Expand Early Intervention in Communities for Substance Use Disorder

Return to Opioid Top-Level Strategy Map

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Early interventions can help people how have started to misuse opioid make choices that help them avoid developing a dependence that can lead to a full Opioid Use Discorder or other form of SUD. 

 

 

Background

The 2014 National Survey on Drug Use and Health demonstrated that opioid misuse is more widespread than realized:

• Approximately 1.9 million Americans met criteria for prescription painkillers use disorder based on their use of prescription painkillers in the past year.
• 1.4 million people used prescription painkillers non-medically for the first time in the past year.
• The average age for first-time prescription painkiller misuse was 21.2 years old.

(as cited by the Substance Abuse and Mental Health Services Administration).

Intervention

• Intervention can be an effective means for getting someone to accept treatment.
• Interventions are most successful when conducted with the help of addiction experts and when users are coming down from a high.
• During an intervention, close friends and family members tell their loved one how their drug use has affected them personally, and the person is presented with the opportunity to seek treatment.

 

Case Studies

Project Engage - Delaware

Project Engage is an early intervention and referral to substance use disorder treatment program designed to help hospital patients who may be struggling with alcohol or drug use. Project Engage collaborates with hospital staff to identify and connect patients with community-based substance use disorder treatment programs and other resources. Project Engage has also formed a partnership with the construction industry to offer recovery support to employees from participating construction companies.

  As part of the initiative, its founder, Dr. Terry Horton, worked to make questions about opioid use standard protocol for patients admitted to the ER. The goal is to identify patients going through withdrawal very quickly in order to treat it rapidly and break the vicious cycle they're in by immediately administering drugs like Suboxone. Health care workers also pair patients with addiction counselors and get them enrolled in community-based drug treatment program before they've even left the hospital. And so far, Christiana Care has been able to steer two-thirds of patients with opioid addiction into drug treatment.

  Project Engage integrates peers in recovery, who are called Engagement Specialists, into the clinical setting in the hospital to meet with patients at their bedside about their alcohol and/or drug use. The Engagement Specialists learn about the patient’s goals and coordinate treatment options that support the patient’s needs. The Engagement Specialists use motivational interviewing to empower each patient in the decision-making process, assisting them to take that critical first step to seek help for their substance use. Project Engage Social Workers are experts in community resources, in obtaining access to facilities in the area and in assisting the team to overcome barriers so patients can receive care and transition into treatment.

  Simply put, Project Engage goes beyond just screening people. It treats opioid addiction as a disease, with medicine and in-house specialists, which is not common in screening programs, nor the American health system in general. The programs founders agree: the best way to curb opioid addiction is to connect patients directly with treatment, instead of leaving it up to patients to follow up on referrals, which is typically how it's done.

  In addition to working with the patient and the hospital clinical team, Project Engage also works with treatment providers and insurers to develop a discharge plan to achieve the best possible outcome for each patient. After leaving the hospital and engaging in treatment, patients may have the opportunity to continue to work with an Engagement Specialist to help them stay engaged in their treatment.

  Learn more about Project Engage here: Project Engage
 

Tools + Resources

TR_-_Increase_Early_Interventions_for_People_Misusing_Drugs

Scorecard Building

Potential Objective Details(Under Construction) 
Potential Measures and Data Sources(Under Construction) 

Actions to Take

Actions for Coalitions
 

Resources to Investigate

More RTI on Increase Early Interventions for People Misusing Drugs

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Sources

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1. https://www.reuters.com/article/us-addiction-methadone-cost/substituting-methadone-for-opioids-could-save-billions-idUSKBN1DK2LE
2. https://www.reuters.com/article/us-addiction-methadone-cost/substituting-methadone-for-opioids-could-save-billions-idUSKBN1DK2LE
3.  
4. Hser YI, Evans E, Grella C, Ling W, Anglin, D. Long Term Course of Opioid Addiction. Harvard Review of Psychiatry. 2015 Mar-Apr;23(2):76-89.
   1. doi: 10.1097/HRP.0000000000000052.
      • https://www.ncbi.nlm.nih.gov/pubmed/25747921
5. Hser YI, Evans E, Grella C, Ling W, Anglin, D. Long Term Course of Opioid Addiction. Harvard Review of Psychiatry. 2015 Mar-Apr;23(2):76-89.
   1. doi: 10.1097/HRP.0000000000000052.
      • https://www.ncbi.nlm.nih.gov/pubmed/25747921