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VA » VA Homeless Programs » NCHAV » The Center Resources » Substance Use/Opioid


VA HOMELESS PROGRAMS

 


SUBSTANCE USE/OPIOID



Center Home

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SUBSTANCE USE/OPIOID



Substance 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.

Downloadable Material

MENTAL AND SUBSTANCE USE DISORDER TREATMENT FOR PEOPLE WITH PHYSICAL AND
COGNITIVE DISABILITIES



September 2019

Download

SUBSTANCE ABUSE AND HOMELESSNESS (2017)


Download

OPIOID USE DISORDERS AND HOMELESSNESS



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

Download

OPIOD USE DISORDER AMONG JUSTICE-INVOLVED VETERANS FACT SHEET


Download

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.

Download
 
Education/Training

Implementation and Evaluation of Medications for Treatment of Opioid Use
Disorder (February 2020)

What is Implementation Science? (January 2020)

Barriers and Facilitators to Use of Medication-Assisted Treatment for Opioid Use
Disorder (August 2019)

The Connections between Opioid Use, Overdose, and Suicide (May 2019)

Opioid Use Disorder and Employment Disparities in Justice-Involved Veterans
(April 2019)

The Opioid Crisis in Rural America (January 2019)

Addiction Housing Case Management for Homeless Veterans Enrolled in Addictions
Treatment (October 10, 2017)

HERS Symposium: Opioid Use Disorders and Homelessness (February 2017)

Motivational Interviewing: Engaging Veterans with Active SUD- Part 1

Motivational Interviewing: Engaging Veterans with Active SUD- Part 2

SAMSHA Training and Webinars
https://www.samhsa.gov/medication-assisted-treatment/training-materials-resources

Data-Based Case Reviews of Patients with Opioid Related Risk Factors as a Tool
to Prevent Overdose and Suicide


Community Care Provider Opioid Safety Initiative – This course was designed to
build a collaborative effort between the VA and non-VA care providers promoting
evidence-based management of Veterans with chronic pain, improve patient
outcomes, and decrease incidence of complications in regard to opioid
prescribing.

Literature Reviews/Research Findings

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]

Innovative Practices

Opioid Epidemic Response and One Site's Journey: The Naloxone Project (October
25, 2017)

Legislation & Regulations

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)

 

Other Resources

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



External Link Disclaimer: This page contains links that will take you outside of
the Department of Veterans Affairs website. VA does not endorse and is not
responsible for the content of the linked websites.

*To search the entire VA.gov site, please use the search bar in the upper right
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U.S. Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420

Last updated February 9, 2022

Last updated: February 9, 2022


VETERAN PROGRAMS AND SERVICES

 * Homeless Veterans
 * Women Veterans
 * Minority Veterans
 * LGBTQ+ Veterans
 * PTSD
 * Mental health
 * Adaptive sports and special events
 * VA outreach events
 * National Resource Directory


MORE VA RESOURCES

 * VA forms
 * VA health care access and quality
 * Accredited claims representatives
 * VA mobile apps
 * State Veterans Affairs offices
 * Doing business with VA
 * Careers at VA
 * VA outreach materials
 * Your VA welcome kit


GET VA UPDATES

 * VA news
 * Press releases
 * Email updates
 * Facebook
 * Instagram
 * Twitter
 * Flickr
 * YouTube
 * All VA social media


IN CRISIS? TALK TO SOMEONE NOW

 * Veterans Crisis Line


GET ANSWERS

 * Resources and support
 * Contact us


 * CALL US
   
   800-698-2411
 * TTY: 711


 * VISIT A MEDICAL CENTER OR REGIONAL OFFICE
   
   Find a VA location

 * Contact us
   
   
   GET ANSWERS
   
    * Resources and support
    * Contact us
   
   
    * CALL US
      
      800-698-2411
    * TTY: 711
   
   
    * VISIT A MEDICAL CENTER OR REGIONAL OFFICE
      
      Find a VA location

 * Veteran programs and services
    * Homeless Veterans
    * Women Veterans
    * Minority Veterans
    * LGBTQ+ Veterans
    * PTSD
    * Mental health
    * Adaptive sports and special events
    * VA outreach events
    * National Resource Directory

 * More VA resources
    * VA forms
    * VA health care access and quality
    * Accredited claims representatives
    * VA mobile apps
    * State Veterans Affairs offices
    * Doing business with VA
    * Careers at VA
    * VA outreach materials
    * Your VA welcome kit

 * Get VA updates
    * VA news
    * Press releases
    * Email updates
    * Facebook
    * Instagram
    * Twitter
    * Flickr
    * YouTube
    * All VA social media


 * LANGUAGE ASSISTANCE
   
    * Español
    * Tagalog
    * Other languages


LANGUAGE ASSISTANCE

 * Español
 * Tagalog
 * Other languages


 * Accessibility
 * Civil Rights
 * Freedom of Information Act (FOIA)
 * Office of Inspector General
 * Plain language
 * Privacy, policies, and legal information
 * VA Privacy Service
 * No FEAR Act Data
 * USA.gov
 * VA performance dashboard
 * Veterans Portrait Project


WE’RE HERE ANYTIME, DAY OR NIGHT – 24/7

If you are a Veteran in crisis or concerned about one, connect with our caring,
qualified responders for confidential help. Many of them are Veterans
themselves.

 * Call 988 and select 1
 * Text 838255
 * Start a confidential chat

 * Call TTY if you have hearing loss800-799-4889

Get more resources at VeteransCrisisLine.net.