Opioid use disorder, a form of substance use disorder, is classified as a chronic, relapsing brain disease. OUD is associated with increased morbidity and death resulting in a decreased life expectancy.

With effective and ongoing treatment, individuals suffering from OUD can reach long-term remission. However, the Substance Abuse and Mental Health Services Administration estimates that nearly 80% of individuals experiencing OUD do not receive treatment. This is largely due to the stigma attached to substance use, the nation’s fragmented care systems, and limited access to effective, evidence-based treatments.

Limited access to health and behavioral health care services, inaccessible OUD treatment, prescribing practices, and social determinants of health — including homelessness, unemployment, and poverty — are contributing factors to Missouri’s opioid epidemic.

There is an immediate need to implement a multifaceted, collaborative public health, and safe approach to the OUD crisis. Addressing OUD requires expanded community resources, and timely and comprehensive surveillance data to inform decisions.

Several Missouri initiatives expand access to integrated prevention, treatment, and recovery support services for individuals with OUD. These initiatives include multidisciplinary provider and layperson training on opioid overdose education and naloxone distribution; increased patient access to pharmacotherapies, including buprenorphine, through clinician education; SUD treatment engagement; and patient care navigation designed to promote the safe and timely transfer of patients between levels and settings of care.

Practice

Opioid Prescribing Guidance

Opioid prescribing recommendations designed to guide hospital-based physicians’ use have been adopted and released by a coalition of health care policy and advocacy organizations. The revised guidance reflects evolving best practices in the use of opioids for pain management and changes in the law designed to reduce the opioid addiction crisis. The guidance was updated in November 2018.

• MHA Board of Trustees Approved Policy – Opioid Prescribing Guidelines
• Hospital and Hospital ED Prescribing Guidelines for Reduced Opioid Misuse and Abuse

CDC Recommendations

The Centers for Disease Control and Prevention issued recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care. The CDC resources available will help providers ensure safe and effective treatment for their patients with chronic pain.