Introduction to the special issue on innovative interventions and approaches to expand medication assisted treatment: Seizing research opportunities made available by the opioid STR program

Watson, Dennis P.; Andraka‐Christou, Barbara; Clarke, Thomas; Wiegandt, Julie

doi:10.1016/j.jsat.2019.10.004

Cited by 16 publications

(14 citation statements)

References 34 publications

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“…The federal government has allocated substantial funding to respond to the drug overdose crisis. A popular provision of the 21st Century Cures Act, passed in 2016, authorized the Substance Abuse and Mental Health Services Administration (SAMHSA) to distribute $1 billion for programs that address opioid addiction and overdose [ 5 ]. Since that time, SAMHSA has continued to fund such programs through the State Opioid Response (SOR) grant program through which an additional $6 billion have been allocated to the states to provide evidence-based opioid use disorder prevention, treatment, and recovery services [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Promoting sustainable responses to the US opioid epidemic with community-academic partnerships: qualitative outcomes from a statewide program

Driscoll

Cuellar

Agarwal

et al. 2022

Subst Abuse Treat Prev Policy

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Background Drug overdose deaths in the United States have continued to increase at an alarming rate. The Substance Abuse and Mental Health Services Administration (SAMHSA) distributed more than $7 billion between January 2016 and June 2020 to address the drug overdose crisis. The funds support evidence-based responses, including medications for opioid use disorder, and other prevention, treatment and recovery activities. Although the State Opioid Response (SOR) grants finance much-needed community level interventions, many of the services they support may not be sustainable, without ongoing assessment, evaluation and planning for continuation. Methods This paper describes a statewide effort to support local entities through SAMHSA’s SOR grants in Virginia. Community agencies across the state participated in detailed needs assessment exercises with VHEOC investigators, and developed requests for proposals (RFPs) to sustain their SOR programs. The RFPs were then distributed to prospective academic partners at the five VHEOC universities, based on the required subject matter expertise identified in the RFP. All responsive proposals were then provided to the local agencies who selected the proposal most likely to meet their needs. VHEOC investigators also conducted an inductive, three-phase content analysis approach to examine the RFPs submitted to the VHEOC to identify nominal categories of support requested of the VHEOC investigators. Results VHEOC Investigators received and coded 27 RFPs from ten community agencies representing four of five regions of the state. We identified six nominal categories of academic assistance with high inter-coder agreement. The six categories of support requested of the academic partners were program development and support, literature review and best practices, outreach and education, data analysis and interpretation, program evaluation, and grant writing assistance. Several RFPs requested up to three categories of support in a single project. Conclusions Our analysis of the requests received by the consortium identified several categories of academic support for SOR-grantees addressing the drug overdose crisis. The most common requests related to development and maintenance of supportive collaborations, which existing research has demonstrated is necessary for the long-term sustainability of SOR-funded services. In this way, the academic partners reinforced sustainable SOR-funded programs. As the state opioid response program is implemented nationally, we hope that other states will consider similar models in response to the opioid crisis.

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Section: Introductionmentioning

confidence: 99%

Promoting sustainable responses to the US opioid epidemic with community-academic partnerships: qualitative outcomes from a statewide program

Driscoll

Cuellar

Agarwal

et al. 2022

Subst Abuse Treat Prev Policy

View full text Add to dashboard Cite

show abstract

“…The urgent need for interventions with potential to help address the opioid crisis is reflected in the 122% increase in opioid-related overdose deaths between 2010 and 2018 in the USA [ 2 ]. This urgency has resulted in the development and implementation of a number of novel interventions that require rapid yet rigorous scientific assessment, which is not conducive to traditional explanatory trials [ 3 ]. Pragmatic trials are a novel and effective solution to meet this challenge, as they are able to deliver more immediate and generalizable solutions due to their situation in “real-world” contexts [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers impacting the POINT pragmatic trial: the unavoidable overlap between research and intervention procedures in “real-world” research

Dir

Watson

Zhiss

et al. 2021

Trials

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Background This manuscript provides a research update to the ongoing pragmatic trial of Project POINT (Planned Outreach, Intervention, Naloxone, and Treatment), an emergency department-based peer recovery coaching intervention for linking patients with opioid use disorder to evidence-based treatment. The research team has encountered a number of challenges related to the “real-world” study setting since the trial began. Using an implementation science lens, we sought to identify and describe barriers impacting both the intervention and research protocols of the POINT study, which are often intertwined in pragmatic trials due to the focus on external validity. Method Qualitative data were collected from 3 peer recovery coaches, 2 peer recovery coach supervisors, and 3 members of the research team. Questions and deductive qualitative analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Results Nine unique barriers were noted, with 5 of these barriers impacting intervention and research protocol implementation simultaneously. These simultaneous barriers were timing of intervention delivery, ineffective communication with emergency department staff, lack of privacy in the emergency department, the fast-paced emergency department setting, and patient’s limited resources. Together, these barriers represent the intervention characteristics, inner setting, and outer setting domains of the CFIR. Conclusion Results highlight the utility of employing an implementation science framework to assess implementation issues in pragmatic trials and how this approach might be used as a quality assurance mechanism given the considerable overlap that exists between research and intervention protocols in real-world trial settings. Previously undocumented changes to the trial design that have been made as a result of the identified barriers are discussed.

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“…This bolus in funding aimed to reduce overdose deaths through expansion of evidence-based treatment; including the FDA-approved medications of methadone, buprenorphine, and naltrexone. States employed a variety of evidence-based programs with this funding, ranging from peer navigators to post-overdose emergency department connection programs [ 3 ]. With this record funding comes a growing concern about the continuation, or sustainment [ 4 ], of these grant-financed programs [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The prospects for sustaining evidence-based responses to the US opioid epidemic: state leadership perspectives

Caton

Yuan

Louie

et al. 2020

Subst Abuse Treat Prev Policy

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Background The US 21st Century Cures Act provided $7.5 billion in grant funding to states and territories for evidence-based responses to the opioid epidemic. Currently, little is known about optimal strategies for sustaining these programs beyond this start-up funding. Methods Using an inductive, conventional content analysis, we conducted key informant interviews with former and current state leaders (n = 16) about barriers/facilitators to sustainment and strategies for sustaining time-limited grants. Results Financing and reimbursement, service integration, and workforce capacity were the most cited barriers to sustainment. Status in state government structure, public support, and spending flexibility were noted as key facilitators. Effective levers to increase chances for sustainment included strong partnerships with other state agencies, workforce and credentialing changes, and marshalling advocacy through public awareness campaigns. Conclusions Understanding the strategies that leaders have successfully used to sustain programs in the past can inform how to continue future time-limited, grant-funded initiatives.

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Introduction to the special issue on innovative interventions and approaches to expand medication assisted treatment: Seizing research opportunities made available by the opioid STR program

Cited by 16 publications

References 34 publications

Promoting sustainable responses to the US opioid epidemic with community-academic partnerships: qualitative outcomes from a statewide program

Promoting sustainable responses to the US opioid epidemic with community-academic partnerships: qualitative outcomes from a statewide program

Barriers impacting the POINT pragmatic trial: the unavoidable overlap between research and intervention procedures in “real-world” research

The prospects for sustaining evidence-based responses to the US opioid epidemic: state leadership perspectives

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