Elizabeth WellsDennis Daley School of Social WorkWestern Psychiatric Institute University of WashingtonUniversity of Pittsbu rgh Supported by Grants # U10 DA and U10 DA from the National Institute on Drug Abuse

 “…serious gaps of communication exist between the research community and community-based drug treatment programs.”* *IOM, 1998 – Executive Summary

CTN Mission  Study behavioral and pharmacological treatments that have high potential for success in community treatment settings  Get research findings into the hands of clinicians who can make the best use of them – as fast as possible

Regional Research and Training Center (RRTC) State with Community Treatment Program (CTP) CTN Across the Nation

University of WA (D. Donovan) WA State University (J. Roll) Providence Behavioral Health Evergreen Manor Recovery Centers of King County Seattle Counseling Services Evergreen Treatment Services Node Structure Triumph Treatment Services Residence XII Puget Sound VA Parent-Child Assistance Program Group Health Cooperative Daybreak Youth Services S.E. Alaska Regional Health Consortium WA Physicians Health Prog. C.H.A.M.M. P.

Regional Research and Training Center (RRTC)  Initiates and Develops Protocols  Arranges Community Treatment Program (CTP) Participation  Conducts Training  Conducts Studies  Disseminates Regionally RRTC

Community Treatment Program (CTP)  Equal representation on national CTN Steering Committee  Participates fully in CTN committees  Generates clinically relevant concepts  Provides setting and staffing for CTN studies  Collects data  Potential early adopters CTP

Assumptions Underlying CTN*  Research findings that would benefit patients are not being used.  Research will be aided by 2-way communication & long-term collaboration between CTPs & researchers.  CTPs will benefit from participating in research. * Also from IOM, 1998

Multi-Site Hybrid Efficacy – Effectiveness* Trials External ValidityInternal Validity  Community-based clinics  Heterogeneity of participants  Community clinicians,  Comparison to “treatment-as-usual”  Cost-effectiveness evaluation  Patient & clinician satisfaction  Interest in sustainability  Random assignment  Study protocol & operations manual  Manual-based treatment  Fidelity monitoring  Standard measures  Quality assurance * Carroll, K.M. & Rounsaville, B.J. (2003) Psychiatric Services, 54.

Increasing Role for Social Work in Addiction Treatment  Integration of substance use and mental health treatment (behavioral health)  With health care reform, larger numbers of behavioral health clients served  With health care reform, integration of behavioral health into health care settings, e.g., primary care

Social Workers’ Multiple Roles in Behavioral Health  Managers in behavioral health settings  Providers in health care settings  Care managers in integrated care  Policy development and oversight

What does the CTN Offer Social Workers? 1. EBPs - What psychosocial or pharmacological interventions for treating substance use disorders (SUD) are effective? 2. EBPs for adolescents 3. EBPs for HIV prevention in SUD treatment settings 4. Evidence-based for all populations (e.g., women, racial and ethnic minorities, sexual minorities)?

What does the CTN Offer Social Workers? 5. Sufficient benefit to warrant cost of training and implementing? 6. What is required to train community providers to deliver EBPs? 7. Characteristics of treatment sites that deliver EBPs successfully? 8. Sustainability of practices

1.EBPs for SUD

2.EBPs for Adolescents

3.HIV Prevention

4.Evidence-Based for Marginalized Populations?

5.Cost-Benefit

6.Training in EBPs

7.Treatment Sites

8.Sustainability of EBPs

Adoption of Buprenorphine over 4 year period in the CTN: Cross-sectional data Paul M. Roman & Amanda J. Abraham, University of Georgia

Adoption of Motivational Incentives over 4 year period in the CTN: Cross-sectional data Paul M. Roman & Amanda J. Abraham, University of Georgia

 Allows researchers to download de- identified data from completed CTN studies to conduct analyses that improve the quality of drug abuse treatment  Data available after primary outcome paper published  Data from 25 CTN studies currently available

The NIDA/SAMHSA Blending Initiative Three components:  Regional Blending Conferences  State Agency Partnerships  Blending Teams

Blending Teams  Use NIDA research findings to design user- friendly science-based tools for use in treatment settings soon after research results are published.  Teams include members from: SAMHSA-CSAT Addiction Technology Transfer Center (ATTC) Network, NIDA researchers, and Community treatment providers participating in the NIDA Drug Abuse Treatment Clinical Trials Network (CTN).

Blending Process Selected CTN protocols or other NIDA Research Selected CTN protocols or other NIDA Research Hand-Off Meeting Create the charge for Blending Team Hand-Off Meeting Create the charge for Blending Team Blending Team Develop dissemination strategies and products. Blending Team Develop dissemination strategies and products.

Current Blending Packages

Blending Packages Available in Spanish ce/blendinginitiative/index.asp

Products Under Development 1. POATS (Prescription Opioid Addiction Treatment Study) 2. Onsite HIV Rapid Testing 3. Buprenorphine for Young Adults (Spanish version)