An Approach to Enhancing Medication Treatment for Opioid Use Disorder in the HEALing Communities Study

Abstract

The HEALing (Helping to End Addiction Long-term) Communities Study (HCS) aims to test the effectiveness of the Communities That HEAL intervention in decreasing opioid overdose deaths in 67 communities across four U.S. states. This intervention enlists a collaborative team of researchers, academic experts, and community coalitions to select and implement interventions from a menu of evidence-based practices, including medications for opioid use disorder (MOUD). The HCS's New York team developed an integrated network systems (INS) approach with a mapping tool to coach coalitions in the selection of strategies to enhance medication treatment. With the INS approach, community coalitions develop a map of service delivery venues in their local county to better engage people with medication treatment wherever this need arises. The map is structured around core services that can provide maintenance MOUD and satellite services, which include all settings where people with opioid use disorder are encountered and can be identified, possibly given medication, and referred to core programs for ongoing MOUD care. This article describes the rationale for the INS mapping tool, with a discussion framed by the consolidated framework for implementation research, and provides a case example of its application.

Keywords: Implementation science; Medication-assisted treatment; Medications for opioid use disorder; Opioid use disorder; Overdoses; Public health.

Figure 1 -

Core services/facilities can provide long term medication treatment for opioid use disorder (MOUD), while the connected satellite services/facilities can identify individuals with opioid use disorder and refer to core MOUD providers, or identify, initiate MOUD, and refer to core providers for ongoing MOUD. Arrows represent the movement of individuals between these agencies. DOH: Department of Health; OTP: Opioid Treatment Program.

Figure 2 -

Services in dark grey had implementation plan agreements in place while services in light grey did not. Abbreviations: DOH: Department of Health; OTP: Opioid Treatment Program.