Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018;39(2):139-144.
doi: 10.1080/08897077.2018.1452327.

Medications for opioid use disorder in the Department of Veterans Affairs (VA) health care system: Historical perspective, lessons learned, and next steps

Jessica J Wyse  1 , Adam J Gordon  2   3 , Steven K Dobscha  1   4 , Benjamin J Morasco  1   4 , Elizabeth Tiffany  1   4 , Karen Drexler  5   6   7 , Friedhelm Sandbrink  8   9   10 , Travis I Lovejoy  1   4
Affiliations

Medications for opioid use disorder in the Department of Veterans Affairs (VA) health care system: Historical perspective, lessons learned, and next steps

Jessica J Wyse et al. Subst Abus. 2018.

Abstract

The US Department of Veterans Affairs (VA), the largest health care system in the US, has been confronted with the health care consequences of opioid disorder (OUD). Increasing access to quality OUD treatment, including pharmacotherapy, is a priority for the VA. We examine the history of medications (e.g., methadone, buprenorphine, injectable naltrexone) used in the treatment of OUD within VA, document early and ongoing efforts to increase access and build capacity, primarily through the use of buprenorphine, and summarize research examining barriers and facilitators to prescribing and medication receipt. We find that there has been a slow but steady increase in the use of medications for OUD and, despite system-wide mandates and directives, uneven uptake across VA facilities and within patient sub-populations, including some of those most vulnerable. We conclude with recommendations intended to support the greater use of medication for OUD in the future, both within VA as well as other large health care systems.

Keywords: Veterans; buprenorphine; opioid use disorder; pharmacotherapy.

PubMed Disclaimer

References

    1. Gordon AJ, Trafton JA, Saxon AJ, et al. and Buprenorphine Work Group of the Substance Use Disorders Quality Enhancement Research Initiative. Implementation of buprenorphine in the Veterans Health Administration: Results of the first 3 years. Drug Alcohol Depend. 2007;90(2):292–296. doi:10.1016/j.drugalcdep.2007.03.010. - DOI - PubMed
    1. VA Mental Health Information System, Measure Components Summary BETA. https://spsites.cdw.va.gov/sites/OMHO_MHMP/_layouts/15/ReportServer/RSVi.... Accessed January 4, 2018.
    1. Bohnert AS, Ilgen MA, Galea S, McCarthy JF, Blow FC. Accidental poisoning mortality among patients in the Department of Veterans Affairs Health System. Med Care. 2011;49(4):393–396. doi:10.1097/MLR.0b013e318202aa27. - DOI - PubMed
    1. Bohnert AS, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioid overdose-related deaths. Jama. 2011;305(13):1315–1321. doi:10.1001/jama.2011.370. - DOI - PubMed
    1. Hadlandsmyth K, Mosher H, Vander Weg MW, Lund BC. Decline in Prescription Opioids Attributable to Decreases in Long-Term Use: A Retrospective Study in the Veterans Health Administration 2010–2016. J Gen Int Med. 2018;1–7. - PMC - PubMed

Publication types

MeSH terms

Substances