The Pennsylvania State University

Communities Free from Addiction: Mobilizing Bold, Scalable Solutions

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Project Summary

Substance misuse and disorders grip our nation. Pennsylvania has been especially hard-hit, with the third-highest overdose death rate in the nation in 2017. In 2018, Penn State made a decisive investment by creating the Consortium to Combat Substance Abuse (CCSA) to fuel interdisciplinary research and prevention and treatment program development and evaluation. Now is the time to put proven solutions into practice in Pennsylvania and beyond. Working with state agency advisors, we propose coordinated scale-up of proven programs to (1) implement universal substance use prevention through Penn State Extension, (2) disseminate effective treatment and recovery services to primary-care doctors, and (3) provide continuity of care services to justice-involved individuals and their families as they reenter communities. We propose persistent, effective communication to policymakers, rigorous monitoring of impact, and the launch of similar, coordinated programs in states across the U.S. toward communities—and a future—free from addiction.

Problem Statement

The opioid crisis grips the U.S., and the overdose death rate continues to shock. More people now die from overdoses than from car accidents. By 2017, Pennsylvania’s overdose death rate reached third in the nation. The opioid crisis is rapidly changing shape as overdoses from cocaine and methamphetamines increase, and we now face another critical concern: youth vaping. It is time for decisive, coordinated action--with solutions specific to the current opioid crisis but adaptable to emerging trends; we need coordinated systems to implement evidence-based approaches to combat substance misuse across the continuum of care. Although only a subset of the population develops substance use disorders, nearly everyone has been impacted—through their own or a loved one’s misuse—and substance abuse touches almost every public system. Etiologies of substance misuse are complex and multifaceted, including pain, mental health issues, trauma, socioeconomic challenges, and social alienation. However, there is hope. Effective prevention programs reduce demand and steer youth toward healthier futures, effective treatments are available, and overdose-reversing medications have widespread use. Yet, evidence-based prevention and treatment approaches are woefully underutilized, and saving lives requires explicitly linking vulnerable individuals, such as those formerly incarcerated and in the process of community reentry, to effective substance misuse treatment and recovery programs. Thus effective solutions require persistent, fundamental, coordinated systems change fostered by bold investments in community-based solutions that leverage our land-grant institutions throughout the nation.

Solution Overview

We propose a comprehensive, systemic solution to substance misuse. It will be implemented across Pennsylvania, one of the hardest hit by surging overdose deaths, and then disseminated nationally. We propose three phases: (1) Scale-up of evidence-based prevention, treatment, and recovery programs to address substance misuse and mitigate future epidemics; (2) Sustainability through partnerships with state government; and (3) Expansion to other states and, ultimately, the entire U.S. Phase 1 (Years 1-3) involves community coalition building to address substance misuse locally, empowering communities to deliver proven-effective prevention, treatment, recovery, and prisoner reentry programs. Prevention in Phase 1 scales up our PROSPER infrastructure through the statewide Extension System to deliver evidence-based prevention to thousands of youth. Treatment in Phase 1 disseminates knowledge about evidence-based treatment for substance use disorder to community doctors via telehealth using the ECHO model. Community corrections and recovery center partnerships that link reentering prison inmates and their families with Certified Recovery Specialists will promote healthy adaptation and reduced recidivism. In Phase 2 (Year 4), as scale-up continues, we will evaluate these programs’ health and economic impacts and deliver strategic communications to our state and local government partners to address capacity and sustainability. This process will inform our Phase 3 dissemination efforts in other states. In Year 5, we will scale up two high-readiness states (Colorado, Washington) and four additional states as proof of concept. Our process evaluation will then be a blueprint for all states, documenting steps to implement a comprehensive, sustainable solution with evidence of impact.

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Project Funders

  • National Institutes of Health 2001 - 2018
  • Pennsylvania Commission on Crime and Delinquency 2018 - 2020
  • Substance Abuse and Mental Health Services Administration 2018 - 2021

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