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Abstract: This Blending Initiative Workshop focused on clinical management of prescription opioid use disorders and screening and brief intervention for substance use disorders in the emergency department. [view flyer | view agenda]

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Session 1: Clinical Management of Prescription Opioid Use Disorders (moderator: Andrew J. Saxon, MD)

• Introduction to the Workshop — Andrew J. Saxon, MD and Megan L. Ranney, MD, MPH
• ACEP Clinical Policy: Review and Implementation of the Clinical Guideines — Knox H. Todd, MD, MPH, FACEP
• Hard Conversations: Addressing Patients with Chronic Pain — Kavita M. Babu, MD, FACEP, FACMT
• Facilitation Through Technology: Prescription Drug Monitoring Programs — Edward W. Boyer, MD, PhD

Session 2: Panel Discussion of Working and Successful Models

• North Carolina Emergency Department Care Coordination Trial — Chris L. Ringwalt, DrPH
• A Randomized Controlled Trial of Citywide Emergency Department Care Coordination — Darin E. Nevin, MD, MS
• Guidance for Opioid Prescribing: Lessons Learned from the NYC Experience — Lewis S. Nelson, MD, FACEP
• Rural Strategy to Reduce Drug Diversion — John J. Graykowski, MPAS, PA-C
• Morning Panel Discussion

Luncheon Roundtable Discussion: Implementation and Application of ACEP Clinical Policy Critical Issues in the Prescribing of Opioids for Adult Patients in the Emergency Department. Moderated by Lewis S. Nelson, MD, FACEP and Knox H. Todd, MD, MPH, FACEP Session 4: Screening and Brief Intervention for Substance Use Disorders (moderator: Megan L. Ranney, MD, MPH)

• Overview of Screening and Brief Intervention in the Emergency Department — Gail D’Onofrio, MD, MS, FACEP
• Addressing Patients with Comorbid Conditions — Douglas F. Zatzick, MD
• Using Technology to Facilitate SBIRT: Web and Computer-Based Screening and Brief Intervention — Rebecca M. Cunningham, MD

Session 5: Panel Discussion of Working and Successful Models

• Training Trauma Center Clinicians to Perform Screening and Brief Intervention: Results from a National Training Effort — Christopher W. Dunn, PhD
• Statewide Dissemination of Emergency Room Screening and Brief Intervention: Lessons Learned Blending Research and Practice — Edward Bernstein, MD, FACEP
• Implementation of a Screening and Brief Intervention Program in a Large Safety-Net Trauma Center — Kerryann B. Broderick, MD, BSN, FACEP
• Screening and Brief Intervention Strategies for Emergency Nurses — Patricia K. Howard, PhD, RN, CEN, CPEN, NC-BC, FAEN
• Afternoon Panel Discussion

Abstract:

The National Drug Abuse Treatment Clinical Trials Network (CTN) is a practice-based research network that partners academic researchers with community based substance use disorder (SUD) treatment programs designed primarily to conduct effectiveness trials of promising interventions. A secondary goal of the CTN is to widely disseminate results of these trials and thus improve the quality of SUD treatment in the U.S. Drawing on data from 156 CTN programs, this study examined the associated between involvement in CTN protocols and overall treatment quality measured by a comprehensive index of 35 treatment services. Negative binomial regression models show that treatment programs participating in a greater number of CTN protocols had significantly higher levels of treatment quality, an association that held after controlling for key organizational characteristics. Given that protocol participation was positively associated with quality of treatment, the question remains about how to successfully translate this knowledge and skill base to community-based treatment programs that are not directly involved in clinical research. The CTN has undertaken a number of dissemination initiatives to do just that, including the NIDA/SAMHSA Blending Initiative and the CTN Dissemination Library, though there have been few studies examining the direct impact of these dissemination activities on the quality of treatment services within and outside the CTN.

Conclusions: At their core, practice-based research networks, such as the CTN, offer community based clinicians the opportunity to bring innovation to and to address problems encountered in everyday treatment practice. They also provide an opportunity to identify barriers to implementation and to tailor implementation strategies to meet the real world needs of community-based treatment programs. However there are significant strides to be made in disseminating knowledge, skills, and training to programs that do not actively participate in clinical research in the wider treatment community. These findings contribute to the growing body of research on the role of practice-based research networks in promoting health care quality.