Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term SM) communities study

Redonna Chandler; Edward V. Nunes; Sylvia Tan; Patricia R. Freeman; Alexander Y. Walley; Michelle Lofwall; Emmanuel Oga; La Shawn Glasgow; Jennifer L. Brown; Laura Fanucchi; Donna Beers; Timothy Hunt; Rachel Bowers-Sword; Carter Roeber; Trevor Baker; T. John Winhusen

doi:10.1016/j.drugalcdep.2023.109804

Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term ^SM) communities study

Redonna Chandler, Edward V. Nunes, Sylvia Tan, Patricia R. Freeman, Alexander Y. Walley, Michelle Lofwall, Emmanuel Oga, La Shawn Glasgow, Jennifer L. Brown, Laura Fanucchi, Donna Beers, Timothy Hunt, Rachel Bowers-Sword, Carter Roeber, Trevor Baker, T. John Winhusen

Research output: Contribution to journal › Article › peer-review

Abstract

The Helping End Addictions Long Term (HEALing) Communities Study (HCS) seeks to significantly reduce overdose deaths in 67 highly impacted communities in Kentucky (KY), Massachusetts (MA), New York (NY), and Ohio (OH) by implementing evidence-based practices (EBPs) to reduce overdose deaths. The Opioid-overdose Reduction Continuum of Care Approach (ORCCA) organizes EBP strategies under three menus: Overdose Education and Naloxone Distribution (OEND), Medication Treatment for Opioid Use Disorder (MOUD), and Safer Prescribing and Dispensing Practices (SPDP). The ORCCA sets requirements for strategy selection but allows flexibility to address community needs. This paper describes and compiles strategy selection and examines two hypotheses: 1) OEND selections will differ significantly between communities with higher versus lower opioid-involved overdose deaths; 2) MOUD selections will differ significantly between urban versus rural settings. Methods: Wave 1 communities (n = 33) provided data on EBP strategy selections. Selections were recorded as a combination of EBP menu, sector (behavioral health, criminal justice, and healthcare), and venue (e.g., jail, drug court, etc.); target medication(s) were recorded for MOUD strategies. Strategy counts and proportions were calculated overall and by site (KY, MA, NY, OH), setting (rural/urban), and opioid-involved overdose deaths (high/low). Results: Strategy selection exceeded ORCCA requirements across all 33 communities, with OEND strategies accounting for more (40.8%) than MOUD (35.1%), or SPDP (24.1%) strategies. Site-adjusted differences were not significant for either hypothesis related to OEND or MOUD strategy selection. Conclusions: HCS communities selected strategies from the ORCCA menu well beyond minimum requirements using a flexible approach to address unique needs.

Original language	English
Article number	109804
Journal	Drug and Alcohol Dependence
Volume	245
DOIs	https://doi.org/10.1016/j.drugalcdep.2023.109804
State	Published - Apr 1 2023

Bibliographical note

Funding Information:
This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term SM ) Initiative under award numbers UM1DA049394 , UM1DA049406 , UM1DA049412 , UM1DA049415 , UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, or the NIH HEAL Initiative SM .

Publisher Copyright:
© 2023 Elsevier B.V.

Keywords

HEALing Communities Study
Medication for opioid use disorder (MOUD)
Naloxone
Opioid prescribing
Opioid-overdose Reduction Continuum of Care Approach (ORCCA)

ASJC Scopus subject areas

Toxicology
Pharmacology
Psychiatry and Mental health
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.drugalcdep.2023.109804

Cite this

Chandler, R., Nunes, E. V., Tan, S., Freeman, P. R., Walley, A. Y., Lofwall, M., Oga, E., Glasgow, L. S., Brown, J. L., Fanucchi, L., Beers, D., Hunt, T., Bowers-Sword, R., Roeber, C., Baker, T., & Winhusen, T. J. (2023). Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term ^SM) communities study. Drug and Alcohol Dependence, 245, Article 109804. https://doi.org/10.1016/j.drugalcdep.2023.109804

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title = "Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term SM) communities study",

abstract = "The Helping End Addictions Long Term (HEALing) Communities Study (HCS) seeks to significantly reduce overdose deaths in 67 highly impacted communities in Kentucky (KY), Massachusetts (MA), New York (NY), and Ohio (OH) by implementing evidence-based practices (EBPs) to reduce overdose deaths. The Opioid-overdose Reduction Continuum of Care Approach (ORCCA) organizes EBP strategies under three menus: Overdose Education and Naloxone Distribution (OEND), Medication Treatment for Opioid Use Disorder (MOUD), and Safer Prescribing and Dispensing Practices (SPDP). The ORCCA sets requirements for strategy selection but allows flexibility to address community needs. This paper describes and compiles strategy selection and examines two hypotheses: 1) OEND selections will differ significantly between communities with higher versus lower opioid-involved overdose deaths; 2) MOUD selections will differ significantly between urban versus rural settings. Methods: Wave 1 communities (n = 33) provided data on EBP strategy selections. Selections were recorded as a combination of EBP menu, sector (behavioral health, criminal justice, and healthcare), and venue (e.g., jail, drug court, etc.); target medication(s) were recorded for MOUD strategies. Strategy counts and proportions were calculated overall and by site (KY, MA, NY, OH), setting (rural/urban), and opioid-involved overdose deaths (high/low). Results: Strategy selection exceeded ORCCA requirements across all 33 communities, with OEND strategies accounting for more (40.8%) than MOUD (35.1%), or SPDP (24.1%) strategies. Site-adjusted differences were not significant for either hypothesis related to OEND or MOUD strategy selection. Conclusions: HCS communities selected strategies from the ORCCA menu well beyond minimum requirements using a flexible approach to address unique needs.",

keywords = "HEALing Communities Study, Medication for opioid use disorder (MOUD), Naloxone, Opioid prescribing, Opioid-overdose Reduction Continuum of Care Approach (ORCCA)",

author = "Redonna Chandler and Nunes, {Edward V.} and Sylvia Tan and Freeman, {Patricia R.} and Walley, {Alexander Y.} and Michelle Lofwall and Emmanuel Oga and Glasgow, {La Shawn} and Brown, {Jennifer L.} and Laura Fanucchi and Donna Beers and Timothy Hunt and Rachel Bowers-Sword and Carter Roeber and Trevor Baker and Winhusen, {T. John}",

note = "Funding Information: This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term SM ) Initiative under award numbers UM1DA049394 , UM1DA049406 , UM1DA049412 , UM1DA049415 , UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, or the NIH HEAL Initiative SM . Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

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Chandler, R, Nunes, EV, Tan, S, Freeman, PR, Walley, AY, Lofwall, M, Oga, E, Glasgow, LS, Brown, JL, Fanucchi, L, Beers, D, Hunt, T, Bowers-Sword, R, Roeber, C, Baker, T & Winhusen, TJ 2023, 'Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term ^SM) communities study', Drug and Alcohol Dependence, vol. 245, 109804. https://doi.org/10.1016/j.drugalcdep.2023.109804

TY - JOUR

T1 - Community selected strategies to reduce opioid-related overdose deaths in the HEALing (Helping to End Addiction Long-term SM) communities study

AU - Chandler, Redonna

AU - Nunes, Edward V.

AU - Tan, Sylvia

AU - Freeman, Patricia R.

AU - Walley, Alexander Y.

AU - Lofwall, Michelle

AU - Oga, Emmanuel

AU - Glasgow, La Shawn

AU - Brown, Jennifer L.

AU - Fanucchi, Laura

AU - Beers, Donna

AU - Hunt, Timothy

AU - Bowers-Sword, Rachel

AU - Roeber, Carter

AU - Baker, Trevor

AU - Winhusen, T. John

N1 - Funding Information: This research was supported by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term SM ) Initiative under award numbers UM1DA049394 , UM1DA049406 , UM1DA049412 , UM1DA049415 , UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, or the NIH HEAL Initiative SM . Publisher Copyright: © 2023 Elsevier B.V.

PY - 2023/4/1

Y1 - 2023/4/1

N2 - The Helping End Addictions Long Term (HEALing) Communities Study (HCS) seeks to significantly reduce overdose deaths in 67 highly impacted communities in Kentucky (KY), Massachusetts (MA), New York (NY), and Ohio (OH) by implementing evidence-based practices (EBPs) to reduce overdose deaths. The Opioid-overdose Reduction Continuum of Care Approach (ORCCA) organizes EBP strategies under three menus: Overdose Education and Naloxone Distribution (OEND), Medication Treatment for Opioid Use Disorder (MOUD), and Safer Prescribing and Dispensing Practices (SPDP). The ORCCA sets requirements for strategy selection but allows flexibility to address community needs. This paper describes and compiles strategy selection and examines two hypotheses: 1) OEND selections will differ significantly between communities with higher versus lower opioid-involved overdose deaths; 2) MOUD selections will differ significantly between urban versus rural settings. Methods: Wave 1 communities (n = 33) provided data on EBP strategy selections. Selections were recorded as a combination of EBP menu, sector (behavioral health, criminal justice, and healthcare), and venue (e.g., jail, drug court, etc.); target medication(s) were recorded for MOUD strategies. Strategy counts and proportions were calculated overall and by site (KY, MA, NY, OH), setting (rural/urban), and opioid-involved overdose deaths (high/low). Results: Strategy selection exceeded ORCCA requirements across all 33 communities, with OEND strategies accounting for more (40.8%) than MOUD (35.1%), or SPDP (24.1%) strategies. Site-adjusted differences were not significant for either hypothesis related to OEND or MOUD strategy selection. Conclusions: HCS communities selected strategies from the ORCCA menu well beyond minimum requirements using a flexible approach to address unique needs.

AB - The Helping End Addictions Long Term (HEALing) Communities Study (HCS) seeks to significantly reduce overdose deaths in 67 highly impacted communities in Kentucky (KY), Massachusetts (MA), New York (NY), and Ohio (OH) by implementing evidence-based practices (EBPs) to reduce overdose deaths. The Opioid-overdose Reduction Continuum of Care Approach (ORCCA) organizes EBP strategies under three menus: Overdose Education and Naloxone Distribution (OEND), Medication Treatment for Opioid Use Disorder (MOUD), and Safer Prescribing and Dispensing Practices (SPDP). The ORCCA sets requirements for strategy selection but allows flexibility to address community needs. This paper describes and compiles strategy selection and examines two hypotheses: 1) OEND selections will differ significantly between communities with higher versus lower opioid-involved overdose deaths; 2) MOUD selections will differ significantly between urban versus rural settings. Methods: Wave 1 communities (n = 33) provided data on EBP strategy selections. Selections were recorded as a combination of EBP menu, sector (behavioral health, criminal justice, and healthcare), and venue (e.g., jail, drug court, etc.); target medication(s) were recorded for MOUD strategies. Strategy counts and proportions were calculated overall and by site (KY, MA, NY, OH), setting (rural/urban), and opioid-involved overdose deaths (high/low). Results: Strategy selection exceeded ORCCA requirements across all 33 communities, with OEND strategies accounting for more (40.8%) than MOUD (35.1%), or SPDP (24.1%) strategies. Site-adjusted differences were not significant for either hypothesis related to OEND or MOUD strategy selection. Conclusions: HCS communities selected strategies from the ORCCA menu well beyond minimum requirements using a flexible approach to address unique needs.

KW - HEALing Communities Study

KW - Medication for opioid use disorder (MOUD)

KW - Naloxone

KW - Opioid prescribing

KW - Opioid-overdose Reduction Continuum of Care Approach (ORCCA)

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