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Resource Will Rate Addiction-Fighting Practices, from Proven to Problematic

November 25, 2019

An online resource of evidence-based practices that officially launched last week has “opioid” in its name, but is designed to offer policy-makers and health professionals a broader look at strategies to combat addiction in general.

The Curated Library About Opioid Use for Decision-Makers (CLOUD) has issued a call for submissions as it seeks to become a clearinghouse of resources that will allow for a one-stop look at strategic successes and failures. The site is being funded with monies from a settlement that state attorneys general reached more than a decade ago in a case involving off-label marketing of the anticonvulsant Neurontin (gabapentin).

The site is being managed by the Center for Evidence-Based Policy at Oregon Health & Science University. Allison Leof, PhD, senior policy analyst at the center, tells Addiction Professional that organizers hope to help policy-makers and professionals leverage the successes that some communities have experienced, while learning from the initiatives that have fallen short.

“This is also not all addiction-related,” Leof says. “We're also looking, for example, at alternative treatments for pain.”

Initial postings

In the work leading up to the official launch, CLOUD listed medication-assisted treatment (MAT) for opioid use disorder (OUD) as a “proven” strategy on its four-stage evidence ranking (the other possible designations for a practice or program will be “promising,” “potential” and “problematic”).

The website states, “Research has proven that MAT is an evidence-based strategy for treating individuals with OUD. Individuals who use MAT as part of their treatment and recovery plan are more likely to be retained in treatment and to have fewer adverse events such as opioid overdose and opioid overdose mortality.”

But the analysis of MAT will not end there, Leof says, as “there is a lot about MAT we don't know.” It will be important to update the site as more information becomes available about factors such as which available medication is likely to work best for which patient, and how a medication taper should proceed.

The site lists Oregon Health & Science University's Improving Addiction Care Team (IMPACT), a hospital-based initiative to link patients with substance use disorders to medication and community-based care, as a “promising” practice. The addiction medicine consulting service seeks to improve care for patients who are hospitalized for a medical issue but have an underlying and often undertreated substance use problem.

“We really see ourselves as a clearinghouse,” says Leof, who explains that the site is divided into three sections designed to appeal to the interests of policy-makers/community leaders, payers/providers, and patients/caregivers. “We want this to be an open-access place where people can review results.”

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