Year of Publication

2018

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Sarah Wackerbarth, PhD

Committee Member

Moaz Abdelwadoud, MD, DrPH, MPH

Committee Member

Julia Costich, JD, PhD

Committee Member

Kathi Harp, PhD

Abstract

Current treatment guideline recommendations published by the American Society of Addiction Medicine for Opioid Use Disorder (OUD) include both psychotherapy and Medication- Assisted Treatment for optimal management of this chronic medical illness. Military veterans are at an increased risk for fatal outcomes related to opioid overdoses due to a higher prevalence of depression/Post-Traumatic Stress Disorder (PTSD) and self-medicated substance use compared to their civilian counterparts. Additionally, many have been diagnosed with OUD but are not being treated in accordance with current treatment recommendations.

In an effort to increase access to treatment and combat the opioid epidemic, the Lexington VA Medical Center Leestown Division is currently re-evaluating their OUD treatment model. Thorough electronic medical chart review of patients diagnosed with OUD was conducted to determine if current treatment recommendations were being implemented. As a primary objective to increase the number of patients with OUD on Medication-Assisted Treatment (MAT), pharmacist referral to primary care or mental health care providers for MAT was performed when intervention was deemed appropriate. A secondary outcome was to ensure all patients with OUD have an active Narcan prescription for emergency situations. Of the 191 veterans reviewed for this capstone project, 36% were not currently receiving treatment and were referred for MAT evaluation by a prescribing provider. Furthermore, 50 veterans with OUD were found to be without a Narcan kit prescription order. Instead of waiting for those at risk to seek treatment, this project highlights a novel approach in OUD treatment with early identification and secondary prevention.

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