This study examines the prevalence and efficacy of treating chronic back pain with opioids and assess its association with addiction. The authors found that opioid use was common and that such drugs me be efficacious for shot-term pain relief but that no data was available for long-term efficacy.  The study also found that substance abuse disorders are common among patients taking opioids for back pain and that aberrant medication-taking behavioral occurs in up to 24 percent of cases. 

Martell, B. A., O'Conner, P. G., Kerns, R. D. et al. (2007). Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals of Internal Medicine. 146(2), 116-127. http://www.annals.org/cgi/content/abstract/146/2/116

Authors:  Bridget A. Martell, Patrick G. O'Connor, Robert D. Kerns, William C. Becker, Knashawn H. Morales, Thomas R. Kosten, David A. Fiellin.  

This paper examines a clinically-driven planning process commissioned by the Ministry of Health of Ontario to identify alternative placements for psychiatric hospitals matching need to care in the least restrictive setting. 

The full report is available from SAMHSA here: http://download.ncadi.samhsa.gov/ken/pdf/ManagedCare/durbin.pdf

Citation: Durbin, J., Cochrane, J., Goering, P., & Macfarlane, D. (2001). Needs-based planning: evaluation of a level-of-care planning model. Journal of Behavioral Health Services & Research, 28(1), 67-80.

This 2001 paper examines the state of cost effectiveness research for alcohol abuse prevention and recommends that prevention be rigorously studied to determine the best return on investment. 

The full paper is available from the SAMHSA here: http://download.ncadi.samhsa.gov/ken/pdf/ManagedCare/holder.pdf 

Citation: Holder, H. D. (2001). Prevention research and its actual application to health services. Journal of Behavioral Health Services & Research, 28(2), 118-129.

This 1999 paper argued that managed care can achieve cost savings and improved outcomes by training utilization managers to make mental health services more accessible to patients who's excessive use of general medical care is related to their mental health condition.  The authors not that such systems are more likely to develop in systems where mental health and medical/surgical management are integrated. 

The full paper is available through the Health Affairs website: http://content.healthaffairs.org/cgi/reprint/18/2/79.pdf 

 Citation: Olfson, M., Sing, M., & Schlesinger, H. J. (1999). Mental health/medical care cost offsets: opportunities for managed care. Health Affairs, 18(2), 79-90.

This article presents the results of a national effort to identify and describe pay-for-performance programs in behavioral health.  The authors conclude that, though pay-for-performance holds promise for advancing performance in the health care system, more intensive efforts to strengthen the quality of the behavioral health infrastructure are required. 

Bremer, R. W., Scholle, S. H., & Keyser, D. (2008). Pay for performance in behavioral health. Psychiatric Services. 59, 1419-1429. DOI: 10.1176/appi.ps.59.12.1419. http://psychservices.psychiatryonline.org/cgi/content/abstract/59/12/1419 

Authors: Robert W. Bremer, Sarah Hudson Scholle, Donna Keyser, Jeanine V. Knox Houtsinger, Harold Alan Pincus.

This study finds that Medicaid managed care in Massachusetts had no effect on the outcomes of substance abuse treatment for adolescents.  These results refute arguments from both managed care’s supporters and detractors about the potential effects of managed care on substance abuse treatment outcomes.   

Harrrow, B. S., Tompkins, C. P., Mitchell, P. D., Smith, K. W., Soldz, S., Kasten, L., et al. (2006). The impact of publicly funded managed care on adolescent substance abuse treatment outcomes. American Journal of Drug and Alcohol Abuse, 32(3), 379-98. DOI: 10.1080/00952990600753677

Authors: Brooke S. Harrow, Christopher P. Tompkins, Paul D. Mitchell, Kevin W. Smith, Stephen Soldz, Linda Kasten, Kathleen Fleming.