Multidisciplinary Strategies for Preventing Opioid Misuse and Escalation by Targeting Mental Health Symptoms and Conditions

Yule, Amy; Fernandes, Claudia-Santi F.; Stormshak, Elizabeth A.; Yang, Yang; Shelley, Lillyan T.; Fiellin, Lynn E.; Larkin, Kirsten; Ridenour, Ty; Saavedra, Lissette M.; Kelleher, Kelly J.; Feng, Xinliang; Walton, Maureen A.; Bonar, Erin E.

doi:10.1007/s11121-023-01556-8

Cited by 4 publications

(2 citation statements)

References 51 publications

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“…By investing in prevention strategies, policymakers can reduce the burden on health care systems and society that results from opioid misuse (Richter et al, 2023;Sterling et al, 2010). Similar to the work in many of these interventions, policy and practice should emphasize a comprehensive and holistic approach to prevention (Yule et al, 2023), including addressing the underlying factors that contribute to opioid misuse, such as mental health symptoms, trauma, and social determinants of health. Prevention scientists can collaborate with policymakers to develop policies that integrate mental health support, education, and communitybased resources, ensuring a multifaceted approach to prevention.…”

Section: Implications For Policy and Practicementioning

confidence: 99%

Adapting Opioid Misuse Prevention Programs During COVID-19: Implications for Increasing Access Post-Pandemic

Saavedra,

Cance,

D'Amico

et al. 2024

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Physical distancing restrictions related to the COVID-19 pandemic accelerated the uptake of virtual options for prevention providers and clinical service provision in general. In this paper, we bring together experiences from the HEAL Prevention Cooperative, a unique cohort of research projects representing a continuum of care from community-level promotion to indicated prevention with older adolescents and young adults to increase access to services to prevent opioid misuse. We offer options that preventionists and other providers can implement or continue to use to expand access to youth and families who experience difficulty accessing opioid-related preventive services and supports. We also discuss challenges in implementing physical distancing adaptations that were required to operate during the pandemic. We discuss intervention adaptations along four pillars useful for providers and researchers: connecting with partners, recruitment, prevention service provision, and data collection and evaluation. We also provide recommendations for health professionals and practitioners and for future research.

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Section: Implications For Policy and Practicementioning

confidence: 99%

Adapting Opioid Misuse Prevention Programs During COVID-19: Implications for Increasing Access Post-Pandemic

Saavedra,

Cance,

D'Amico

et al. 2024

Self Cite

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“…There is a signi cant association between mental health conditions and opioid use initiation/continuation,( 52) , (53)…”

Section: Overcoming Structural Challengesmentioning

confidence: 99%

Naloxone Distribution in Texas 2018-2022: A State-Wide Program for Opioid Overdose Prevention

Irwin,

Mathias,

Wang

et al. 2023

Preprint

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Background Opioid-related overdose mortality has steadily increased throughout the United States. The distribution of the opioid agonist naloxone has been a critical first-line prevention strategy for preventing opioid overdose deaths. The continued geographic and demographic spread of opioid overdose poses significant challenges for targeting naloxone distribution to those most likely to witness and respond to an overdose. To achieve equity and impact, state-level naloxone distribution programs must account for numerous factors that shape the disproportionate burden of overdose mortality, including poor access to health services, rural location, cost, and responsiveness to shifting geographical trends. Case Presentation: This paper describes a large state-level, naloxone distribution initiative in Texas that aims to overcome these distribution challenges. Between 2018 and 2022, this centralized naloxone program distributed 576,360 doses of naloxone to individuals, agencies, and organizations. Naloxone went to 87.6% of Texas’ counties that reported overdoses. Fulfilled orders spanned sectors (Individuals, Community Organizations, Law Enforcement, Health Services, EMS/Fire, Schools, and Government Agencies) in mental health services shortage areas (91.3%), rural locations (4.7%), and Hispanic majority (21.6%) communities. Conclusions A centralized, statewide naloxone distribution program, like the one in Texas described in this paper, offers numerous benefits, including state-level monitoring of naloxone distribution effectiveness and reach across large geographic, service, and population sectors.

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Commentary: Improving the Effectiveness and Utility of the Helping to End Addiction Long-Term (HEAL) Prevention Cooperative: A Full Translational Framework

Andersen

Fishbein

2022

Prev Sci

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The Helping to End Addiction Long-term (HEAL) Prevention Collaborative (HPC) is designed to expedite the development of programs aimed at preventing opioid misuse and opioid use disorder (OUD) in older adolescents and young adults (ages 16–30). Funded by the National Institutes of Health Office of the Director (ODP-NIH), the HPC includes ten outcome studies that focus on distinct interventions to determine their effectiveness and real-world applicability. Also included is a coordinating center at RTI International that supports the individual projects. This commentary highlights the scientific and practical significance of this cooperative and its promise for facilitating the production and implementation of successful interventions. Attributes such as novel program designs, advanced methodologies, addressing unique characteristics of diverse populations, and real-time analysis of data and costs make this cooperative highly innovative. We note, however, that papers in this Supplemental Issue did not specifically address the persistent need to obtain stronger effect sizes than those achieved to date. Existing data captured earlier in development (< 16 years of age) are uncovering interactive neurocognitive and social-contextual mechanisms underlying the phenomena we wish to prevent. HPC projects could be guided by this information to incorporate developmentally appropriate measures of mechanisms shown previously to be influential in targeted outcomes and determine how they are impacted by specific components of their interventions. This mechanistic information can provide a roadmap for constructing interventions that are more precision-based and, thus, more likely to yield greater benefits for a larger number of recipients. Furthermore, an understanding of underlying mechanism(s) promises to shed light on the sources of heterogeneity in outcomes for further intervention refinement. It is quite possible, if not probable, that meaningful measures of underlying processes will reveal subtypes—some with very high effect sizes and others that are much lower—directly enabling program refinements to more directly target mechanisms that portend and explain less favorable outcomes. Described herein is a full-spectrum translational approach which promises to significantly boost effect sizes, a key objective that should be reached prior to scaling.

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Multidisciplinary Strategies for Preventing Opioid Misuse and Escalation by Targeting Mental Health Symptoms and Conditions

Cited by 4 publications

References 51 publications

Adapting Opioid Misuse Prevention Programs During COVID-19: Implications for Increasing Access Post-Pandemic

Adapting Opioid Misuse Prevention Programs During COVID-19: Implications for Increasing Access Post-Pandemic

Naloxone Distribution in Texas 2018-2022: A State-Wide Program for Opioid Overdose Prevention

Commentary: Improving the Effectiveness and Utility of the Helping to End Addiction Long-Term (HEAL) Prevention Cooperative: A Full Translational Framework

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