{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:17:24Z","timestamp":1788286644835,"version":"build-2803163510"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R21DA062182"],"award-info":[{"award-number":["R21DA062182"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["U01MH121954"],"award-info":[{"award-number":["U01MH121954"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Most people with opioid use disorder (OUD) do not receive effective treatments despite their existence. The OUD cascade of care framework can be used to inform quality improvement efforts to address this gap, but data access and linkage requirements may limit its use. We sought to adapt the framework under the constraints of electronic health record data and identify patient populations at risk for OUD treatment discontinuity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We extracted data on patients with OUD from the Los Angeles County Department of Health Services from July 2022 through June 2023. We adapted the cascade of care to include probable OUD diagnosis, receipt of naloxone prescription, and receipt of \u22651 and \u22652 buprenorphine prescriptions. We then stratified and conducted statistical analyses for associations by sex, race and ethnicity, and facility type (inpatient, primary care, emergency, or urgent care).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 3881 patients identified with probable OUD, 49% received a naloxone prescription and 30% and 17% had \u22651 and \u22652 buprenorphine prescriptions, respectively, in 1 year. Non-Hispanic Black and Hispanic patients were less likely to receive buprenorphine prescriptions than were non-Hispanic White patients and patients of other or unknown race and ethnicity. We observed larger gaps in care between receipt of \u22651 and \u22652 buprenorphine prescriptions for patients using urgent care and emergency departments compared with patients in other settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practice Implications:<\/jats:title>\n                    <jats:p>This study illustrates substantial gaps between OUD diagnosis and treatment. This adapted framework for the OUD cascade of care can serve as a quality-monitoring tool to aid clinicians and health care administrators in narrowing the treatment gap for people with OUD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549261467293","type":"journal-article","created":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T16:49:14Z","timestamp":1788108554000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Framework for the Opioid Use Disorder Cascade of Care: Adaptation and Application for a Large Municipal Health System"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7329-8931","authenticated-orcid":false,"given":"Mariah M.","family":"Kalmin","sequence":"first","affiliation":[{"name":"RAND, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Crowley","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Pak","sequence":"additional","affiliation":[{"name":"RAND, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0028-726X","authenticated-orcid":false,"given":"Colleen M.","family":"McCullough","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth Ann","family":"Griffin","sequence":"additional","affiliation":[{"name":"RAND, Arlington, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Ragins","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Health Services, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hrishikesh","family":"Belani","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Health Services, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7573-5292","authenticated-orcid":false,"given":"Katherine E.","family":"Watkins","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"issue":"457","key":"e_1_3_2_2_2","first-page":"1","article-title":"Drug overdose deaths in the United States, 2001-2021","volume":"2022","author":"Spencer MR","unstructured":"Spencer MR, Mini\u00f1o AM, Warner M. Drug overdose deaths in the United States, 2001-2021. NCHS Data Brief. 2022(457):1-8.","journal-title":"NCHS Data Brief"},{"issue":"427","key":"e_1_3_2_3_2","first-page":"1","article-title":"Mortality in the United States, 2020","author":"Murphy SL","year":"2021","unstructured":"Murphy SL, Kochanek KD, Xu J, Arias E. Mortality in the United States, 2020. NCHS Data Brief. 2021;(427):1-8.","journal-title":"NCHS Data Brief"},{"issue":"6","key":"e_1_3_2_4_2","first-page":"1","article-title":"Deaths: leading causes for 2017","volume":"68","author":"Heron M","year":"2019","unstructured":"Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep. 2019;68(6):1-77.","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.14997"},{"key":"e_1_3_2_6_2","unstructured":"Centers for Disease Control and Prevention. Understanding the opioid overdose epidemic. 2025. Accessed June 3 2026. https:\/\/www.cdc.gov\/overdose-prevention\/about\/understanding-the-opioid-overdose-epidemic.html"},{"key":"e_1_3_2_7_2","unstructured":"Substance Abuse and Mental Health Services Administration. Medications for Opioid Use Disorder Among Adults Who Had an Opioid Use Disorder. NSDUH Data Spotlight; 2025. Accessed June 3 2026. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt56616\/2024-nsduh-spotlight-moud.pdf"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.3821"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7325a1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20220456"},{"key":"e_1_3_2_11_2","unstructured":"National Committee for Quality Assurance. Initiation and engagement of substance use disorder treatment (IET). No date. Accessed June 3 2026. https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/initiation-and-engagement-of-substance-use-disorder-treatment-iet"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2018.1546862"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.6.1677"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq243"},{"issue":"47","key":"e_1_3_2_15_2","first-page":"1618","article-title":"Vital signs: HIV prevention through care and treatment\u2014United States","volume":"60","author":"Cohen SM","year":"2011","unstructured":"Cohen SM, van Handel MM, Branson BM, et al. Vital signs: HIV prevention through care and treatment\u2014United States. MMWR Morb Mortal Wkly Rep. 2011;60(47):1618-1623.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2022.2074604"},{"key":"e_1_3_2_17_2","unstructured":"Substance Abuse Prevention and Control Bureau Los Angeles County Department of Public Health. Data Report: Fentanyl Overdoses in Los Angeles County. Los Angeles County Department of Public Health; 2025. Accessed June 3 2026. http:\/\/lapublichealth.org\/sapc\/MDU\/SpecialReport\/Fentanyl-Overdoses-in-Los-Angeles-County.pdf"},{"key":"e_1_3_2_18_2","unstructured":"County of Los Angeles Public Health. SAPC data brief: prescription (Rx) opioid misuse\/abuse and consequences. November 2025. Accessed June 3 2026. http:\/\/ph.lacounty.gov\/sapc\/MDU\/MDBrief\/Opioid-Brief.pdf"},{"key":"e_1_3_2_19_2","unstructured":"Los Angeles County Department of Health Services. About LA County Health Services. No date. Accessed June 3 2026. https:\/\/ladhsphysicianjobs.com\/about"},{"key":"e_1_3_2_20_2","unstructured":"World Health Organization. International Statistical Classification of Diseases and Related Health Problems 10th Revision. 6th ed. World Health Organization; 2019. Accessed June 3 2026. https:\/\/icd.who.int\/browse10\/Content\/statichtml\/ICD10Volume2_en_2019.pdf"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.5055\/jom.0960"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.15909"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-022-01010-4"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2212412"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2025.112636"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2025.112945"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.07.002"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002963"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2024.2302500"},{"key":"e_1_3_2_31_2","unstructured":"Johnson K Williams AR Chalk M. Making the opioid use disorder cascade of care a reality despite data limitations. Health Aff Forefront. October 23 2018. Accessed June 3 2026. https:\/\/www.healthaffairs.org\/content\/forefront\/making-opioid-use-disorder-cascade-care-reality-despite-data-limitations"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103786"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2009.09081087"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/adm.0000000000000164"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2025.2494106"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/1178221820976988"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109123"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.14947"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2021.108404"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.3934\/publichealth.2025005"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-07315-9"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.12.022"},{"key":"e_1_3_2_43_2","unstructured":"Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health (NSDUH). National reports and tables. NSDUH detailed tables. 2016-2020 2022-2023. Accessed June 3 2026. https:\/\/www.samhsa.gov\/data\/data-we-collect\/nsduh-national-survey-drug-use-and-health\/national-releases\/2023"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261467293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549261467293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549261467293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T17:52:11Z","timestamp":1788285131000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549261467293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,30]]},"references-count":42,"alternative-id":["10.1177\/00333549261467293"],"URL":"https:\/\/doi.org\/10.1177\/00333549261467293","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,30]]},"article-number":"00333549261467293"}}