Opioid Use Disorder/Substance Use Disorder Care Continuum Initiative
About
This three-year grant started in October of 2018. Our multidisciplinary team developed and implemented a ‘hub and spoke’ strategy to expand recovery services to individuals with opioid use disorder (OUD) in Northeast Indiana. The hub provided the most acute behavioral health services, including inpatient and outpatient programs located in Allen County, as well as a Medication Assisted Treatment (MAT) outpatient treatment clinic that was established in the first year of the grant period. The spoke clinics providing MAT services in Year 2 and 3 included locations in Adams, Wells, Whitley, Wabash, LaGrange, Noble, Kosciusko, and Huntington counties.
Outcomes to date:
Changes seen in our Government Performance and Results Act/ National Outcome Measures (GPRA/NOMs) outcomes at 3 and 6 months (Table 2 and 3) revealed that our participants were successful in recovery. Abstinence measures improved to 70% and 73.4% at 3- and 6-month follow-up, respectively. Employment and education also increased substantially to 72.8% and 69% at the 3- and 6-month follow-up respectively.
Our peer recovery coach program remains a strong source of internal referrals. In Year 2 (2020) peer recovery coaches connected with 593 patients with OUD in Parkview Emergency Departments. Of those, 201 (34%) were referred to our Hub MAT clinic. Of the 201 referred patients, 34 (17%) entered the MAT program within 30 days of being seen in the emergency department.
Due to the complexity of determining the drug of influence, we report fatal and non-fatal overdoses from all substances. Non-fatal overdoses are determined by EMS runs and fatal doses are determined by post-mortem toxicology reports. Post our program’s implementation, there was a 23% drop in non-fatal overdose in 2019 when compared to 2018 but a 12% increase in deaths in 2019 when compared with the preceding year. In 2020, we rebounded with a 21% increase in non-fatal overdose, but saw a 35% drop in fatal overdose when compared to 2019.
Our goal of this program was to provide support for individuals with opioid use disorder in rural areas by extending our network of care, enhancing our main hub MAT clinic, and helping to reduce stigma associated with drug abuse treatment in all of the participating Northeast Indiana counties.
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Funding
- Substance Abuse and Mental Health Services (SAMHSA) Grant# 1H79TI081404-01
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