The overarching goal of the study — part of the National Institute of Health‘s (NIH) Helping to End Addiction Long-term (HEAL) Initiative, announced in April 2018 — is to reduce overdose deaths by 40% within 3 years in select communities in Kentucky, Massachusetts, New York, and Ohio.
“The HEALing Communities Study is an exciting, unprecedented effort to support communities in using and expanding our scientific understanding of effective interventions,” said HHS Secretary Alex Azar in a statement.
Instead of having a siloed approach with multiple separate interventions — such as housing assistance, medication-assisted treatment, and drug courts — the study designees will create integrated programs that provide continuous, wraparound support for people with substance use disorders, said Azar at a press briefing.
“Think about these communities pulling all of those strings together and building that around the individual,” he said, adding that the programs will become a long-term safety net.
“That whole surround is there for you to enable lifelong treatment and recovery programs,” said Azar.
NIH Director Francis Collins, MD, said that although research has helped find medication and other treatments that work for opioid use disorder, much is still unclear — including the optimal duration of treatment and how to design effective recovery programs. And many previous studies have “tended to be relatively circumscribed in a fairly well-studied environment,” and thus haven’t necessarily translated well into the real world, said Collins at the briefing.
“This program aims to change all that,” he said. “This is real-world research. This is not ivory tower at all.”
A “Dream Team”
The hope is that the four states will quickly share what they learn with other areas of the country.
Each state’s effort will be coordinated by an academic medical center. Grants were awarded to: the University of Kentucky, Lexington, with Sharon L. Walsh, PhD, as the principal investigator (PI); Boston Medical Center, Boston, with Jeffrey Samet, MD, as PI; Columbia University, New York City, with Nabila El-Bassel, MD, as PI; and Ohio State University, Columbus, with Rebecca Jackson, MD, as PI.
“This is the team and it’s a dream team for all of us,” said Collins.
Each site will join with at least 15 communities to measure the impact of integrating evidence-based prevention, treatment, and recovery interventions across primary care, behavioral health, justice, and other settings, according to the NIH. North Carolina-based RTI International will be the study coordinating center. It will conduct data analysis and health economics research and disseminate the research findings.
The study will track the incidence of opioid use disorder and the number of individuals receiving medication-based treatment for opioid use disorder — aiming to decrease the former and increase the latter. Goals also include increasing the number of individuals who are in treatment beyond 6 months, providing recovery support services, and expanding the distribution of the overdose antidote naloxone.
“We believe that this effort will show that truly dramatic and material reductions in overdose deaths are possible and provide lessons and models for other communities to adopt and emulate,” said Azar. “We don’t have to be intimidated by the scale of this challenge. We can start saving lives now.”