Approved Strategies

The two largest opioid settlements include requirements on how funds can be spent. Learn more about approved uses of the funds that are high-impact and under county authority.

Image of Thumbnail_Tile 2.png

Syringe Services Programs

Syringe Services Programs (SSPs) provide low-barrier access to sterile supplies for safer substance use, naloxone and overdose prevention tools like fentanyl test strips and drug checking services.

Image of Thumbnail_Tile 3.png

Effective Treatment for Opioid Use Disorder for Incarcerated Populations

Medication-assisted treatment is considered the “gold standard” of care for opioid use disorder (OUD). The FDA has approved three medications for treating OUD: methadone, buprenorphine and naltrexone.

Image of Thumbnail_Tile 4.png

Treatment and Recovery for Pregnant and Parenting People

During pregnancy, the evidence-based standard of care for opioid use disorder (OUD) is treatment with methadone or buprenorphine. 

About the Brief

Author

Jennifer J. Carroll, PhD, MPH

References

  1. Carroll JJ, Asher A, Krishnasamy V, Dowell D. Linking People with Opioid Use Disorder to Medication Treatment. Published online 2022. Accessed June 8, 2022. Available here.
  2. Jones CM, Campopiano M, Baldwin G, McCance-Katz E. National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment. Am J Public Health. 2015;105(8):e55-63. Available here.
  3. Mauro PM, Gutkind S, Annunziato EM, Samples H. Use of Medication for Opioid Use Disorder Among US Adolescents and Adults With Need for Opioid Treatment, 2019. JAMA Network Open. 2022;5(3):e223821. Available here.
  4. Marino LA, Campbell AN, Nunes EV, Sederer LI, Dixon LB. Factors Influencing Buprenorphine Prescribing among Physicians in New York State. J Addict. 2019;2019:7832752. Available here.
  5. Peterson LE, Morgan ZJ, Borders TF. Practice Predictors of Buprenorphine Prescribing by Family Physicians. Journal of the American Board of Family Medicine: JABFM. 2020;33(1):118-123. Available here
  6. Kaplan-Dobbs M, Kattan JA, Tuazon E, Jimenez C, Saleh S, Kunins HV. Increasing Access to Buprenorphine in Safety-Net Primary Care Clinics: The New York City Buprenorphine Nurse Care Manager Initiative. American Journal of Public Health. 2021;111(2):215-218. Available here.
  7. LaBelle CT, Han SC, Bergeron A, Samet JH. Office-Based Opioid Treatment with Buprenorphine (OBOT-B): Statewide Implementation of the Massachusetts Collaborative Care Model in Community Health Centers. Journal of Substance Abuse Treatment. 2016;60:6-13. Available here
  8. Eisenstat S, Siegel AL, Carlson K, Ulman K. Putting Group Visits into Practice: APractical Overview to Preparation, Implementation, and Maintenance of Group Visits at Massachusetts General Hospital. Published online January 2012. Accessed May 29, 2019. Available here.
  9. Brooklyn JR, Sigmon SC. Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder: Development, Implementation, and Impact. J Addict Med. 2017;11(4):286-292. Available here.
  10. U.S. Substance Abuse and Mental Health Services Administration. The Case for Screening and Treatment of Co-Occurring Disorders. SAMHSA. Published 2022. Accessed February 26, 2023. Available here
  11. El-Sabawi T, Baney M, Canzater SL, Weizman S. The New Mobile Methadone Rules And What They Mean For Treatment Access | Health Affairs Forefront. Health Affairs. Published August 4, 2021. Accessed June 8, 2022. Available here.
  12. Clark SA, Davis C, Wightman RS, et al. Using telehealth to improve buprenorphine access during and after COVID-19: A rapid response initiative in Rhode Island. J Subst Abuse Treat. 2021;124:108283. Available here.
  13. Lagisetty P, Klasa K, Bush C, Heisler M, Chopra V, Bohnert A. Primary care models for treating opioid use disorders: What actually works? A systematic review. PLoS ONE. 2017;12(10):e0186315. Available here.
  14. Beharie N, Kaplan-Dobbs M, Urmanche A, Paone D, Harocopos A. “I didn’t feel like a number”: The impact of nurse care managers on the provision of buprenorphine treatment in primary care settings. Journal of Substance Abuse Treatment. 2022;132. Available here
  15. Liebschutz JM, Xuan Z, Shanahan CW, et al. Improving Adherence to Long-term Opioid Therapy Guidelines to Reduce Opioid Misuse in Primary Care. JAMA Intern Med. 2017;177(9):1265-1272. Available here.
  16. Samet JH, Tsui JI, Cheng DM, et al. Improving the Delivery of Chronic Opioid Therapy among People Living with HIV: A Cluster Randomized Clinical Trial. Clin Infect Dis. Published online July 22, 2020. Available here.
  17. Carroll JJ, Colasanti J, Lira MC, Del Rio C, Samet JH. HIV Physicians and Chronic Opioid Therapy: It’s Time to Raise the Bar. AIDS Behav. Published online December 5, 2018. Available here.
  18. Noffsinger EB. Running Group Visits in Your Practice. Springer; 2009. Accessed September 9, 2022. Available here.
  19. Vakkalanka JP, Lund BC, Ward MM, et al. Telehealth Utilization Is Associated with Lower Risk of Discontinuation of Buprenorphine: a Retrospective Cohort Study of US Veterans. J Gen Intern Med. 2022;37(7):1610-1618. Available here.
  20. Stratyner HB. Meeting People Where They Are At. Psychology Today. Published March 2, 2010. Accessed May 23, 2023. Available here
  21. Bachhuber MA, Thompson C, Prybylowski A, Benitez J, Mazzella S, Barclay D. Description and outcomes of a buprenorphine maintenance treatment program integrated within Prevention Point Philadelphia, an urban syringe exchange program. Subst Abus. 2018;39(2):167-172. Available here.
  22. Prevention Point Philadelphia. STEP. Prevention Point. Published 2020. Accessed June 8, 2022. Available here.
  23. Howard Center. Syringe Exchange and Overdose Prevention. Published 2019. Accessed May 31, 2019. Available here.
  24. Harrington D. The Kraft Center for Community Health at MGH mobilizes care for opioid use disorder to Boston’s most vulnerable. Boston Health Care for the Homeless Program. Published January 11, 2018. Accessed May 31, 2019. Available here.
  25. Hood JE, Banta-Green CJ, Duchin JS, et al. Engaging an unstably housed population with low-barrier buprenorphine treatment at a syringe services program: Lessons learned from Seattle, Washington. Substance Abuse. 2019;0(0):1-9. Available here.
  26. Carter J, Zevin B, Lum PJ. Low barrier buprenorphine treatment for persons experiencing homelessness and injecting heroin in San Francisco. Addiction Science & Clinical Practice. 2019;14(1):20. Available here.
  27. U.S. Centers for Disease Control and Prevention. Tribal Syringe Services Program Helps Reduce Harm from Injection Drug Use. Public Health Professionals Gateway. Published 2020. Accessed October 29, 2021. Available here.
  28. Registration Requirements for Narcotic Treatment Programs With Mobile Components. Federal Register. Published June 28, 2021. Accessed September 8, 2022. Available here
  29. Rural Health Information Hub. Mobile Clinic Model for Improving Access to Medication for Opioid Use Disorder (MOUD) - RHIhub Toolkit. RHI Hub. Published 2023. Accessed February 26, 2023. Available here.
  30. Pew Charitable Trusts. Mobile Medication Units Help Fill Gaps in Opioid Use Disorder Treatment. Pew. Published November 22, 2021. Accessed September 8, 2022. Available here.
  31. Andrilla CHA, Moore TE, Patterson DG, Larson EH. Geographic Distribution of Providers With a DEA Waiver to Prescribe Buprenorphine for the Treatment of Opioid Use Disorder: A 5-Year Update. J Rural Health. 2019;35(1):108-112. Available here
  32. Flavin L, Malowney M, Patel NA, et al. Availability of Buprenorphine Treatment in the 10 States With the Highest Drug Overdose Death Rates in the United States. J Psychiatr Pract. 2020;26(1):17-22. Available here.
  33. U.S. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.; 2021. Accessed October 22, 2021. Available here.
  34. Sawyer W, Wagner P. Mass Incarceration: The Whole Pie 2022. Prison Policy Initiative. Published March 14, 2022. Accessed September 9, 2022. Available here.
  35. Bronson J, Stroop J, Zimmer S, Berzofsky M. Drug Use, Dependence, and Abuse among State Prisoners and Jail Inmates, 2007-2009. Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; 2017. Accessed December 14, 2018. Available here.
  36. Mumola CJ, Karberg JC. Drug Use and Dependence, State and Federal Prisoners, 2004. Bureau of Justice Statistics, Office of Justice Programs, U.S. Department of Justice; 2007. Accessed May 27, 2019. Available here.
  37. U.S. Department of Housing and Urban Development, Office of Community Planning and Development. The 2020 Annual Homeless Assessment Report (AHAR) to Congress. Part 1: Point in Time Estimates of Sheltered Homelessness. Published online January 2021. Accessed September 9, 2022. Available here.
  38. Sharp A, Jones A, Honermann B, Millett G. Vulnerable counties: One year later. Poster Presentation presented at: Conference on Retroviruses and Opportunistic Infections (CROI); March 2018. Accessed July 27, 2019. Available here.
  39. Mette E. Q&A: A Deep Dive into New York’s Drug User Health Hubs with New York’s Allan Clear. The National Academy for State Health Policy. Published May 18, 2020. Accessed September 9, 2022. Available here.
  40. Pew Charitable Trusts. State Policy Changes Could Increase Access to Opioid Treatment via Telehealth. PEW. Published December 14, 2021. Accessed September 9, 2022. Available here.
  41. Weizman S, El-Sabawi T, Baney M, Manoff I. National Snapshot: Access to Medications for Opioid Use Disorder in U.S. Jails and Prisons. Published online July 28, 2021. Accessed September 9, 2022. Available here.
  42. Cernasev A, Hohmeier KC, Frederick K, Jasmin H, Gatwood J. A systematic literature review of patient perspectives of barriers and facilitators to access, adherence, stigma, and persistence to treatment for substance use disorder. Explor Res Clin Soc Pharm. 2021;2:100029. Available here.
  43. Samuels EA, Clark SA, Wunsch C, et al. Innovation During COVID-19: Improving Addiction Treatment Access. J Addict Med. 2020;14(4):e8-e9. Available here.
  44. Caroline County Health Department. Mobile Addiction Treatment Unit Will Serve Caroline County, Providing Medication Assisted Treatment for Opioid Use Disorders. Published online 2019. Accessed March 2, 2023. Available here.
  45. Caroline County Health Department. Mobile Care Unit Pics. Caroline County Health Department. Published 2019. Accessed March 2, 2023. Available here
  46. Mehri McKellar. PARTNER UP Providing a Resource: Telemedicine at Syringe Services Programs to Reach Underserved Populations. Presented at: June 30, 2021. Accessed September 9, 2022. Available here.
  47. Leonard N. Mobile Methadone Clinic Brings Treatment to New Jersey Prisoners. NBC10 Philadelphia. Published August 19, 2017. Accessed September 9, 2022. Available here.