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 - 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 -