TY - JOUR
T1 - The Opioid-overdose Reduction Continuum of Care Approach (ORCCA)
T2 - Evidence-based practices in the HEALing Communities Study
AU - Winhusen, Theresa
AU - Walley, Alexander
AU - Fanucchi, Laura C.
AU - Hunt, Tim
AU - Lyons, Mike
AU - Lofwall, Michelle
AU - Brown, Jennifer L.
AU - Freeman, Patricia R.
AU - Nunes, Edward
AU - Beers, Donna
AU - Saitz, Richard
AU - Stambaugh, Leyla
AU - Oga, Emmanuel A.
AU - Herron, Nicole
AU - Baker, Trevor
AU - Cook, Christopher D.
AU - Roberts, Monica F.
AU - Alford, Daniel P.
AU - Starrels, Joanna L.
AU - Chandler, Redonna K.
N1 - Funding Information:
This research was supported by the National Institutes of Healththrough the NIH HEAL Initiative with the following awards: UM1DA049394,UM1DA049406,UM1DA049412,UM1DA049415, andUM1DA049417. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or its NIH HEAL Initiative.RS reports Alkermes provided injectable naltrexone to Boston University for an NIH-funded study of which he is principal investigator. JS reports receiving research support from the Opioid Post-marketing Requirement Consortiumand having served as a core expert on the 2016 CDC Guideline committee. The other authors declare no conflicts of interest.
Funding Information:
This research was supported by the National Institutes of Health through the NIH HEAL Initiative with the following awards: UM1DA049394, UM1DA049406, UM1DA049412, UM1DA049415, and UM1DA049417. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or its NIH HEAL Initiative.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Background: The number of opioid-involved overdose deaths in the United States remains a national crisis. The HEALing Communities Study (HCS) will test whether Communities That HEAL (CTH), a community-engaged intervention, can decrease opioid-involved deaths in intervention communities (n = 33), relative to wait-list communities (n = 34), from four states. The CTH intervention seeks to facilitate widespread implementation of three evidence-based practices (EBPs) with the potential to reduce opioid-involved overdose fatalities: overdose education and naloxone distribution (OEND), effective delivery of medication for opioid use disorder (MOUD), and safer opioid analgesic prescribing. A key challenge was delineating an EBP implementation approach useful for all HCS communities. Methods: A workgroup composed of EBP experts from HCS research sites used literature reviews and expert consensus to: 1) compile strategies and associated resources for implementing EBPs primarily targeting individuals 18 and older; and 2) determine allowable community flexibility in EBP implementation. The workgroup developed the Opioid-overdose Reduction Continuum of Care Approach (ORCCA) to organize EBP strategies and resources to facilitate EBP implementation. Conclusions: The ORCCA includes required and recommended EBP strategies, priority populations, and community settings. Each EBP has a “menu” of strategies from which communities can select and implement with a minimum of five strategies required: one for OEND, three for MOUD, and one for prescription opioid safety. Identification and engagement of high-risk populations in OEND and MOUD is an ORCCArequirement. To ensure CTH has community-wide impact, implementation of at least one EBP strategy is required in healthcare, behavioral health, and criminal justice settings, with communities identifying particular organizations to engage in HCS-facilitated EBP implementation.
AB - Background: The number of opioid-involved overdose deaths in the United States remains a national crisis. The HEALing Communities Study (HCS) will test whether Communities That HEAL (CTH), a community-engaged intervention, can decrease opioid-involved deaths in intervention communities (n = 33), relative to wait-list communities (n = 34), from four states. The CTH intervention seeks to facilitate widespread implementation of three evidence-based practices (EBPs) with the potential to reduce opioid-involved overdose fatalities: overdose education and naloxone distribution (OEND), effective delivery of medication for opioid use disorder (MOUD), and safer opioid analgesic prescribing. A key challenge was delineating an EBP implementation approach useful for all HCS communities. Methods: A workgroup composed of EBP experts from HCS research sites used literature reviews and expert consensus to: 1) compile strategies and associated resources for implementing EBPs primarily targeting individuals 18 and older; and 2) determine allowable community flexibility in EBP implementation. The workgroup developed the Opioid-overdose Reduction Continuum of Care Approach (ORCCA) to organize EBP strategies and resources to facilitate EBP implementation. Conclusions: The ORCCA includes required and recommended EBP strategies, priority populations, and community settings. Each EBP has a “menu” of strategies from which communities can select and implement with a minimum of five strategies required: one for OEND, three for MOUD, and one for prescription opioid safety. Identification and engagement of high-risk populations in OEND and MOUD is an ORCCArequirement. To ensure CTH has community-wide impact, implementation of at least one EBP strategy is required in healthcare, behavioral health, and criminal justice settings, with communities identifying particular organizations to engage in HCS-facilitated EBP implementation.
KW - Continuum of care
KW - Evidence-based practice
KW - HEALing communities study
KW - Helping to end addiction long-term
KW - Medication
KW - Naloxone
KW - Opioid use disorder
KW - Overdose
KW - Prescription opioid safety
KW - Retention
UR - http://www.scopus.com/inward/record.url?scp=85092473499&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092473499&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2020.108325
DO - 10.1016/j.drugalcdep.2020.108325
M3 - Article
C2 - 33091842
AN - SCOPUS:85092473499
SN - 0376-8716
VL - 217
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 108325
ER -
