Helping connect people with treatment opportunities focus of IU research
A central barrier to overcoming addiction in Indiana is that people with risky substance use are too rarely referred to treatment. Although nearly a third of people visiting emergency rooms report using alcohol or non-prescription drugs, very few appear to be evaluated for risky substance use or receive counseling on addressing these problems, and there is often no structured system or process for connecting patients to treatment options.
Robin Newhouse's project for the Responding to the Addictions Crisis Grand Challenge charts a course for closing these gaps by evaluating Indiana’s current capacity for treating substance use disorders, mapping workforce needs and strategies to fulfill them and creating a web-based resource to match people with appropriate and accessible treatment options.
Our project goals initially emerged directly from needs of clinicians practicing in hospital settings, and heard clearly from primary care clinicians that are experiencing similar challenges.
A collaboration between the IU School of Nursing, the Bowen Center for Health Workforce and Policy at the IU School of Medicine and the IU School of Informatics and Computing, the first phase of the project focused on understanding what happens when people who are using drugs and alcohol visit Indiana hospitals for other types of health problems. Data from 14 hospitals and interviews with medical professionals showed missed opportunities for evaluation, counseling and referring people with risky substance use to help them address these issues.
Additionally, hospital staff did not know where to refer patients for outpatient treatment (appointments or visits to health care providers that do not involve stays in a hospital or treatment facility) and hospitals were not collecting information on high-risk drug and alcohol use in a thorough, consistent or useful way.
A second phase mapped the current treatment resources in 14 different areas of the state, including interviews to develop a comprehensive and up-to-date database of outpatient local facilities and providers treating addiction.
Newhouse and her team considered not only services for directly managing addiction (such as medications like methadone or buprenorphine) but also "wraparound" supports such as mental health care, financial and job counseling, and transportation to and from clinics. This process highlighted a number of gaps and opportunities in the addiction treatment workforce that the team is currently assessing to create a set of recommendations for education, training, and state priorities.
Newhouse’s team is testing an interactive web-based tool that will enable health care providers in Indiana to determine the best local outpatient addiction treatment options for each individuals’ needs and circumstances. This user-friendly interface can be utilized by doctors, nurses, or counselors to guide the referral process and includes features ensuring that it stays up to date.
The tool is intended to be used in conjunction with a structured Screening, Brief Intervention, and Referral to Treatment process for assessing and addressing risky drug and alcohol use, which Newhouse’s team has implemented through a related study.
The immediate results of the project will enable Indiana health care professionals to connect patients to existing addiction treatment providers and will inform health care leaders as well as state and local policymakers about gaps and opportunities, providing potential workforce solutions to address treatment capacity for people with risky substance use.
On a broader scale, the project approach can serve as a model for any state or community interested in assessing treatment capacity, not only for addressing substance use disorders but also other health and social needs from mental health support to cancer treatment.