By Ishara Nanayakkara
In October, The Pew Charitable Trusts released an analysis of the core measures states can identify to address and mitigate the opioid epidemic. The information included in this article originates from this analysis.
This article is the second in a three-part series. The first article can be viewed here.
In 2021, the U.S. set a record high for fatal opioid overdoses. However, when data is used to address opioid use disorder, effective change can be made. The Pew Charitable Trusts developed a series of recommendations for state policymakers to consider when implementing opioid use disorder treatment measures. The recommendations, which are addressed in Pew’s analysis, were developed by an expert panel along with a review of important literature. A summary of these recommendations can be found below.
1. Publicly Report Opioid Use Disorder and Treatment Data
In addition to publicly reporting overdose death statistics, states should also report several core measures, including availability of opioid use disorder measures and use by regions and demographic groups. Research found that public reporting results in improvements in outcomes.
2. Create a Plan to Use Opioid Use Disorder Treatment Data
Lawmakers responsible for addressing the crisis should regularly review available data and use it to inform policy decisions. A point person should be assigned to ensure data is updated and relevant, convene stakeholders across agencies, groups and communities and review resources available to support improvement efforts.
3. Disaggregate Data to Improve Health and Equity
There are significant differences in overdose death rates based on race and ethnicity. A study conducted by the CDC found that the overdose death rate increased most among Black individuals at 44% and American Indian/Alaskan Native people at 39%, while the increase for Caucasians was 22%. Additionally, due to barriers to treatment, Black and Hispanic people are less likely to seek and continue treatment. Disaggregating data by factors such as race, ethnicity, location, gender and age provides policymakers with information on where to best direct resources, which will help ensure that all people have access to services.
4. Integrate Community Members and Providers into Decision-making
People with lived experiences, including those with opioid use disorder and providers, provide valuable insight into effective areas of the treatment system and those requiring improvement. For instance, researchers in Minnesota found that members of tribal nations with opioid use disorder had a distrust and fear of the healthcare system and that treatment plans did not acknowledge or incorporate traditional healing systems. This information provides insight into how the treatment system can be altered to better meet the needs of tribal nations. Knowing similar information about other demographics may help policymakers target areas of concern.
In addition to providing policymakers with valuable information on how to best serve their constituents, community members also benefit from this information sharing process as they have their voices heard, gain new skills, and may be compensated.
Treatment providers should also be involved when analyzing metrics. Individuals moving through the cascade of care system will interact with multiple providers in varying settings, including emergency departments, peer recovery coaches, and opioid treatment providers. Professionals can work together to support patient’s smooth transitions from one part of the process to the next.
5. Address Data Challenges
The quality of data regarding race and ethnicity provided by insurers varies as many commercial health insurance plans do not collect data on these factors. State Medicaid agencies are required to collect demographic information and acquire self-reported data provided by patients during the application process. This means that data accuracy and completeness may vary across states. Researchers have raised “high concerns” about race or ethnicity information quality in 19 states due to missing data and mismatches between responses on Medicaid applications and Census Bureau surveys. To improve accuracy in reporting, experts recommend employing intake workers to help applicants fill out forms or utilizing standard reporting forms that provide more specificity instead of using broad ethnicity categories, such as Asian or Hispanic. States can also compare data and strategies on core performance measures to identify inequalities among communities and potential solutions.
To read about case studies, see The Pew Charitable Trusts issue brief, “States Should Measure Opioid Use Disorder Treatment to Improve Outcomes.” These examples depict success in areas where states collected and acted on data. By using the core opioid use disorder treatment measures, treatment systems can be reshaped to effectively address the crisis.