The analysis highlights the policy preferences of these payers. Follow-up studies should examine the payer decision-making processes, preferences, and attitudes that affect support for pharmacotherapy for opioid dependence.
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http://dx.doi.org/10.1097/ADM.0000000000000369 | DOI Listing |
Orthop Rev (Pavia)
December 2024
Anesthesiology Montefiore Medical Center, Albert Einstein College of Medicine.
Introduction: Opioid use disorder is a chronic illness with significant morbidity and mortality. Opioid agonists, like buprenorphine, are commonly used to prevent relapse. Recent changes in buprenorphine legislation are expected to increase prescription and guidelines recommend its continuation during the perioperative period for many patients.
View Article and Find Full Text PDFCureus
November 2024
Anesthesiology, Hospital Clínica Bíblica, San José, CRI.
Pain is a prevalent issue among patients, requiring effective management to prevent the transition of acute pain into chronic pain and to mitigate significant clinical and socioeconomic impacts, such as increased morbidity, mortality, prolonged recovery, unplanned readmissions, and diminished quality of life. Despite advancements in pain management guidelines, achieving consistent pain relief remains challenging due to individual differences in pain thresholds, the nature of surgical procedures, patient age, and existing comorbidities. Tapentadol, an opioid that acts as both a μ-opioid receptor agonist and a noradrenaline reuptake inhibitor, presents a promising option for pain management.
View Article and Find Full Text PDFBMC Psychiatry
December 2024
Department of Economics, University of Bergen, Postboks, Bergen, 7802, 5020, Norway.
Background: Opioid use disorders constitute a vast disease burden, need for comprehensive treatment, and substantial costs to individuals, families, and society. The multifaceted needs of people with opioid dependence call for integrated care. The study aims to assess the added value of an integrated medically assisted rehabilitation (MAR) program providing opioid agonist therapy for patients with opioid dependence as compared to the standard of care (SoC) in Norway.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
Department of Emergency Medicine, Emory University, Atlanta, Georgia.
Importance: Recreational use of drug-soaked paper strips (hereafter, strips) in correctional facilities poses a major public health risk owing to the diverse and potentially severe toxic effects of the substances they contain. Understanding the clinical manifestations and outcomes of exposure to these strips is important for developing effective management and prevention strategies.
Objective: To characterize the clinical manifestations, management, and outcomes of intoxication from strips in a correctional facility population, and to identify the specific substances present in these strips.
Harm Reduct J
December 2024
Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
Background: People who inject drugs (PWID) are at high risk of blood-borne infections, and injection drug use contributes significantly to hepatitis C virus (HCV) transmission. The WHO has therefore set targets of reducing HCV incidence and prevalence among PWID and increasing treatment coverage to eliminate HCV by 2030. The DRUCK study (2011-2014) found high HCV prevalence and low treatment coverage among PWID in Germany.
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