Improving outcomes for people with opioid use disorder
In May 2022, the CDC estimated that more than 107,600 Americans died from drug overdoses from December 2020 to December 2021, setting another tragic record in the nation’s SUD crisis. More than 75% of those deaths were from opioids (75,673). With alarming statistics like these, the need for effective treatment options for opioid use disorder (OUD) is urgent.
The use of medications for opioid use disorder (MOUD) is currently the most effective treatment for OUD. Although there are three FDA-approved medications (methadone, buprenorphine, and naltrexone), MOUD is not utilized as much as it could be. In acute care settings many inpatient units still rely on traditional withdrawal management protocols, which are associated with high risk for relapse, accidental overdose, and/or death due to decreased physical tolerance.
In 2018, Beacon Health Options and the Connecticut Behavioral Health Partnership (CT BHP) launched Changing Pathways to promote MOUD, improve outcomes for individuals with OUD, and save lives. The model is now at the forefront of the state’s response to the opioid epidemic and has recently expanded to New York.
The three elements of Changing Pathways are: 1) thorough education on treatment options including the three FDA-approved MOUD provided to all members entering care with OUD, 2) offering MOUD induction for members who are interested, and 3) seamless connection to aftercare for the continuation of MOUD.
Peer specialists play a key role in this program by providing education and support starting in the inpatient unit and up to 90 days after discharge. “Because the participant knows the peer understands what they are going through, a peer is able to make a more personal connection. Participants are more likely to develop trust with someone who’s been through it themselves,” said Mary Jo Capitani, Certified Peer Recovery Specialist.
In the Changing Pathways program, participants begin receiving MOUD during a withdrawal management episode. They are then discharged on a stable dose. The program links members with a community provider so that they can continue MOUD and follow a plan to recovery.
To date, the outcomes for Changing Pathways have been positive. Member engagement has increased and more people with OUD are experiencing successful recovery. In the program’s first 18 months, inducted participants experienced a number of positive outcomes including:
- Increased connection to MOUD by 32%
- Decrease in readmissions to inpatient facilities by 12% within 30 days compared to traditional withdrawal management
- Decrease in the average number of behavioral health ED visits, inpatient days, and withdrawal management episodes by 54%, 39.7%, and 55.8% respectively, in the 90 days following discharge for participants who remained MOUD adherent
- Reduction in overdoses by 74% for individuals who remained MOUD adherent for 90 days following discharge
Changing Pathways is changing the game in the fight against the opioid epidemic through practice change, education on the importance of MOUD, and life-saving strategies that increase MOUD adherence. Get our provider toolkit online to learn more.
 CDC National Center for Health Statistics, Drug Overdose Deaths in the U.S. Top 100,000 Annually,
 “Adherence” refers to using MOUD at least 80% of days for the three months following discharge.