The role of social work in the opioid epidemic: office-based opioid treatment programs

Lombardi, Brianna M.; Zerden, Lisa de Saxe; Guan, Ting; Prentice, Amy

doi:10.1080/00981389.2018.1564109

Cited by 22 publications

(12 citation statements)

References 14 publications

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“…Quick Response Teams could use the data up-to-date data on treatment providers to link individuals to care without worrying about the patient not being able to enter treatment because the data on OUD treatment providers was out of date, which anecdotally happens quiet often in low-resources settings even in a populous county such as Franklin County, OH. Social workers are addressing the opioid epidemic in a number of different ways, including being a part behavioral health teams [ 68 ] and Quick Response Teams [ 69 ], where one of their roles is linking individuals after an overdose with treatment and other services that will support staying in treatment. The effectiveness of social worker-based interventions could potentially be improved by optimally allocating resources in areas identified as Opioid Treatment Deserts.…”

Section: Discussionmentioning

confidence: 99%

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

et al. 2021

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Objectives An Opioid Treatment Desert is an area with limited accessibility to medication-assisted treatment and recovery facilities for Opioid Use Disorder. We explored the concept of Opioid Treatment Deserts including racial differences in potential spatial accessibility and applied it to one Midwestern urban county using high resolution spatiotemporal data. Methods We obtained individual-level data from one Emergency Medical Services (EMS) agency (Columbus Fire Department) in Franklin County, Ohio. Opioid overdose events were based on EMS runs where naloxone was administered from 1/1/2013 to 12/31/2017. Potential spatial accessibility was measured as the time (in minutes) it would take an individual, who may decide to seek treatment after an opioid overdose, to travel from where they had the overdose event, which was a proxy measure of their residential location, to the nearest opioid use disorder (OUD) treatment provider that provided medically-assisted treatment (MAT). We estimated accessibility measures overall, by race and by four types of treatment providers (any type of MAT for OUD, Buprenorphine, Methadone, or Naltrexone). Areas were classified as an Opioid Treatment Desert if the estimate travel time to treatment provider (any type of MAT for OUD) was greater than a given threshold. We performed sensitivity analysis using a range of threshold values based on multiple modes of transportation (car and public transit) and using only EMS runs to home/residential location types. Results A total of 6,929 geocoded opioid overdose events based on data from EMS agencies were used in the final analysis. Most events occurred among 26–35 years old (34%), identified as White adults (56%) and male (62%). Median travel times and interquartile range (IQR) to closest treatment provider by car and public transit was 2 minutes (IQR: 3 minutes) and 17 minutes (IQR: 17 minutes), respectively. Several neighborhoods in the study area had limited accessibility to OUD treatment facilities and were classified as Opioid Treatment Deserts. Travel time by public transit for most treatment provider types and by car for Methadone-based treatment was significantly different between individuals who were identified as Black adults and White adults based on their race. Conclusions Disparities in access to opioid treatment exist at the sub-county level in specific neighborhoods and across racial groups in Columbus, Ohio and can be quantified and visualized using local public safety data (e.g., EMS runs). Identification of Opioid Treatment Deserts can aid multiple stakeholders better plan and allocate resources for more equitable access to MAT for OUD and, therefore, reduce the burden of the opioid epidemic while making better use of real-time public safety data to address a public health epidemic that has turned into a public safety crisis.

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Section: Discussionmentioning

confidence: 99%

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

et al. 2021

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“…Similar training should be incorporated in the curricula of other healthcare professionals including nursing and pharmacy as well as in schools of social work across the country [97,133,134]. These front-line providers typically have greater opportunities to interact with patients than physicians, particularly in rural areas [135][136][137][138]. Outside of the healthcare system, education and training in criminal justice settings is also critical [15,98].…”

Section: Availability Of Buprenorphine-waivered Providers In the Usamentioning

confidence: 99%

Availability of Medications for the Treatment of Alcohol and Opioid Use Disorder in the USA

et al. 2020

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Despite high mortality rates due to opioid overdose and excessive alcohol consumption, medications for the treatment of alcohol and opioid use disorder have not been widely used in the USA. This paper provides an overview of the literature on the availability of alcohol and opioid used disorder medications in the specialty substance use disorder treatment system, other treatment settings and systems, and among providers with a federal waiver to prescribe buprenorphine. We also present the most current data on the availability of alcohol and opioid use disorder medications in the USA. These estimates show steady growth in availability of opioid use disorder medications over the past decade and a decline in availability of alcohol use disorder medications. However, overall use of medications in the USA remains low. In 2017, only 16.3% of specialty treatment programs offered any single medication for alcohol use disorder treatment and 35.5% offered any single medication for opioid use disorder treatment. Availability of buprenorphine-waivered providers has increased significantly since 2002. However, geographic disparities in access to buprenorphine remain. Some of the most promising strategies to increase availability of alcohol and opioid use disorder medications include the following: incorporating substance use disorder training in healthcare education programs, educating the substance use disorder workforce about the benefits of medication treatment, reducing stigma surrounding the use of medications, implementing medications in primary care settings, implementing integrated care models, revising regulations on methadone and buprenorphine, improving health insurance coverage of medications, and developing novel medications for the treatment of substance use disorder.

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“…This workforce knowledge is particularly salient to the social work profession because the role of social workers in integrated primary care and the interventions they deploy requires careful and considerable attention to adequately articulate the scope of practice and contributions of the profession (Fraser et al, 2018). Lombardi et al (2019) articulated the roles of social work in addressing the opioid epidemic and discussed the potential to increase services in OBOT settings.…”

Section: Psychosocial Interventions As Components Of Office-based Opimentioning

confidence: 99%

“…Further, the workforce involved in this aspect of MAT is not well understood and can include a variety of professional providers across health disciplines. Although Lombardi et al (2019) helped to articulate the role of social work in the opioid epidemic, it is critical to determine how behavioral health components of MAT are used to support patients in their primary care OUD treatment. To address gaps in the literature on the psychosocial interventions as integral components of OBOT programs, this systematic review examined the specific psychosocial interventions used in primary care MAT programs to better understand the psychosocial interventions used for treating OUD.…”

Section: Study Purposementioning

confidence: 99%

“…This systematic review aims to identify and describe psychosocial interventions as part of larger MAT programs in primary care settings. Social work may be one workforce with the necessary skills and training to fulfill roles on OBOT teams to address behavioral health and psychosocial needs (Lombardi, Zerden, Guan, & Prentice, 2019). However, without clear treatment guidelines on the psychosocial interventions as part of OBOT, the profession cannot ensure that social work students and practitioners are trained in necessary models of care.…”

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confidence: 99%

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Psychosocial Interventions in Office-Based Opioid Treatment: A Systematic Review

Zerden

Guan

Lombardi

et al. 2020

Journal of the Society for Social Work and Research

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Medication-assisted treatment (MAT) in office-based opioid treatment (OBOT) is expanding treatment of opioid use to primary care settings. OBOT combines MAT and behavioral health interventions; however, the literature varies on best practices. This review focuses on psychosocial interventions as an OBOT component. Method: Protocol and eligibility criteria were published on PROSPERO; intervention characteristics, setting, provider, location, and duration were considered. Results: Search results and initial screening yielded 539 articles for abstract review; 67 articles were retained for full-text review. Of these, 30 articles (reporting on 25 studies) met inclusion criteria. The majority of studies were conducted in academic medical centers (72%), primarily in the Northeast U.S. Study samples consisted of a majority of men and White participants. Psychosocial interventions included individual counseling (88%), mutual help programs (36%), group counseling (28%), case management (24%), and referral to outpatient treatment (24%). Therapeutic approaches used motivational interviewing, cognitive behavioral therapy, and 12-step facilitation. Interventions were administered by interprofessional providers-most frequently medical providers, social workers, and a variety of behavioral health providers. Conclusions: Despite progress in expanding OBOT, a critical need remains to identify and support psychosocial interventions as essential, concurrent components of MAT. Implications for practice, workforce, team-based care, and future research needs are addressed.

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The role of social work in the opioid epidemic: office-based opioid treatment programs

Cited by 22 publications

References 14 publications

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county

Availability of Medications for the Treatment of Alcohol and Opioid Use Disorder in the USA

Psychosocial Interventions in Office-Based Opioid Treatment: A Systematic Review

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