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

Theresa Winhusen; Alexander Walley; Laura C. Fanucchi; Tim Hunt; Mike Lyons; Michelle Lofwall; Jennifer L. Brown; Patricia R. Freeman; Edward Nunes; Donna Beers; Richard Saitz; Leyla Stambaugh; Emmanuel A. Oga; Nicole Herron; Trevor Baker; Christopher D. Cook; Monica F. Roberts; Daniel P. Alford; Joanna L. Starrels; Redonna K. Chandler

doi:10.1016/j.drugalcdep.2020.108325

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

Theresa Winhusen, Alexander Walley, Laura C. Fanucchi, Tim Hunt, Mike Lyons, Michelle Lofwall, Jennifer L. Brown, Patricia R. Freeman, Edward Nunes, Donna Beers, Richard Saitz, Leyla Stambaugh, Emmanuel A. Oga, Nicole Herron, Trevor Baker, Christopher D. Cook, Monica F. Roberts, Daniel P. Alford, Joanna L. Starrels, Redonna K. Chandler

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

23 Scopus citations

Abstract

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.

Original language	English
Article number	108325
Journal	Drug and Alcohol Dependence
Volume	217
DOIs	https://doi.org/10.1016/j.drugalcdep.2020.108325
State	Published - Dec 1 2020

Bibliographical note

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.

Keywords

Continuum of care
Evidence-based practice
HEALing communities study
Helping to end addiction long-term
Medication
Naloxone
Opioid use disorder
Overdose
Prescription opioid safety
Retention

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.2020.108325

Cite this

Winhusen, T., Walley, A., Fanucchi, L. C., Hunt, T., Lyons, M., Lofwall, M., Brown, J. L., Freeman, P. R., Nunes, E., Beers, D., Saitz, R., Stambaugh, L., Oga, E. A., Herron, N., Baker, T., Cook, C. D., Roberts, M. F., Alford, D. P., Starrels, J. L., & Chandler, R. K. (2020). The Opioid-overdose Reduction Continuum of Care Approach (ORCCA): Evidence-based practices in the HEALing Communities Study. Drug and Alcohol Dependence, 217, [108325]. https://doi.org/10.1016/j.drugalcdep.2020.108325

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

abstract = "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.",

keywords = "Continuum of care, Evidence-based practice, HEALing communities study, Helping to end addiction long-term, Medication, Naloxone, Opioid use disorder, Overdose, Prescription opioid safety, Retention",

author = "Theresa Winhusen and Alexander Walley and Fanucchi, {Laura C.} and Tim Hunt and Mike Lyons and Michelle Lofwall and Brown, {Jennifer L.} and Freeman, {Patricia R.} and Edward Nunes and Donna Beers and Richard Saitz and Leyla Stambaugh and Oga, {Emmanuel A.} and Nicole Herron and Trevor Baker and Cook, {Christopher D.} and Roberts, {Monica F.} and Alford, {Daniel P.} and Starrels, {Joanna L.} and Chandler, {Redonna K.}",

note = "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: {\textcopyright} 2020 Elsevier B.V.",

year = "2020",

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doi = "10.1016/j.drugalcdep.2020.108325",

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Winhusen, T, Walley, A, Fanucchi, LC, Hunt, T, Lyons, M, Lofwall, M, Brown, JL, Freeman, PR, Nunes, E, Beers, D, Saitz, R, Stambaugh, L, Oga, EA, Herron, N, Baker, T, Cook, CD, Roberts, MF, Alford, DP, Starrels, JL & Chandler, RK 2020, 'The Opioid-overdose Reduction Continuum of Care Approach (ORCCA): Evidence-based practices in the HEALing Communities Study', Drug and Alcohol Dependence, vol. 217, 108325. https://doi.org/10.1016/j.drugalcdep.2020.108325

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.

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KW - Helping to end addiction long-term

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KW - Naloxone

KW - Opioid use disorder

KW - Overdose

KW - Prescription opioid safety

KW - Retention

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DO - 10.1016/j.drugalcdep.2020.108325

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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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