Opioids and Substance Use Disorders: What's New
New review finds pharmacotherapies are moderately effective for treating alcohol use disorder in combination with behavioral treatment
Researchers supported through the Evidence-based Practice Centers program found that two medications—acamprosate and oral naltrexone—help prevent individuals with an alcohol use disorder (AUD) from returning to drinking and can reduce the amount of drinking in people who continue to drink alcohol. The research team, which included experts from RTI, The Ohio State University and the Kaiser Permanente Center for Health Research, used data from 118 randomized clinical trials that were conducted in outpatient settings. Researchers compared the efficacy of nine pharmacotherapies, including three approved by the U.S. Food and Drug Administration (FDA) and six off-label medications commonly used for AUD treatment. The study updated a 2014 systematic review on the benefits and harms of pharmacotherapies for AUD. The full review is available on the Effective Healthcare website and a summary was published in the Journal of the American Medical Association on Tuesday. November 2023
Prescription opioid use continues to decline
AHRQ has released two opioid-related MEPS Statistical Briefs: “Any Use and ‘Frequent Use’ of Opioids among Non-Elderly Adults in 2020-2021, by Socioeconomic Characteristics” (PDF, 668) and “Any Use and ‘Frequent Use’ of Opioids among Elderly Adults in 2020-2021, by Socioeconomic Characteristics” (PDF, 726). The first brief finds that 6.4 percent of adults aged 18-64, on average, filled at least one outpatient opioid prescription, and 1.8 percent had four or more prescription fills during the year. The second brief finds that 12.8 percent of adults aged 65 and older, on average, filled at least one outpatient opioid prescription, and 4.4 percent obtained four or more prescription fills during the year. This represents a continuing decrease in rates of filled prescriptions for both age groups compared to previous MEPS Briefs which looked at data for 2018-2019 and 2015-2016. September 2023
Validated Screening Tools for Unhealthy Alcohol Use Are Available But Not Regularly Used in Primary Care Settings
An AHRQ-funded study of primary care practices across Virginia found that, while most clinicians (76%) asked patients about alcohol use, only 11% documented using a validated screening tool such as the AUDIT-C. In addition, when comparing EHR documentation to matched patient surveys, far fewer patients were documented as having unhealthy alcohol use than would be expected based on patient self-reported drinking. Refer to The Current State of Alcohol Screening and Management in Virginia Primary Care Practices in the journal Medical Clinics of North America for more information. August 2023.
Persistent Racial Inequities in End-of-Life Care
An AHRQ-funded study found that older Black and Hispanic patients with advanced cancer are less likely to receive opioid medications, and that these inequities are not mediated by socioeconomic variables. "Disparities in Opioid Access and Urine Drug Screening Among Older Patients With Poor-Prognosis Cancer Near the End of Life," June 2023
Health IT functionality and onsite behavioral clinicians linked to increased screening and treatment of OUD
Using a national cross-section database of multi-physician primary care and multispecialty practices, AHRQ-funded researchers found that access to advanced health information technology (IT) and access to onsite behavioral clinicians were associated with a higher extent of physician practices offering the screenings and the medications for opioid use disorder (OUD). More details can be found in Internal and Environmental Predictors of Physician Practice Use of Screening and Medications for Opioid Use Disorders, Medical Care Research and Review. April 2023
Opioids Newsroom
AHRQ's blog posts, infographics, and announcements on its latest efforts to help end the opioid epidemic.