USPSTF Targets Opioid Abuse Prevention

Megan Brooks

December 20, 2018

In a critical first step in the process of eventually issuing a recommendation statement, the US Preventive Services Task Force (USPSTF) is reviewing evidence on ways to prevent prescription opioid abuse and opioid use disorder (OUD), the organization has announced.

Prescription misuse and illicit opioid use are serious health concerns; the problems are increasingly prevalent in the United States. In 2017, an estimated 2.1 million people aged 12 years and older had an OUD, and opioid use was involved in nearly two thirds of the more than 70,000 fatal drug overdoses.

This is the first time the task force is reviewing the evidence specifically related to the prevention of prescription opioid miuse and illicit opioid use, noted vice-chair of the USPSTF Alex H. Krist, MD, professor of family medicine at Virginia Commonwealth University, Richmond.

"Opioid misuse and overdoses are a very important topic, and the idea of trying to prevent people from developing opioid use disorder is very relevant," Krist told Medscape Medical News.

"There is emerging evidence that there may be things that primary care clinicians can do to prevent opioid use disorder, so all of these things made us prioritize this topic now," he said.

The task force has posted their draft research plan on interventions to prevent OUD on their website and is seeking public comment through January 16.

Three Key Questions

The proposal includes the following three key questions:

  1. Do interventions to prevent OUD that are feasible for implementation in or referred from primary care improve patient health outcomes in persons not currently using opioids?

  2. Do interventions to prevent opioid use disorder that are feasible for implementation in or referred from primary care prevent the initiation of unnecessary opioid use, reduce the amount of opioid use, or prevent prescription misuse in persons not currently using opioids?

  3. What are the harms of interventions to prevent opioid use disorder that are feasible for implementation in or referred from primary care in persons not currently using opioids?

The process will include an extensive review of published literature by an independent research team, the seeking of input from additional topic experts, and the development of a draft recommendation statement based on this evidence.

"We are at the beginning of a multistep process where we will pull together all the evidence, look at it systematically, and in an ideal world, there would be clear evidence where we could make a recommendation. Although it is possible that we could go through this process and it not be clear," Krist said.

"The whole process could take a couple years," he added.

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