Projects
Project Date
30 Sep 2023 - 30 Jun 2028
Funding
National Institute on Drug Abuse R01 grant - R01DA057943
Researchers
- Thuy Nguyen (Contact Principal Investigator)
- Mark Bicket (Multiple Princial Investigator)
Project Summary
Medications for opioid use disorder (MOUD)–buprenorphine, methadone, and naltrexone–decrease
illicit opioid use, increase retention in treatment, and save lives. However, for
patients taking MOUD, and buprenorphine in particular, the treatment of acute pain
after surgery is challenging. Buprenorphine is a partial opioid agonist that acts
as a competitive antagonist for traditional opioids. Due to this fact, perioperative
guidelines have historically advocated that patients temporarily discontinue buprenorphine
before surgery. However, the national conversation has recently shifted with guidelines
recommending that buprenorphine, and to a lesser extent methadone, be continued in
the perioperative setting. The evidence supporting this change has relied on small
samples, non-surgical cohorts, and studies failing to examine relevant outcomes for
pain and opioid use disorder. In this proposal, we will use several state-of-the-art
national databases to achieve a better understanding of perioperative management of
MOUD and the consequences of therapy retention on opioid overdose risk.
Publications
- Bicket MC, Chua KP, Lagisetty P, Li Y, Waljee J, Brummett C, Nguyen TD. Prevalence
of Surgery Among Individuals in the United States. Annals of Surgery 5(2):p e421,
June 2024.DOI: 10.1097/AS9.0000000000000421.
https://journals.lww.com/aosopen/pages/default.aspx - Chua KP, Bicket MC, Bohnert ASB, Conti RM, Lagisetty P, Nguyen TD. Buprenorphine Dispensing
after Elimination of the Waiver Requirement. N Engl J Med. 2024;390(16):1530-1532.
doi:10.1056/NEJMc2312906.
https://www.nejm.org/doi/full/10.1056/NEJMc2312906
In the News
- It’s easier now to treat opioid addiction with medication -- but use has changed little
https://ihpi.umich.edu/news/its-easier-now-treat-opioid-addiction-medication-use-has-changed-little - $3.3M grant to support U-M research surrounding surgical care for patients with opioid
use disorder
https://sph.umich.edu/news/2023posts/3-3m-to-aid-research-into-surgical-care-for-opioid-patients.html
Project Date
30 Sep 2022 - Present
Researchers
- Thuy Nguyen
- Kao-Ping Chua
- Pooja Lagisetty
- Amy Bohnert
Project Summary
Despite a substantial rise in U.S. opioid overdose deaths in recent years, buprenorphine,
a medication for opioid use disorder (OUD) that substantially decreases fatal overdose
risk, remains widely underused, even after emergency department visits for opioid
overdose. Moreover, little is known about buprenorphine treatment among the 38% of
low-income adults with OUD covered by Medicaid, a disproportionate share of whom are
people of color. To address this knowledge gap, the team will analyze racial and ethnic
disparities in the receipt of buprenorphine among Medicaid enrollees to inform targeted
interventions focused on improving equity of buprenorphine treatment.
In the News
- IHPI Funds Four Policy-Relevant Projects Focused on Advancing Health Equity https://ihpi.umich.edu/news/ihpi-funds-four-policy-relevant-projects-focused-advancing-health-equity
- Lifesaving Addiction Medications are Rarely Started Following Opioid Overdose Emergencies https://ihpi.umich.edu/news/lifesaving-addiction-medications-are-rarely-started-following-opioid-overdose-emergencies
Project Date
30 Sep 2022 - 31 Jul 2026
Funding
National Institute on Drug Abuse R01 grant - R01DA056438
Researchers
- Kao-Ping Chua (Contact Principal Investigator)
- Thuy Nguyen (Multiple Princial Investigator)
Project Summary
In 2020, a record 71,000 opioid overdose deaths occurred in the U.S, highlighting
the importance of mitigating insurance-related barriers to accessing medications for
opioid use disorder (MOUD). In this proposal, we will provide actionable, policy-relevant
information on the effect of cost-sharing for MOUD in privately insured patients and
on the effect of removing prior authorization requirements for MOUD in Medicaid patients.
Results will inform and spur efforts to optimize insurance benefit design for MOUD
in private and Medicaid plans, potentially leading to the removal of insurance-related
barriers that may be contributing to rising opioid-related morbidity and mortality.
Publications
- Chua KP, Conti RM, Lagisetty P, Bohnert A, Nuliyalu U, Nguyen TD. Association Between
Cost-Sharing and Buprenorphine Prescription Abandonment. J Gen Intern Med. 2024; https://doi.org/10.1007/s11606-024-08819-2.
https://link.springer.com/article/10.1007/s11606-024-08819-2#citeas - Chua KP, Bicket MC, Bohnert ASB, Conti RM, Lagisetty P, Nguyen TD. Buprenorphine Dispensing
after Elimination of the Waiver Requirement. N Engl J Med. 2024;390(16):1530-1532.
doi:10.1056/NEJMc2312906.
https://www.nejm.org/doi/full/10.1056/NEJMc2312906 - Chua KP, Nguyen TD, Zhang J, Conti RM, Lagisetty P, Bohnert AS. Trends in Buprenorphine
Initiation and Retention in the United States, 2016-2022. JAMA. 2023;329(16):1402-1404.
doi:10.1001/jama.2023.1207
https://pubmed.ncbi.nlm.nih.gov/37097363/ - Chua KP, Nguyen TD, Waljee JF, Nalliah RP, Brummett CM. Association Between State
Opioid Prescribing Limits and Duration of Opioid Prescriptions From Dentists. JAMA
Netw Open. 2023;6(1):e2250409. Published 2023 Jan 3. doi:10.1001/jamanetworkopen.2022.50409
https://pubmed.ncbi.nlm.nih.gov/36630136/ - Andraka-Christou B, Simon KI, Bradford WD, Nguyen T. Buprenorphine Treatment For Opioid
Use Disorder: Comparison Of Insurance Restrictions, 2017-21. Health Aff (Millwood).
2023;42(5):658-664. doi:10.1377/hlthaff.2022.01513
https://pubmed.ncbi.nlm.nih.gov/37126752/
Visual Abstracts
- Association Between Cost-Sharing and Buprenorphine Prescription Abandonment
- Buprenorphine Dispensing after Elimination of the Waiver Requirement
In the News
- It’s easier now to treat opioid addiction with medication -- but use has changed little
https://ihpi.umich.edu/news/its-easier-now-treat-opioid-addiction-medication-use-has-changed-little - Study: Treatment for Opioid Addiction Lags Despite Policies Designed to Increase It
https://www.newswise.com/articles/study-treatment-for-opioid-addiction-lags-despite-policies-designed-to-increase-it?sc=rsgt - Opioid Limits Didn’t Change Surgery Patients’ Experience, Study Shows
https://www.newswise.com/articles/opioid-limits-didn-t-change-surgery-patients-experience-study-shows?sc=rsgt
Project Date
01 Jan 2021 - Present
Researchers
- Thuy Nguyen
- Christopher Whaley
- Kosali Simon
- Jonathan Cantor
Project Summary
The COVID-19 pandemic has caused a variety of disruptions to the health care workforce.
Although publications on select workforce sectors chronicle patterns in employment
through the early pandemic, there is a lack of national studies on the broad health
care workforce using more recent data in this period of rapid change. This limits
the ability of health care organizations and policy makers to ensure that patient
needs are met. This project aims to address this knowledge gap, providing data driven
insights into health care employment using large national databases.
Publications
- Nguyen T, Whaley C, Simon KI, Cantor J. Changes in Employment in the US Health Care
Workforce, 2016-2022. JAMA. 2023;330(20):2018-2019. doi:10.1001/jama.2023.18932
https://pubmed.ncbi.nlm.nih.gov/37917055/ - Cantor J, Whaley C, Simon K, Nguyen T. US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic. JAMA Health Forum. 2022;3(2):e215217. Published 2022 Feb 25. doi:10.1001/jamahealthforum.2021.5217. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2789521
- Nguyen T, Cantor J, Andraka-Christou B, Bradford WD, Simon KI. Where did the specialty
behavioral health workforce grow between 2011 and 2019? Evidence from census data.
Journal of Substance Abuse Treatment. 2021;130. doi:10.1016/j.jsat.2021.108482.
https://www.sciencedirect.com/science/article/pii/S0740547221002087
In the News
- Can Ads Help a Michigan Nursing Home Fix a Staffing Crisis?
https://www.mlive.com/public-interest/2023/11/can-ads-help-a-michigan-nursing-home-fix-a-staffing-crisis.html?gift=ee4dc0f1-bc56-4ab6-bced-d79f89540cd1 - Nursing Homes Hardest Hit by Health Care Employment Declines
https://sph.umich.edu/news/2023posts/nursing-homes-hardest-hit-by-health-care-employment-declines.html
Project Date
1 Sep 2019 - present
Researchers
- Thuy Nguyen
- Kosali Simon
- David Bradford
- Basia Andraka-Christou
Project Summary
Physician prescribing behavior may be influenced by a number of factors including
prescriber incentives and pharmaceutical policy. As we search for solutions to address
the ongoing opioid epidemic, it is important that we understand both the intended
and unintended consequences of such opioid related policies. For example, previous
studies by the team have demonstrated an association between less restrictive scope-of-practice
regulations and greater buprenorphine prescribing by nurse practitioners. Future work
will continue to explore the link between opioid related policy and clinician behavior.
Publications
- Nguyen TD, Bradford WD, Simon KI. Pharmaceutical payments to physicians may increase
prescribing for opioids. Addiction. 2019;114(6):1051-1059. doi:10.1111/add.14509
https://pubmed.ncbi.nlm.nih.gov/30667135/ - Nguyen T, Andraka-Christou B, Simon K, Bradford WD. Comparison of Rural vs Urban Direct-to-Physician
Commercial Promotion of Medications for Treating Opioid Use Disorder. JAMA Netw Open.
2019;2(12):e1916520. Published 2019 Dec 2. doi:10.1001/jamanetworkopen.2019.16520
https://pubmed.ncbi.nlm.nih.gov/31790568/ - Nguyen T, Andraka-Christou B, Simon K, Bradford WD. Provider-directed marketing may
increase prescribing of medications for opioid use disorder. J Subst Abuse Treat.
2019;104:104-115. doi:10.1016/j.jsat.2019.06.014
https://pubmed.ncbi.nlm.nih.gov/31370974/ - Scrivner O, Nguyen T, Simon K, Middaugh E, Taska B, Börner K. Job postings in the
substance use disorder treatment related sector during the first five years of Medicaid
expansion. PLoS One. 2020;15(1):e0228394. Published 2020 Jan 30. doi:10.1371/journal.pone.0228394
https://pubmed.ncbi.nlm.nih.gov/31999764/ - Andraka-Christou B, Nguyen T, Bradford DW, Simon K. Assessing the impact of drug courts
on provider-directed marketing efforts by manufactures of medications for the treatment
of opioid use disorder. J Subst Abuse Treat. 2020;110:49-58. doi:10.1016/j.jsat.2019.12.004
https://pubmed.ncbi.nlm.nih.gov/31952628/ - Nguyen TD, Gupta S, Ziedan E, et al. Assessment of Filled Buprenorphine Prescriptions
for Opioid Use Disorder During the Coronavirus Disease 2019 Pandemic. JAMA Intern
Med. 2021;181(4):562-565. doi:10.1001/jamainternmed.2020.7497
https://pubmed.ncbi.nlm.nih.gov/33346795/ - Sacks DW, Hollingsworth A, Nguyen T, Simon K. Can policy affect initiation of addictive
substance use? Evidence from opioid prescribing. J Health Econ. 2021;76:102397. doi:10.1016/j.jhealeco.2020.102397
https://pubmed.ncbi.nlm.nih.gov/33383263/ - Nguyen T, Muench U, Andraka-Christou B, Simon K, Bradford WD, Spetz J. The Association
Between Scope of Practice Regulations and Nurse Practitioner Prescribing of Buprenorphine
After the 2016 Opioid Bill. Med Care Res Rev. 2022;79(2):290-298. doi:10.1177/10775587211004311
https://pubmed.ncbi.nlm.nih.gov/33792414/ - Nguyen T, Cantor J, Andraka-Christou B, Bradford WD, Simon K. Where did the specialty
behavioral health workforce grow between 2011 and 2019? Evidence from census data.
J Subst Abuse Treat. 2021;130:108482. doi:10.1016/j.jsat.2021.108482
https://pubmed.ncbi.nlm.nih.gov/34118714/ - Nguyen T, Andraka-Christou B, Bradford WD, Simon K. Opting into the Public List of
DATA-Waivered Practitioners: Variations by Specialty, Treatment Capacity, and Practitioner
Characteristics. J Addict Med. 2022;16(3):e197-e202. doi:10.1097/ADM.0000000000000911
https://pubmed.ncbi.nlm.nih.gov/34669615/
In the News
- Payments to Physicians May Increase Opioid Prescribing
https://www.eurekalert.org/news-releases/594741 - Tighter Regulation Lowers Targeted, but Not Overall, Opioid Use
https://www.nber.org/bh-20203/tighter-regulation-lowers-targeted-not-overall-opioid-use