Collaborating to Address Substance Use Disorder in Correctional Settings

2019 ◽  
pp. 123-134
Author(s):  
Rosemarie A. Martin ◽  
Nicole Alexander-Scott ◽  
Joseph Wendelken ◽  
Jennifer G. Clarke
Keyword(s):  
Substance Use ◽  
Rhode Island ◽  
Substance Use Disorder ◽  
Program Implementation ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
The Social ◽  
Correctional Settings ◽  
State Programs

For years, advocates in Rhode Island, including many individuals on staff at the Rhode Island Department of Corrections, envisioned a criminal justice system that did not perpetuate the crises of substance use disorder and overdose and instead helped address them thought treatment and recovery supports. In 2016, the state’s corrections department introduced the first statewide correctional system medication-assisted treatment program in the country to initiate a comprehensive program to screen for opioid use disorder. The program is demonstrating successful results. Continued public health and corrections collaboration lay the groundwork for additional innovations in program implementation, including the Rhode Island Department of Health’s focus on health equity and the social determinants of health. This chapter shares the Rhode Island experience as a potential model for other state programs.

Medication-Assisted Treatment of Adolescents With Opioid Use Disorders

2018 ◽  
pp. 105-108
Author(s):  
Keyword(s):  
Substance Use ◽  
Young Adults ◽  
Developmentally Appropriate ◽  
Opioid Use Disorder ◽  
Age Group ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
Appropriate Treatment ◽  
Opioid Use Disorders ◽  
New Treatments

Opioid use disorder is a leading cause of morbidity and mortality among US youth. Effective treatments, both medications and substance use disorder counseling, are available but underused, and access to developmentally appropriate treatment is severely restricted for adolescents and young adults. Resources to disseminate available therapies and to develop new treatments specifically for this age group are needed to save and improve lives of youth with opioid addiction.

scholarly journals A facilitation model for implementing quality improvement practices to enhance outpatient substance use disorder treatment outcomes: a stepped-wedge randomized controlled trial study protocol

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Megan A. O’Grady ◽  
Patricia Lincourt ◽  
Belinda Greenfield ◽  
Marc W. Manseau ◽  
Shazia Hussain ◽  
...  
Keyword(s):  
Substance Use ◽  
Quality Improvement ◽  
Substance Use Disorder ◽  
Controlled Trial ◽  
Opioid Use Disorder ◽  
Treatment Quality ◽  
Opioid Use ◽  
Substance Use Disorder Treatment ◽  
Randomized Controlled ◽  
Disorder Treatment

Abstract Background The misuse of and addiction to opioids is a national crisis that affects public health as well as social and economic welfare. There is an urgent need for strategies to improve opioid use disorder treatment quality (e.g., 6-month retention). Substance use disorder treatment programs are challenged by limited resources and a workforce that does not have the requisite experience or education in quality improvement methods. The purpose of this study is to test a multicomponent clinic-level intervention designed to aid substance use disorder treatment clinics in implementing quality improvement processes to improve high-priority indicators of treatment quality for opioid use disorder. Methods A stepped-wedge randomized controlled trial with 30 outpatient treatment clinics serving approximately 2000 clients with opioid use disorder each year will test whether a clinic-level measurement-driven, quality improvement intervention, called Coaching for Addiction Recovery Enhancement (CARE), improves (a) treatment process quality measures (use of medications for opioid use disorder, in-treatment symptom and therapeutic progress, treatment retention) and (b) recovery outcomes (substance use, health, and healthcare utilization). The CARE intervention will have the following components: (1) staff clinical training and tools, (2) quality improvement and change management training, (3) external facilitation to support implementation and sustainability of quality improvement processes, and (4) an electronic client-reported treatment progress tool to support data-driven decision making and clinic-level quality measurement. The study will utilize multiple sources of data to test study aims, including state administrative data, client-reported survey and treatment progress data, and staff interview and survey data. Discussion This study will provide the field with a strong test of a multicomponent intervention to improve providers’ capacity to make systematic changes tied to quality metrics. The study will also result in training and materials that can be shared widely to increase quality improvement implementation and enhance clinical practice in the substance use disorder treatment system. Trial registration Trial #NCT04632238NCT04632238 registered at clinicaltrials.gov on 17 November 2020

scholarly journals Targeting the Barriers in the Substance Use Disorder Continuum of Care With Peer Recovery Support

2021 ◽  
Vol 15 ◽  
pp. 117822182097698
Author(s):  
Milena Stanojlović ◽  
Larry Davidson
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Recovery Process ◽  
Continuum Of Care ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Care Continuum ◽  
Cascade Of Care ◽  
Recovery Support ◽  
The Continuum

Substance Use Disorder (SUD) has been recognized as a chronic, relapsing disorder. However, much of existing SUD care remains based in an acute care model that focuses on clinical stabilization and discharge, failing to address the longer-term needs of people in recovery from addiction. The high rates of client’s disengagement and attrition across the continuum of care highlight the need to identify and overcome the obstacles that people face at each stage of the treatment and recovery process. Peer recovery support services (PRSS) show promise in helping people initiate, pursue, and sustain long-term recovery from substance-related problems. Based on a comprehensive review of the literature, the goal of this article is to explore the possible roles of peers along the SUD care continuum and their potential to improve engagement in care by targeting specific barriers that prevent people from successfully transitioning from one stage to the next leading eventually to full recovery. A multidimensional framework of SUD care continuum was developed based on the adapted model of opioid use disorder cascade of care and recovery stages, within which the barriers known to be associated with each stage of the continuum were matched with the existing evidence of effectiveness of specific PRSSs. With this conceptual paper, we are hoping to show how PRSSs can become a complementary and integrated part of the system of care, which is an essential step toward improving the continuity of care and health outcomes.

scholarly journals Cross-Training Needs Among Community-Based Clinicians in HIV and Substance Use

2021 ◽  
Author(s):  
Kasey Claborn ◽  
Kelli Scott ◽  
Sara J Becker
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Scale Up ◽  
Opioid Use Disorder ◽  
Training Needs ◽  
Opioid Use ◽  
Double Burden ◽  
Individual Interviews ◽  
Cross Training ◽  
Training Need

Abstract Background: People with double burden of HIV and substance use have poorer treatment engagement and worse treatment outcomes. Cross-training of HIV and substance use disorder clinicians can potentially enhance the scale up and quality of integrated care. Research is needed on clinicians’ areas of greatest training need in order to inform training development. Methods: Data from semi-structured individual interviews with 16 HIV and 13 substance use disorder clinicians (N=29) examining clinician perspectives on their training needs were analyzed using thematic analysis. Results: Overall, three themes emerged in regards to the clinicians’ need for training: 1) past training experiences: both HIV and substance use clinicians reported they had received minimal formal cross-training; 2) gaps in training: sensitivity and anti-stigma training, the latest medications for opioid use disorder and HIV prevention/treatment and referral resources emerged as key areas of cross-training need; and 3) training and supervision format/structure: clinicians cited didactic workshops and ongoing supervision as appealing strategies. Conclusions: Results show that lack of formal and updated training for clinicians is an important gap in providing integrated HIV and substance use treatment. Didactic workshops and ongoing support strategies that address stigma, medications for HIV and substance use disorder, and referral resources are likely to be particularly valuable.

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