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

Autor: Winhusen T; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA. Electronic address: winhusen@carc.uc.edu., Walley A; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA., Fanucchi LC; Division of Infectious Diseases, Department of Medicine, University of Kentucky College of Medicine, Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, USA., Hunt T; Columbia University, School of Social Work, Center for Healing of Opioid and Other Substance Use Disorders (CHOSEN), 1255 Amsterdam, Avenue, Rm 806, New York, NY 10027, USA., Lyons M; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA; Department of Emergency Medicine, University of Cincinnati College of Medicine 231 Albert Sabin Way, Cincinnati, OH 45267, USA., Lofwall M; Departments of Behavioral Science and Psychiatry, University of Kentucky College of Medicine, Center on Drug and Alcohol Research, 845 Angliana Avenue, Lexington, KY 40508, USA., Brown JL; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA., Freeman PR; Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 S Limestone St, Lexington, KY 40536, USA., Nunes E; Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, Division on Substance Use, 1051 Riverside Drive, New York, NY 10032, USA., Beers D; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA., Saitz R; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA; Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue 4th Floor, Boston, MA, 02118, USA., Stambaugh L; Center for Applied Public Health Research, Research Triangle Institute (RTI) International, 6110 Executive Boulevard, Suite 902, Rockville. MD 20852, USA., Oga EA; Center for Applied Public Health Research, Research Triangle Institute (RTI) International, 6110 Executive Boulevard, Suite 902, Rockville. MD 20852, USA., Herron N; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA; Center for Addiction Research, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH 45267, USA., Baker T; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA., Cook CD; Opioid/Substance Use Priority Research Area, University of Kentucky, 845 Angliana Ave Lexington, KY 40508, USA., Roberts MF; Opioid/Substance Use Priority Research Area, University of Kentucky, 845 Angliana Ave Lexington, KY 40508, USA., Alford DP; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA., Starrels JL; Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E. 210th Street, Bronx, NY 10467, USA., Chandler RK; National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Rockville, MD 20892, USA.
Jazyk: angličtina
Zdroj: Drug and alcohol dependence [Drug Alcohol Depend] 2020 Dec 01; Vol. 217, pp. 108325. Date of Electronic Publication: 2020 Oct 04.
DOI: 10.1016/j.drugalcdep.2020.108325
Abstrakt: 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.
(Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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