PROJECT OVERVIEW

The opioid crisis has multiple causes, and it must be addressed in multiple ways. No one fix will, by itself, reduce or eliminate the crisis.

For example, the nation will need to address how opioids are supplied, through legal channels by pharmaceutical companies, doctors, pharmacists, as well as through illegal channels, such as street markets and the illegal distribution of otherwise legal drugs.

In addition, the nation will need to address how and why opioids are demanded and used by individual users. Some individuals have legitimate medical needs for opioid medications, which can later, however, lead to opioid abuse and addiction. Other individuals begin with the non-medical initiation of opioid use, which can also be followed by abuse and addiction.

Multiple steps will need to be taken, if the nation is to significantly reduce the number of persons who become addicted to opioids, who overdose on opioids, and who die from opioid overdoses.

DSG has given a high priority to addressing this crisis in a variety of ways, through contracts that address different aspects of the crisis.

For example, DSG has had contracts for the following:

• supporting the certification of physicians, physician assistants, and nurse practitioners who are authorized to provide buprenorphine for the treatment of persons with opioid disorders
• Documenting prescription drug practices and issues, nationwide, including prescriptions for opioid medications and their adverse consequences;
• assessing interventions that are effective in addressing behavioral health issues in general, and opioid abuse and addiction in particular;
• supporting the advanced education of behavioral health professionals focusing on minority behavioral health, with special attention to substance abuse in general and opioid abuse and addiction in particular.

Supporting the certification of buprenorphine providers for the treatment of opioid disorders. DSG also administers the SAMHSA contract for the certification and tracking of physicians, physician assistants, and nurse practitioners who are authorized to provide buprenorphine for the treatment of persons with opioid abuse and addiction problems. Under this contract, and in response to expanded legislation that authorizes programs and appropriates funding for the treatment and prevention of opioid abuse and addiction, DSG has helped to rapidly and substantially increase the number of such practitioners (now more than 40,000, nationwide) who are authorized to provide buprenorphine for the treatment of opioid disorders. DSG analyzes and reports on data about these practitioners, prepares and distributes an informative newsletter to all of the practitioners, and contributes updated information to the SAMHSA webpage about this program.

Documenting prescription drug practices and issues, including opioids. Under a SAMHSA contract that addressed prescription drug practices and consequences, especially in workplaces, DSG had a subcontract under which it produced a weekly newsletter that summarized and linked to articles in newspapers, magazines, and professional journals about prescription drugs and their consequences. Many of these articles addressed the opioid crisis. Making such information widely available is a first and important step for adequately addressing the current opioid crisis. Researchers, practitioners, policy makers, and the public at large need to know what is going on before they can adequately respond to it. This project made a significant early contribution to the sharing of information about prescription drug practices and the opioid crisis that those practices were associated with.

Assessing interventions that address behavioral health issues, including opioid disorders. DSG has been a national leader, and indeed an international leader, in assessing behavioral health interventions that have been proven by rigorous research to achieve the outcomes they have been designed to achieve. DSG pioneered the development of the Model Programs Guide (MPG) for the Department of Justice (DOJ). The MPG is a web-based repository of evidence-based programs that address the needs of at-risk juveniles and juveniles who come in contact with the juvenile justice system. DSG has also been a major contributor to DOJ’s CrimeSolutions.gov, a web-based repository of evidence-based interventions for juvenile and adult criminal justice interventions. In addition, for several years DSG had the contract for the National Registry of Evidence-based Programs and Practices (NREPP), funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). Under this contract, and at the direction of SAMHSA, DSG made major improvements to the NREPP process and website, including major expansions to the NREPP Learning Center. These improvements included the development of a wider range of user-friendly information, in print and video formats, about behavioral health interventions, including treatment and prevention interventions for substance abuse, such as for opioid abuse and addiction.

Supporting the advanced education of behavioral health professionals focusing on minority behavioral health. DSG also contributed to the advanced education of behavioral health professionals about minority health and minority health disparities, through its initiation and management over more than a decade of the Minority Fellowship Program Coordinating Center (MFPCC). The MFPCC provided technical assistance to the national behavioral health membership organizations – for psychiatry, psychology, social work, nursing, counseling, and addiction practitioners – that had SAMHSA grants to provide fellowships in minority behavioral health. Under this contract, DSG provided webinars, newsletters, a website, and national conferences, all of which addressed issues and interventions in substance abuse, including for opioid abuse and addiction.