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�� �� ��Substance Use Disorder

Primary, Secondary, and Tertiary Prevention of Substance Use Disorders through Socioecological Strategies

September 6, 2023

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Employing a socioecological lens to better understand the complex social and structural factors driving substance use disorder and overdose risk provides a framework for developing comprehensive and integrated cross-sectoral prevention strategies and highlights examples of existing evidence- and practice-based interventions spanning primary, secondary, and tertiary prevention to inform and encourage widescale adoption of effective, equity.

Methadone Treatment for Opioid Use Disorder: Improving Access Through Regulatory and Legal Change: Proceedings of a Workshop

July 15, 2022

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Methadone is the oldest medication for the treatment of OUD with decades of science supporting its effectiveness in��improving the health of people with OUD. Despite its effectiveness in saving lives, many barriers impede access to, initiation of, and retention in methadone treatment for OUD. To address these barriers, the 911������ Academies of Sciences, Engineering, and Medicine hosted a public workshop on “Methadone Treatment for Opioid Use Disorder: Examining Federal Regulations and Laws,” at the request of the Office of 911������ Drug Control Policy in the Executive Office of the President. This publication summarizes the presentations and discussions of the workshop.

Additional Materials:

• ������Գ�—Methadone Treatment for Opioid Use Disorder: Examining Federal Regulations Workshop

Stigma of Addiction Summit: Lessons Learned and Priorities for Action

January 31, 2022

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Stigma directly harms people experiencing addiction, as it can alienate them from loved ones and peer support, contribute to delays in seeking medical treatment, and can even manifest in shame around taking evidence-based medications for opioid use disorder (OUD). To explore the negative impact of stigma on people with OUD and elevate action-oriented strategies to address and eliminate the harms caused by stigma, NAM, Dell Medical School at The University of Texas at Austin, and Shatterproof cohosted the Stigma of Addiction Summit on June 10, 2021. This publication summarizes presentations and discussions of the event.

Additional Materials:

• ������Գ�—Stigma of Addiction Summit

Combatting the Stigma of Addiction – The Need for a Comprehensive Health System Approach

November 9, 2020

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Stigma is a pervasive force alienating those who experience addiction from medical care and recovery support.��The COVID-19 pandemic increased stress on the health system, which in turn exposed and exacerbated the barriers to care often faced by individuals with opioid use disorder (OUD). In response, this commentary, individually authored by members of NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic, calls for a cohesive, evidence-driven health system effort to eliminate stigma against OUD and build individual and structural competency to drive change.

Guide for Future Directions for the Addiction and OUD Treatment Ecosystem

April 5, 2021

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Identifying, addressing, and closing existing gaps in the addiction and opioid use disorder (OUD) treatment ecosystem is a vital step in addressing America’s epidemic of drug overdose and death. This discussion paper from NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic outlines major gaps and proposes a framework— “The 4 Cs: Capacity, Competency, Consistency, and Compensation”—to guide funding and action towards building a robust, well-functioning OUD treatment system

The American Opioid Epidemic in Special Populations: Five Examples

October 26, 2020

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The U.S. is in the midst of an unprecedented crisis of prescription and illicit opioid misuse, use disorder, and overdose. Although the crisis has affected large swaths of the U.S. population, it has impacted certain segments of the population with an extra level of intensity—including justice-involved populations, rural populations, veterans, adolescents and young adults, and people who inject drugs. This discussion paper from NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic focuses on these five identified populations and, for each, reviews why the population warrants focused attention, explores current barriers encountered in accessing care, identifies promising approaches in supporting this population, and proposes high-impact research and action priorities.

Additional Materials:

• �����dzܰ�����—Key Messages
• ���������—Justice-involved
• ���������—People who inject drugs
• ���������—Rural
• ���������—Veterans
• ���������—Adolescents

Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers Within the Treatment System

April 27, 2020

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Though medications for opioid use disorder (MOUD) are effective and approved by the FDA, almost four in five Americans with opioid use disorder (OUD) do not receive treatment with these medications. The gap in access to evidence-based care, including treatment with these medications, stems in part from barriers to change within the health care system. This discussion paper from NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic identifies nine key barriers that prevent access to evidence-based care and proposes strategies to address these barriers and increase access to MOUD.

Additional Materials:

• �����dzܰ�����—Key Messages
• ���������—Provider
• ���������—Financial
• ���������—Regulatory
• ���������—Institutional
• ���������—Research

Dismantling Buprenorphine Policy Can Provide More Comprehensive Addiction Treatment

September 9, 2019

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Reversing the trends of the opioid epidemic will require as many qualified practitioners as possible, willing to provide their patients the care they need. Every health care provider should be empowered to give their patients the care they need if it is safe and reasonable, but they need education and clinical support. Regulatory restrictions on clinicians, along with stigma around addiction treatment, are impeding the abilities of health care providers to adequately treat opioid use disorder (OUD). This commentary, individually authored by members of NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic, unpacks how timely action toward dismantling legislative restrictions on buprenorphine prescribing could be a powerful step towards increasing access to treatment of OUD in the U.S.

Supporting People with Addiction During COVID-19: A Webinar Series

May 7, 2020

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Individuals experiencing addiction have been significantly impacted by the COVID-19 pandemic.��In response, the NAM Action Collaborative on Countering the U.S. Opioid Epidemic and the American Society of Addiction Medicine co-hosted a webinar series to provide insight and targeted guidance on how to ensure that these individuals are cared for and protected during the ongoing public health crisis.

Additional Materials:��

• ������Գ�—Webinar 1: Helping People with Addiction Stay Connected During COVID-19
• �����dzܰ�����—Webinar 1 Slides
• ������Գ�—Webinar 2: Treating Addiction Across the Care Continuum During COVID-19: Challenges and Promising Practices
• �����dzܰ�����—Webinar 2 Slides
• ������Գ�—Webinar 3: Strengthening Coordination Across the Social Safety Net for Patients with Addiction
• �����dzܰ�����—Webinar 3 Slides

�� �� ��Education

The 3Cs Framework for Pain and Unhealthy Substance Use: Minimum Core Competencies for Interprofessional Education and Practice

June 6, 2022

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Adequate, efficient, effective, and compassionate care for pain and unhealthy substance use requires a health care workforce that is appropriately prepared to deliver that care. A new framework from the NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic outlines minimum core competencies for all health care professionals who encounter patients experiencing pain or unhealthy substance use.

Educating Together, Improving Together: Harmonizing Interprofessional Approaches to Address the Opioid Epidemic

December 16, 2021

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The opioid epidemic is complex and ever-evolving. In order to ensure future generations of health care professionals and health educators are equipped to reverse the deadly trends of the opioid crisis, there is a critical need to identify and address professional practice gaps (PPGs) related to pain management and opioid use disorder (OUD). This special publication from NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic presents two information-gathering efforts to assess persisting PPGs pertaining to pain management and SUD care and identifies five action-oriented priorities to support a harmonized interprofessional, person- and family-centered approach for the continuum of health professional education.

Additional Materials:

• �����dzܰ�����—Executive Summary
• �����dzܰ�����—Social Media Toolkit

�� �� ��Cross-Cutting

Collaborative Short-Term Action to Advance America’s Health

February 29, 2024

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The health challenges facing the United States in the 21st century require a reinvigorated, feasible approach to public health and accountable population health – an approach that leverages traditional public health institutions working in close partnership with health systems and social services. This approach will require better leveraging of digital data systems, biomedical innovations, and trends in health policy and payment reforms to enhance community-specific capabilities through public-private collaboration. Enhanced collaboration will, in turn, enable better prediction and response to public health challenges; restored public trust and confidence; and better, more resilient, and more sustainable health care and public health capabilities.

Additional Materials:

• ������Գ�—Integrating Telehealth and Traditional Care in Chronic Pain Management and Substance Use Disorder Treatment��
• �����dzܰ�����—
• ���������—Collaborative Short-Term Action to Advance America’s Health Issue Brief
• Commentary—coming soon

Integrating Telehealth and Traditional Care in Chronic Pain Management and Substance Use Disorder Treatment: An Action Agenda for Building the Future State of Hybrid Care

October 26, 2023

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The surge in telehealth and virtual care services opened new horizons in health care delivery, particularly in the domains of chronic pain management and substance use disorder care. Drawing on insights from the Action Collaborative’s , an action agenda proposes concrete steps that stakeholders—including health professionals, health system leaders, educators, policy makers, regulators, payers, researchers, technology developers, and patients and caregivers—can take to advance hybrid care models that leverage the strengths of telehealth and traditional in-person care to improve access, safety, quality, and the overall value of chronic pain management and substance use disorder care.

Additional Materials:

• Web page—Integrating Telehealth and Traditional Care in Chronic Pain Management and Substance Use Disorder Treatment��
• Policy ���������—coming soon
• Stakeholder Briefs—coming soon

Improving Telehealth and Virtual Care for Pain Management and Substance Use Disorders

December 17, 2021

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Throughout the course of the COVID-19 public health emergency, telehealth and virtual care services emerged as paradigm-shifting tools for both pain management and substance use disorder (SUD) care. However, in an order to fully integrate these services across the continuum of pain management and SUD care, several challenges must be addressed, including those related to policy, regulation, payment, training, technology, and equity. In response, the NAM Action Collaborative on Countering the U.S. Opioid Epidemic convened a 4-part meeting series to unpack these barriers and identify key areas of opportunity for improving access, quality, and care delivery of telehealth and virtual care for pain management and SUD.

Additional Materials:

• ������Գ�—Improving Telehealth and Virtual Care for Pain Management and Substance Use Disorders Meeting 1
• Discussion Proceedings—Introduction to Improving Telehealth and Virtual Care for Pain Management and Opioid/Substance Use Disorder
• ������Գ�—Improving Telehealth and Virtual Care for Pain Management and Substance Use Disorders Meeting 2
• Discussion Proceedings—NAM Action Collaborative on Countering the U.S. Opioid Epidemic Telehealth and Virtual Care Meeting Series: Improving Access��
• ������Գ�—Improving Telehealth and Virtual Care for Pain Management and Substance Use Disorders Meeting 3
• Discussion Proceedings—NAM Action Collaborative on Countering the U.S. Opioid Epidemic Telehealth and Virtual Care Meeting Series: Improving Care Delivery and Innovation
• ������Գ�—Improving Telehealth and Virtual Care for Pain Management and Substance Use Disorders Meeting 4
• Discussion Paper—Integrating Telehealth and Traditional Care in Chronic Pain Management and Substance Use Disorder Treatment: An Action Agenda for Building the Future State of Hybrid Care

Countering the Opioid Crisis: Time to Act

April 29, 2021

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The NAM Action Collaborative on Countering the U.S. Opioid Epidemic and the Aspen Institute created this limited-series podcast to expand upon issues critical to reversing the deadly trends of the U.S. opioid epidemic, including the impact of COVID-19, structural racism, the war on drugs, stigma against people with addiction, the promise of improving education and training for health care professionals, and more.

NAM Action Collaborative on Countering the U.S. Opioid Epidemic Research Agenda

August 17, 2023 (2023 Update)
April 19, 2021 (2021 Release)

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The polysubstance use crisis in America represents a more dangerous phase in the evolution of the opioid crisis, a situation exacerbated by the COVID-19 pandemic that is driving overdose mortality numbers. In response, the 911������ Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic has released an updated list of cross-sectoral research priorities designed to encourage additional research and forge a responsive, evidence-based, and equity-informed path forward. Highlights from the updated research agenda include a focus on telehealth for substance use disorder (SUD) and chronic pain management, recognizing the surge in telehealth and virtual care services amid the pandemic. The updated research agenda aims to serve as a guide for public, private, and non-profit institutions and funders to advance needed research and catalyze action that will address the critical needs of the evolving opioid crisis. By leveraging evidence-informed action, we can more effectively counter the opioid crisis and related overdose epidemic, providing improved support to individuals and communities affected by its devastating effects.

Additional Materials:

• 2023 Update
  • ���������—Health Professional Education and Training
  • ���������—Pain Management Guidelines & Evidence Standards
  • ���������—Prevention, Treatment, and Recovery Services
  • ���������—Telehealth for SUD and Chronic Pain Management

• 2021 Release
  • ���������—Health Professional Education and Training
  • ���������—Pain Management Guidelines & Evidence Standards
  • ���������—Prevention, Treatment, and Recovery Services

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�� �� ��Pain Management

Best Practices, Research Gaps, and Future Priorities to Support Tapering Patients on Long-Term Opioid Therapy for Chronic Non-Cancer Pain in Outpatient Settings

August 10, 2020

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Ensuring high-quality, respectful, and appropriate management of chronic non-cancer pain (CNCP) in the context of the U.S. opioid crisis is a critical and complex endeavor. Unfortunately, data regarding the best way to proceed with care for these patients in terms of opioid maintenance or tapering are lacking. This discussion paper from NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic highlights key decision points and available evidence to support tapering strategies for specific patient populations being treated for CNCP and identifies priorities for future research to generate the evidence required to fully support patients and clinicians managing CNCP.

Additional Materials:

• �����dzܰ�����—Key Messages
• �մǴDZ�—Decision Tree
• ������Գ�—Best Practices, Research Gaps, and Future Priorities to Support Tapering Patients on Long-Term Opioid Therapy
• ������Գ�—Tapering Guidance for Opioids: Existing Best Practices and Evidence Standards

Patient-Centered Chronic Pain Journey Map

April 20, 2022

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People living with chronic pain often experience a complicated and confusing path as they seek high quality, compassionate health care for safe, effective pain management. To help individuals with chronic pain and members of their care team navigate this journey, NAM’s Action Collaborative on Countering the U.S. Opioid Epidemic developed the Person-Centered Chronic Pain Journey Map—an interactive, web-based tool that takes users along the path of long-term chronic pain management and offers a curated library of resources and tools to help improve quality of life for people with pain.

Additional Materials:

• �մǴDZ�—
• �մǴDZ�—Written Guidance
• �����dzܰ�����—Patient-centered Brief (coming soon)
• �����dzܰ�����—Social Media Toolkit
• ������Գ�—Implementing the Chronic Pain Journey Map
• ������Գ�—Caring for Patients with Chronic Pain: Perspectives from Clinicians | Listening Session
• ������Գ�—Living With Chronic Pain: Perspectives from Persons with Lived Experience | Listening Session

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The Action Collaborative serves as a neutral platform through which to facilitate dialogue and discussion among representatives from multiple sectors around topics of mutual interest and concern. Individual participating members of the Action Collaborative on Combatting Substance Use and Opioid Crises have disclosed any perceived or actual interests (financial, organizational, professional, or personal in nature) relevant to the activities of the Action Collaborative.��Summaries of relevant interests reported can be found here.