About The Cascade
of Care
Recognized by the National Institutes of Health and the Centers for Disease Control and Prevention, the Cascade of Care is a public health framework for organizing, monitoring, and improving effectiveness of evidence-based care and achieving health milestones. The framework supports tracking health goals across consecutive care stages over time. The Cascade of Care is defined by five sequential stages of treatment for people with opioid use disorder: opioid use disorder identification (diagnosis); treatment initiation, including psychosocial treatment and medication for opioid use disorder treatment; treatment engagement; treatment retention over time; and remission. Patient progression within this cascade of evidence-based diagnostic and treatment services is measured to guide intervention development, service delivery, identify disparities, and inform quality improvement. The Cascade of Care framework can help structure local and state efforts to combat the opioid epidemic by identifying key targets, interventions, and quality indicators across populations and settings to reduce deaths.
Understanding the Cascade of Care
Understanding how health and social service systems are performing in identifying and treating people with opioid use disorder can improve care and save lives. The Cascade of Care framework is essential for measuring opioid use disorder because it offers a structured approach to understanding the treatment process. It divides care into distinct stages—such as diagnosis, engagement, retention, and recovery—making it easier to identify where individuals may be falling out of the system. This helps pinpoint gaps in care and design targeted interventions to improve treatment outcomes. Additionally, the framework supports effective resource allocation by highlighting where resources are needed most. It also enables data-driven decision-making and ensures a comprehensive, patient-centered approach to managing opioid use disorder. Resources for understanding the Cascade of Care include:
- Why States Should Measure Opioid Use Disorder Treatment to Improve Outcomes
- Use a Cascade of Care Approach to Evaluate Gaps in the Opioid Use Disorder Treatment Pipeline
- State Measures for Improving Opioid Use Disorder Treatment Implementation Toolkit
- How Clinicians Can Achieve the Care Cascade
- Understand the National Landscape of Treatment for Opioid Use Disorder