The Opioid-overdose Reduction Continuum of Care Approach (ORCCA): Evidence-based practices in the HEALing Communities Study

Winhusen, Theresa; Walley, Alexander Y.; Fanucchi, Laura; Hunt, Tim; Lyons, Michael D.; Lofwall, Michelle R.; Brown, Jennifer L.; Freeman, Patricia R.; Nunes, Edward V.; Beers, Donna; Saitz, Richard; Stambaugh, Leyla; Oga, Emmanuel; Herron, Nicole; Baker, Trevor; Cook, Christopher D.K.; Roberts, Monica; Alford, Daniel P.; Starrels, Joanna L.; Chandler, Redonna K.

doi:10.1016/j.drugalcdep.2020.108325

Cited by 79 publications

(49 citation statements)

References 235 publications

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“… 38 Regarding OUD, retention on medication for OUD, particularly methadone and buprenorphine, is associated with decreased mortality both from overdose and all-cause mortality, with the risk of overdose increasing significantly after discontinuation of medication. 47 …”

Section: Discussionmentioning

confidence: 99%

Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Clarke

Ibrahim

Doty

et al. 2021

SAR

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Introduction The need for innovative approaches to address the opioid epidemic in the United States is widely recognized. Many challenges exist to addressing this epidemic, including the obstacles outpatient substance use treatment practices face in implementing measurement-based care (MBC), quality measurement systems, and evidence-based treatments. Also, there are insufficient opportunities for clinicians in these settings to participate in research, resulting in diminished translation of research findings into community-based practice. To address these challenges, the Addiction Medicine Practice-Based Research Network (AMNet) was developed to facilitate the uptake of MBC in outpatient practices via implementation of patient-reported assessments and quality of care performance measures to improve patient outcomes. This network will offer clinicians in outpatient settings (not incuding opioid treatment programs [OTPs]) the opportunity to participate in future substance use disorder treatment research studies. Methods A key step in the development of AMNet was the selection of substance use-specific assessment tools and quality of care performance measures for incorporation into the American Psychiatric Association’s mental health patient registry, PsychPRO. A scoping review and multi-step consensus-based process were used to identify, review and select candidate assessment tools and quality of care performance measures for opioid use disorders (OUD) and substance use disorders (SUD). Results Following a consensus-based methodology, 12 standardized assessment tools and 3 quality of care performance measures for OUD and SUD were selected to help facilitate the implementation of MBC and quality improvement for AMNet participants. These tools were further categorized as core and optional. Conclusion By offering a collection of carefully vetted assessment tools and quality measures through PsychPRO, AMNet will help participating clinicians with the systematic uptake of MBC and delivery of evidence-based treatment for patients with SUD. Also, AMNet will act as a centralized repository of data collected from patients and clinicians in non-OTP outpatient addiction medicine practices and serve as a platform for opioid treatment research.

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Section: Discussionmentioning

confidence: 99%

Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Clarke

Ibrahim

Doty

et al. 2021

SAR

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“…OEND was created as a harm reduction tool by PWUD and advocacy agencies to empower PWUD and their communities. ( Dettmer et al, 2001 ; Maxwell et al, 2006 ; Winhusen et al, 2017 ). Syringe Service Programs (SSP) are ideal places for OEND because they provide culturally relevant services designed to reach persons at high risk for experiencing or observing an opioid overdose (Lambdin et al, 2020).…”

Section: Background and Rationalementioning

confidence: 99%

Community Case Study of Naloxone Distribution by Hospital-Based Harm Reduction Program for People Who Use Drugs in New York City

et al. 2021

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Background: In 2017, The Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program at Mount Sinai Hospital became a registered Opioid Overdose Prevention Program (OOPP) and received funding from the New York City Department of Health and Mental Hygiene to develop a program to provide overdose education and naloxone distribution (OEND) training to at risk population and bystanders. We report on the programmatic quality improvement initiatives conducted.Methods: From April 2017 to December 2020, the REACH OOPP conducted 290 opioid overdose reversal trainings, throughout the Mount Sinai Health System and in multiple other community settings. OEND training was at times offered alone and in other settings alongside Hepatitis C Virus point of care testing. Additionally, a “train the trainer” model was implemented whereby medical students and nurses at outpatient clinics were trained to train others.Results: There were 4235 naloxone kits distributed to 3,906 participants. The training venues included hospital settings (patients and medical staff), public events, substance use programs, educational facilities, homeless prevention programs, faith-based organizations, alternative to incarceration programs, and community-based organizations. We implemented two types of training. During outreach sessions, we utilized one-on-one personalized sessions to train bystanders. When training clinic staff in the “train the trainer” model we utilized a standardized didactic presentation with slides. The two top reasons participants reported for being trained were “Just in case I see someone overdose” (59.3%) and “I'm worried that someone I know will overdose OR that I will overdose” (20.2%).Conclusion: The REACH program at Mount Sinai Hospital developed an effective model to train community bystanders and health care staff by leveraging administrative support and building on broader programmatic initiatives to promote drug user health and stigma-free care for people who use drugs. Hospitals do not currently mandate staff training or keeping naloxone stocked at inpatient units or outpatients clinics posing a challenge when implementing an OEND program in this setting. A recommended policy change needed to decrease overdose deaths is for hospitals to be required to implement systematic naloxone education and access for all health care personal and at risk patients.

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“…The goal of the HCS is to examine the effectiveness and implementation success of the Communities that Heal Intervention (CTH), a three-component intervention based on expanding evidence-based practices (EBPs) shown to reduce opioid overdose deaths [12]. The three CTH components include: 1) community engagement with coalitions to develop and deploy comprehensive, data-driven plans for EBP selection and implementation across multiple community sectors [13]; 2) the Opioid Reduction Continuum of Care Approach (ORCCA), which consists of a menu of EBPs to be implemented in the areas of overdose education and naloxone distribution (OEND), medication for opioid use disorder (MOUD) treatment and safer opioid prescribing [14]; and 3) community-informed communication campaigns to address stigma and raise awareness about services [15].…”

Section: Introductionmentioning

confidence: 99%

Coalition Building: What Happens When External Facilitators Put the CBPR Principles in Practice? Ethnographic Examples From the Massachusetts HEALing Communities Study

Drainoni

Walt

Martínez

et al. 2022

Preprint

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Background The HEALing Communities Study (HCS) is a large-scale multisite study testing Community Engagement using coalition facilitation as an approach to addressing the worsening overdose crisis. Within Community Engagement, Community-Based Participatory Research (CBPR) principles guide researchers on best practices for working in partnership with communities, yet these principles have not been well researched in large complex multi-site studies. Methods This paper used ethnographic methods to explore how coalitions operationalized the CBPR principles during early coalition formation. Two coders independently analyzed 101 ethnographies from HCS coalition meetings in eight Massachusetts communities held between November 2019 and December 2020. Themes were developed through consensus between the coders followed by group discussions among the authorship team. Results We found mutual trust, shared goals, addressing power dynamics, meeting structure and attending to the sociopolitical community context could all serve as barriers or facilitators to operationalizing the CBPR principles. Conclusions These findings provide unique suggestions for future community-engaged multisite studies, and demonstrate the importance of research teams to mitigate inherent power imbalances by acknowledging and creating space for community ownership. The findings also highlight the value of a community engaged facilitator role to promote the CBPR principles. Strategies such as transparency, uniting over shared interests and bringing in a wide range of stakeholders were notable facilitators for operationalizing the principles.

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The Opioid-overdose Reduction Continuum of Care Approach (ORCCA): Evidence-based practices in the HEALing Communities Study

Cited by 79 publications

References 235 publications

Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Addiction Medicine Practice-Based Research Network (AMNet): Assessment Tools and Quality Measures

Community Case Study of Naloxone Distribution by Hospital-Based Harm Reduction Program for People Who Use Drugs in New York City

Coalition Building: What Happens When External Facilitators Put the CBPR Principles in Practice? Ethnographic Examples From the Massachusetts HEALing Communities Study

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