Quantifying opioid use disorder Cascade of Care outcomes in an American Indian tribal nation in Minnesota

Abstract

American Indian communities in Minnesota have been disproportionately impacted by the opioid use disorder (OUD) epidemic, which tribal communities have taken numerous steps to address. The Cascade of Care is a public health framework for measuring population-level OUD risk, treatment engagement, treatment retention, and recovery outcomes, which can help communities monitor the impact of responses to the OUD epidemic and identify where treatment- and recovery-related barriers and facilitators may exist. However, no studies have quantified the Cascade of Care stages within tribal communities and the extent to which these stages can be quantified using existing data sources is unknown. We utilized data from the Minnesota Drug and Alcohol Abuse Normative Evaluation System (DAANES) to quantify OUD Cascade of Care stages for an American Indian tribal nation in Minnesota and for the entire state. DAANES data indicated 269 individuals in the tribal community received treatment for opioid-related problems in 2018. Among them, an estimated 65-99 % initiated medications for OUD and an estimated 13-41 % were retained in treatment for at least 180 days. Existing state-level data can provide information about Cascade of Care stages for American Indian communities, particularly with regard to treatment admission, initiation of medications for OUD, and treatment retention. Additional data sources are needed to measure population-level OUD risk, recovery, and cultural and contextual factors that may impact treatment and recovery.

Keywords: Cascade of Care; Medications for opioid use disorder; Opioid use disorder; Substance use disorder treatment.

Figure 1.

Preliminary Cascade of Care for adults in the tribal community who received treatment for an opioid use problem in 2018.

Figure 2.

Preliminary Cascade of Care for all adults in Minnesota who received treatment for an opioid use problem in 2018.