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trends over time and geographic patterns in prescription opioid use and likely misuse, which can help to target resource allocation,” Kreiner explains. “A number of our measures and surveillance approaches have been taken up by states that are newly funded by the CDC to address the opioid crisis, and we’ve been working with the CDC to assist them.” On the treatment side, IBH’s work falls into two broad areas: access to treatment and quality of treatment. Within the quality sphere, Heller researchers have done a lot of work on performance measurement. They’ve published a series of papers based on performance measures they developed for medication-assisted treatment, led by Professor Cindy Parks Thomas, PhD’00, who is now working with the American Society of Addiction Medicine to further develop these measures so they can be put into practice. Additionally, the Centers for Medicare and Medicaid Services have hired IBH and Mathematica Policy Research Inc. to develop medication-assisted treatment performance measures for use in Medicaid.


Sharon Reif has also co-authored several papers with Horgan and others on access to treatment, including one that examines what opioid addiction-treatment medications are covered by private insurance companies. Another looks at whether treatment services are covered. “It shows, over time, some interesting patterns with respect to the availability of methadone, which used to be the only pharmacological approach for opioids,” Reif says. Thomas adds, “One of the important things about treatment for substance use in general, and particularly for opioids, is that for a very long time, medications were not an acceptable answer for many people in the field — both people who have the problems and people who are treating the problems. It was seen as treating an addiction to a substance with another substance.” You can actually see a shift in public and professional opinion on medication-assisted treatment through the papers IBH has produced over the years. While methadone has a long history, one of the early papers by Horgan

18 heller magazine

Heller Magazine, Summer 2017  
Heller Magazine, Summer 2017  

A magazine of the Heller School for Social Policy and Management at Brandeis University