Implementation Science & Health Services

Helping to End Addiction Long-term® Initiative

Implementation Science & Health Services

Closing the gap between evidence-based practices and real-world care

People who inject opioids have high rates of serious infections that may require hospitalization (including systemic bacterial infections and heart infections), as well as chronic infections such as HIV and hepatitis C virus. If opioid use disorder is not addressed, these infections can relapse or recur, leading to preventable emergency department visits, hospitalizations, and deaths due to infection or opioid use. The CHOICE study evaluates 2 interventions: (1) an integrated infectious diseases and medications for opioid use disorder (MOUD) clinic, and (2) a patient navigation intervention. Analyses across a patient’s continuum of care – both during initial hospitalization and after discharge - will determine how well each intervention is accepted and adopted, and its cost-effectiveness. Learn more with the resources below:

Email: Henry Masur, M.D., [email protected]

The HEALing Communities Study (HCS) was the largest addiction prevention and treatment implementation study ever conducted. Launched in 2019, the study was conducted across 67 communities in Kentucky, Massachusetts, New York, and Ohio – four states disproportionately affected by the opioid crisis. Findings from the study will help establish best practices for integrating prevention, treatment, and recovery strategies that can be adapted and implemented by communities nationwide. Learn more with the resources below:

Email: [email protected]

The Integrative Management of chronic Pain and OUD for Whole Recovery (IMPOWR) program develops and tests combined interventions—such as psychotherapy, medications for OUD, exercise, and pain self-management—embedded within primary care and opioid treatment programs and delivered with a holistic, whole-patient focus. The IMPOWR research network partners with individuals who have lived/living experience, as well as public and private stakeholders, to examine implementation factors such as financing and organizational barriers. Across approximately 2,000 participants, the program collects harmonized measures spanning pain, substance use disorder, co-occurring conditions, and health service utilization, forming what will be the largest integrated dataset on pain and addiction to date. Learn more with the resources below:

Email: Shelley Su, Ph.D., [email protected]

The Multilevel Interventions to Reduce Opioid-Related Health Impacts and Improve Quality of Life for Patients on Long-Term Opioid Therapy (MIRHIQL) program develops interventions to reduce reliance on long-term opioid therapy (LTOT) when its adverse effects outweigh its benefits. The program also creates resources for research and clinical practice, including a risk-benefit decision tool that helps providers determine when opioids should be continued, tapered, or tapered and discontinued. In addition, MIRHIQL works to clinically define when the risks of opioid use outweigh its benefits by identifying relevant risk and benefit symptoms and behaviors, developing a corresponding screening assessment, and validating this definition in an independent, prospective sample. Learn more with the resources below:

Email: Shelley Su, Ph.D., [email protected]

Services like naloxone distribution, and HIV/HCV testing help people to reduce the risk of certain health and safety issues associated with drug use, including overdose and transmission of infectious diseases. The Research on Interventions for Stability & Engagement (RISE) Network is a national network of research projects that builds on existing research into strategies to prevent overdose and other negative outcomes of drug use. Studies within the network are examining the effectiveness, implementation, and impact of these strategies. Research supported by this program is conducted in real-world settings and in collaboration with a wide range of partners, who help to ensure that the strategies being studied are sustainable and scalable. Learn more with the resources below:

Email: [email protected]

There are multiple effective evidence-based treatments and prevention programs for individuals with or at-risk for addiction. Most Americans at risk for or who have this condition, however, do not receive treatment and/or had no exposure to evidence-based prevention.  More research is needed to better understand how promising, evidence-based strategies can reach more people affected by addiction (either alone or together with pain), in the context of the overdose crisis (e.g., opioids, stimulants, polysubstance). This trans-NIH collaborative program supports bi-directional translational research that moves from implementation to epidemiological surveillance and real-world data and back again. This includes implementation research to test the integration of scalable and replicable evidence-based interventions in various community settings, as well as research on surveillance, risk prediction, and population-level overdose and treatment patterns. The program also examines fundamental barriers and facilitators to reducing overdose deaths at the individual, provider, organizational, community, or system levels. Research funded through this program should generate actionable evidence to: reduce the initiation or progression of pain or substance use, reduce overdoses, enhance treatment access, optimize the quality of care, provide recovery support, and create patient-centered systems of care such that people who are at risk for or experience addiction can recover and sustain their recovery over the long-term. Learn more with the resources below:

Email: Tisha Wiley, Ph.D., [email protected]; Sean Lynch, Ph.D., LCSW, [email protected]

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