AHRQ Intensifies the Battle Against Opioid Misuse in 2017, Commits to More Progress in 2018

2017 was quite busy for AHRQ in the area of helping researchers, policymakers, clinicians, and patients better understand and battle against the opioid epidemic. We wholeheartedly accepted the challenge from President Trump to find ways to stem the rampant misuse of opioids, and would like to share a few of those milestones.

AHRQ's investments last year were aimed squarely at utilizing the Agency's strengths. First, we conducted data analyses to better understand the opioid epidemic, particularly its impact on hospitals. Second, we funded research to generate new knowledge about potential strategies to attack the epidemic. Finally, we offered tools and training to on-the-ground physicians treating patients suffering from opioid addiction.

A few more specifics illustrate our contributions.

Providing Data Insights Into Opioid Prescription Costs and Hospitalizations

AHRQ provides researchers and policymakers with data that help track the use and costs of outpatient prescription opioids. A statistical brief from our Medical Expenditure Panel Survey showed the U.S. civilian noninstutionalized adult population purchased nearly 153 million opioid prescriptions during 2015. The costs were staggering: nearly $11 billion in outpatient prescription expenses, and an annual average of more than $400 per person in out-of-pocket payments.

While these numbers show what Americans are paying out-of-pocket for outpatient prescription opioids, another story has unfolded within the Nation’s hospitals. The Fast Stats database from AHRQ's Healthcare Cost and Utilization Project provides quarterly insights into the impact of the opioid burden as measured by hospital stays. New 2017 data available for seven States show that in five States—Georgia, Hawaii, Maryland, Minnesota, and New Jersey—hospitalizations were higher in the first quarter of 2017 than the average rate for 2016. Such data snapshots may highlight opportunities to identify and enroll high-risk patients in care and treatment.

For those of us who are visual learners, AHRQ has created an online map that depicts opioid-related hospitalization trends for most States. You'll find statistics on opioid-related hospital care and patient characteristics for the years 2009 to 2014. The map data showcase how the epidemic has impacted some States more than others, providing important insights into populations to target for treatment and prevention.

Funding and Disseminating Evidence-based Opioids Research

In a development with important implications for first responders, a recent AHRQ study, funded in partnership with the National Highway Traffic Safety Administration and Department of Transportation, examined questions surrounding dosing and methods of administering naloxone, a potentially life-saving drug that blocks the harmful effects of an overdose. The study, published in the Annals of Internal Medicine and based on an AHRQ evidence review, found that naloxone may be similarly effective whether inhaled or injected. The findings are significant for emergency medical service team members who provide on-the-spot care to overdose victims.

In another significant advancement, an AHRQ-funded study examining the effects of prescription drug monitoring programs (PDMP) showed that mandatory-access provisions—systems that require clinicians to query the PDMP prior to prescribing a controlled drug—have been shown to help reduce prescription drug abuse, specifically related to adults 18–24 years of age. These findings provide critical guidance to State policymakers as they continue to address the opioid epidemic.

Providing Tools and Training To Help Patients Overcome Opioid Use Disorder

Finally, AHRQ is also contributing vital information to clinicians who frequently deal with patients struggling with opioid addiction. An environmental scan published in October outlines three promising strategies for overcoming obstacles to implementing medication-assisted treatment (MAT) in rural primary care practices. The report also includes links and descriptions to nearly 250 tools and resources to support the delivery of MAT. As time goes on, we’ll provide updates from AHRQ grantees who are using MAT to treat patients in Colorado, New Mexico, North Carolina, Oklahoma, and Pennsylvania.

We made significant strides last year in assisting HHS' efforts to defeat the opioid epidemic, but we still have a long way to go. In 2018, we will continue to pursue the challenge in various ways—through research to address pressing questions related to prevention and treatment, through direct support to clinicians working diligently to help their patients, and through the continued development of data to track the Nation's progress toward eliminating this public health crisis.

Gopal Khanna is the Director of AHRQ.