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21. Substance Use Resources | The Academy
    integrationacademy.ahrq.gov/products/substance-use-resources
    January 01, 2016 - Literature on Opioids and Substance Use The Academy Literature Collection contains more than 1,000 … resources related to opioids and substance use, including journal articles, reports, clinical guidelines

22. May is Mental Health Awareness Month | The Academy
    integrationacademy.ahrq.gov/news-and-events/news/may-mental-health-awareness-month
    May 01, 2025 - Use Tools & Resources Collection – A collection of items for addressing substance use (especially opioids … literature on integrated behavioral health related to topics such as financing and sustainability, opioids

23. Tracking Patient Outcomes | The Academy
    integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/monitor-patient-and-program-progress/tracking-patient-outcomes
    February 01, 2024 - Continuing to use illicit substances, such as opioids and other drugs, or a recurrence of use is another … For example, patients who continue to use opioids may not be receiving a dosage of medications for opioid … If patients disclose they began using opioids again, providers should try to understand the reasons or … Missed appointments may be an indicator that the patient is struggling and perhaps has returned to using opioids … For some, their main goal may be to reduce use of opioids, rather than stopping altogether.

24. Implementing Medication-Assisted Treatment for Opioid Use Disorder in Rural Primary Care: Environmental Scan Volume 1 (pdf file)
    integrationacademy.ahrq.gov/sites/default/files/2020-06/mat_for_oud_environmental_scan_volume_1_1.pdf
    January 01, 2020 - opioid prescription within the past month.7 Primary care providers (PCPs) are the main prescribers of opioid … analgesics, with approximately 29 percent of prescriptions coming from these physicians.7 Increased … access and availability to prescription opioids brings a greater risk of misuse and abuse. … Agonists include opioids such as heroin and prescription pain medications. … For example, individuals with OUD who started misusing opioid analgesics prescribed for chronic pain

25. Opioid Epidemic COVID-19 Deepening Disparities | The Academy
    integrationacademy.ahrq.gov/news-and-events/news/opioid-epidemic-and-covid-19-pandemic-deepening-disparities
    December 23, 2020 - Prepandemic AHRQ data  show that overdose deaths involving synthetic opioids were contributing heavily

26. AHRQ Initiatives | The Academy
    integrationacademy.ahrq.gov/about/initiatives
    June 01, 2022 - unhealthy alcohol use, implementing medications for opioid use disorder in rural areas, and managing opioids

27. Quick Start Guide to Medications for Opioid Use Disorder | The Academy
    integrationacademy.ahrq.gov/products/playbooks/moud-playbook/quick-start-guide
    January 01, 2021 - Synthetic opioids—especially fentanyl and its analogs—have been a main driver of overdose deaths in recent … , specifically prescription opioids (excluding fentanyl) (34.2%), heroin (27.4%), fentanyl (25.7%), and … Distribution of these opioids varied by region. … (Note that the tolerance and withdrawal criteria are not considered to be met for those taking opioids … Some opioids such as fentanyl may require greater than 12 hours.

28. Pharmacotherapy | The Academy
    integrationacademy.ahrq.gov/products/playbooks/moud-playbook/implementing-treatment/pharmacotherapy
    January 01, 2019 - of the existing literature on starting buprenorphine is based on people using heroin or prescription opioids … reserved for more complex cases, such as patients transitioning from methadone or other long-acting opioids … starting MOUD, such as: Alpha 2 agonists (e.g., clonidine) for anxiety, agitation, and muscle aches; Non-opioid … analgesics (e.g., ibuprofen, acetaminophen) for minor aches and discomfort; Antispasmodics (e.g., dicyclomine … Patients may be surprised by the level of emotions they experience once non-prescribed opioids and other

29. Opioid Epidemic COVID OUD Treatment Telehealth | The Academy
    integrationacademy.ahrq.gov/news-and-events/news/opioid-epidemic-and-covid-19-pandemic-oud-treatment-telehealth
    December 23, 2020 - Preliminary data indicate the rate of overdose deaths involving opioids increased nationally during

30. Challenging Patient Behaviors and Concerns | The Academy
    integrationacademy.ahrq.gov/products/playbooks/moud-playbook/implementing-treatment/challenging-patient-behaviors-and-concerns
    January 01, 2021 - Continued Substance Use is Common Individuals with OUD may use other substances alongside opioids … Intentional and unintentional use of other substances along with opioids is common—particularly combinations … of opioids with xylazine, methamphetamine, or alcohol. … and treatments. 3 Similarly, patients receiving medication for OUD may continue to use non-prescribed opioids

31. Pharmacotherapy | The Academy
    integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/implement-mat-for-oud/pharmacotherapy
    January 01, 2018 - (e.g., employment, scheduling limitations), Pregnancy status, and Patient’s physical dependence on opioids … Stop using illicit opioids or other substances (depending on program policies). … reserved for more complex inductions, such as those transitioning from methadone or other long-acting opioids … If medication management visits indicate a patient has begun to or is at risk of using illicit opioids … screen results can be an important tool for providers as they can help reveal a return to use of illicit opioids

32. Pharmacotherapy Training | The Academy
    integrationacademy.ahrq.gov/products/playbooks/moud-playbook/obtain-training-and-support/pharmacotherapy-training
    January 01, 2023 - Common adulterants, excluding fentanyl analogs and precursors, include other opioids (heroin and tramadol … acetaminophen, and diphenhydramine 12,13 and most recently medetomidine. 14 In addition, people who use opioids … blocks the mu opioid receptors in the brain and therefore blocks the "high" or euphoric effects of opioids … (competitive binding) for mu opioid receptors, administration to a person who has recently ingested opioids … However, it is more difficult to begin, as the patient must be completely abstinent from opioids.

33. Orientation to Opioid Use Disorder Treatment | The Academy
    integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/obtain-training-and-support-providers-and-staff/clinicwide-orientation-oud-treatment
    January 01, 2019 - Nora Volkow, Director of the National Institute on Drug Abuse, talks about the way opioids “hijack the

34. Opioid Use Disorder Resources—2018 Updates | The Academy
    integrationacademy.ahrq.gov/news-and-events/news/opioid-use-disorder-resources-2018-updates
    January 11, 2018 - Utilization Project now provides county-level data of hospitalization rates for substance use, including opioids … teach clinicians and public health professionals about the appropriate, safe, and effective use of opioids … Primer on Opioids (National Association of State Alcohol and Drug Abuse Directors)—this issue brief … provides an overview of opioids, including the treatment of opioid use disorder.

35. Tracking Patient Outcomes | The Academy
    integrationacademy.ahrq.gov/products/playbooks/moud-playbook/monitor-patient-outcomes/tracking-patient-outcomes
    May 29, 2025 - and quality of life outcome measures. 23 Continued Substance Use: Continuing to use drugs, such as opioids … are: Attendance at appointments : Missed appointments may indicate the patient is struggling, using opioids … Facing Addiction in America: The Surgeon General's Spotlight on Opioids. NIDA. 2019. … nidamed-medical-health-professionals/opioid-crisis-pain-management/facing-addiction-in-america-surgeon-generals-spotlight-opioids … Effects of medication-assisted treatment on mortality among opioids users: a systematic review and meta-analysis

36. Repairing the Roots: Substance Use and Child Welfare: Rebuilding Family-Centered Systems of Care | The Academy
    integrationacademy.ahrq.gov/news-and-events/calendar/event/23298
    June 09, 2025 - While synthetic opioids remain central to the overdose crisis, deaths related to stimulants and alcohol

37. Delivering Medications for Opioid Use Disorder in Primary Care: Environmental Scan (pdf file)
    integrationacademy.ahrq.gov/sites/default/files/2025-07/MOUD_Playbook_Environmental_Scan_2025.pdf
    January 01, 2025 - State policies have been enacted to curtail prescribing prescription opioids. … Notably, the shift from prescription opioids to synthetic opioids, use of stimulants, and polysubstance … The Future of Fentanyl and Other Synthetic Opioids. RAND Corporation; 2019. … Facing Addiction in America: The Surgeon General’s Spotlight on Opioids. U.S. … CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022.

38. Expansion of MOUD Supported by DEA and HHS | The Academy
    integrationacademy.ahrq.gov/news-and-events/news/expansion-moud-supported-dea-and-hhs
    March 29, 2024 - The Academy Literature Collection includes references on both Healthcare Policy and Opioids & Substance

39. Screening and Diagnosis | The Academy
    integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/implement-mat-for-oud/screening-and-diagnosis
    January 01, 2018 - PDMPs can help identify patients who may be misusing or diverting prescription opioids. … Practices should ensure their providers’ full participation in PDMPs when prescribing opioids. … Scale (COWS) (PDF—610 KB) is an instrument to assess common signs and symptoms of withdrawal from opioids

40. Emergency Department Buprenorphine – A New Study | The Academy
    integrationacademy.ahrq.gov/news-and-events/news/emergency-department-buprenorphine-new-study
    February 26, 2024 - Collection , the Medications for Opioid Use Disorder Playbook , and Literature Collection references on opioids