An Online Training Support System to Increase Community Clinic Use of an Evidence-Based Treatment for Opioid and Other Drug Addictions in Emerging Adults

Sheidow Consulting, Inc., Eugene OR

Investigators

Abstract

PROJECT SUMMARY/ABSTRACT The societal costs of drug addiction are astounding (over $400 billion annually), exceeding costs for any other health problem. The opioid epidemic, especially, is devastating: over 100 American overdose deaths daily at a cost of $78.5 billion per year. Each year, 8 million emerging adults (EAs; ages 18-25) use illicit drugs (1 in 4 EAs), and over 5 million are in need of treatment for substance use disorders (SUD). EAs represent the age group with the highest rates of initiation of substance use, increases in substance use, and progression of substance use into SUD, contributing to many serious problems for EAs including suicide, car accidents, and other lethal events. SUD during this transitional age also leads to increased unemployment and job instability. EAs with SUD represent a tremendously underserved population, with high likelihood of ?slipping through the cracks? as they transition from child to adult treatment services. Thus, this group presents significant short- and long-term costs for individuals, families, and society. Unfortunately, community-based clinics are unlikely to provide anything approximating an evidence-based practice (EBP). Given this, there is a clear public health need for improving and expanding the delivery of EBP?s for EAs with SUD. Despite this clear need, there is a large divide between science and practice. The proposed project has the potential to overcome a gaping need within the outpatient treatment sector, the largest purveyor of SUD treatment in the country. Specifically, the proposed SBIR Phase I project will build upon an existing Training Support System (TSS) through creation of an entirely online, ongoing training and quality assurance tool to make it possible for community-based agencies to adopt, implement, and sustain use of Contingency Management (CM), an EBP for EA addiction. This support system would generate a cost-effective platform for outpatient counselors that would enable them to learn an EBP with ongoing monitoring, support, and coaching to ensure fidelity and rapid uptake of the EBP. The project?s first aim is to develop an online computer-assisted training program for counselors and modify the existing online TSS to provide individual- and agency-level performance assessment and feedback processes, coaching and remediation training, immediate training access when turnover occurs, and clinical expert guidance and technical assistance for counselors and agencies using the CM treatment approach. The project?s second aim is to pilot the TSS in urban, suburban, and rural community-based settings with both seasoned and novice clinicians. The feasibility of the TSS for ensuring uptake and use of CM will be examined from the perspective of both counselors and agency administrators. Phase I will conclude with proof of feasibility of the TSS for real world counselors treating EAs with CM, to make it practicable but effective within the resources of community-based agencies. If successful, this work could generate a cost-effective strategy to increase the use of EBPs for EAs who need them and rarely have access to them.