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Ohio's Response to 21St Century Cures Act in Addressing the Opioid Crisis: a Targeted Response Initiative, November 2017 – April 2019, Follow-Up Assessment

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Ohio's Response to 21St Century Cures Act in Addressing the Opioid Crisis: a Targeted Response Initiative, November 2017 – April 2019, Follow-Up Assessment OSAM Ohio Substance Abuse Monitoring Network Ohio’s Response to 21st Century Cures Act in Addressing the Opioid Crisis: A Targeted Response Initiative, November 2017 – April 2019 Follow-up Assessment May 2020 Mike DeWine, Governor Lori Criss, Director Prepared by: Ohio Department of Mental Health and Addiction Services Office of Quality, Planning and Research Ohio Substance Abuse Monitoring (OSAM) Network OSAM Research Administrators: R. Thomas Sherba, PhD, MPH, LPCC — OSAM Principal Investigator Sarah Balser, MPH, MSW, LSW, CHES — OSAM Coordinator Jessica Linley, PhD, MSW, LSW — OSAM Quantitative Data Analyst OSAM Regional Epidemiologists: Gretchen Clark-Hammond, PhD, MSW, LSW, LCDCIII, TTS Louis Guardiola, Jr., MSW, LSW, LICDC-CS Jennifer Olejownik, PhD Alycia Taylor, MPA Jennifer Tulli, MSW, LISW-S, LCDC III Acknowledgments: We would like to acknowledge the OSAM Regional Epidemiologists listed above for their efforts to this study in data collection and data organization. We would also like to acknowledge Donna Baker, BA, Kathleen Gallant, BA, Mandy McGlone, MS, LCDC III, OCPS II, TTS and Alina Sharafutdinova, BS for their assistance in data collection. Recommended citation for this report: Ohio Department of Mental Health and Addiction Services [OhioMHAS]. (2020). Ohio Substance Abuse Monitoring (OSAM) Network. Ohio's Response to 21st Century Cures Act in Addressing the Opioid Crisis: A Targeted Response Initiative, November 2017 – April 2019, Follow-up Assessment. Columbus, OH. Ohio Substance Abuse Monitoring Network TARGETED RESPONSE INITIATIVE TABLE OF CONTENTS I. Abstract .....................................................................................................................................................1 II. Introduction .............................................................................................................................................1 a. TRI Purpose ......................................................................................................................................2 III. Methods ....................................................................................................................................................2 a. Participants ......................................................................................................................................3 b. Data Collection ...............................................................................................................................3 c. Instrumentation .............................................................................................................................3 IV. Data Analysis ...........................................................................................................................................4 V. Results ........................................................................................................................................................5 a. Participants .....................................................................................................................................5 b. Current Community Messages Related to the Opioid Epidemic .................................6 c. Preferred Community Messaging Related to Opioids .....................................................7 d. Perceived Stigma of Addiction Scale (PSAS) ....................................................................10 e. Community Approaches to Combat the Opioid Crisis .................................................10 i. Client knowledge of community approaches ..........................................................10 ii. Family member and community professional knowledge of community approaches ............................................................................................................................12 f. Assessment of Naloxone Knowledge and Experience ...................................................13 i. Client naloxone knowledge and experience .............................................................13 ii. Family member naloxone knowledge and experience .........................................14 iii. Community professional naloxone knowledge and experience .......................15 g. How Communities Are Responding to Approaches ......................................................15 i. Additional treatment needs ...........................................................................................17 ii. Treatment services for at-risk populations................................................ .................19 h. Client Treatment Experience ..................................................................................................20 i. Treatment Service Extent .........................................................................................................21 i. Coordination of services ...................................................................................................22 ii. Community professional assessments.........................................................................23 1. Drug and Drug Problems Perceptions Questionnaire (DDPPQ)................23 2. Professional Quality of Life (ProQOL)...................................................................24 VI. Discussion.................................................................................................................................................24 VII. Conclusion ...............................................................................................................................................26 VIII. References ...............................................................................................................................................27 Ohio’s Response to 21st Century Cures Act in Addressing the Opioid Crisis • i TARGETED RESPONSE INITIATIVE Ohio Substance Abuse Monitoring Network IX. Appendices ...............................................................................................................................................29 a. Ohio’s STR Grant Funding Tiers ...............................................................................................30 b. Client Demographics...................................................................................................................31 c. Substances Used by Clients in the Past Six Months by Tier and Cycle......................32 d. Family Member Demographics...............................................................................................33 e. Community Professional Demographics..............................................................................34 f. Where Naloxone Was Obtained...............................................................................................35 ii • Ohio’s Response to 21st Century Cures Act in Addressing the Opioid Crisis Ohio Substance Abuse Monitoring Network TARGETED RESPONSE INITIATIVE Ohio’s Response to 21st Century Cures Act in Addressing the Opioid Crisis: A Targeted Response Initiative, November 2017 – April 2019 Follow-up Assessment ABSTRACT This targeted response initiative final report serves as a follow-up assessment to Ohio’s State Targeted Response (STR) to the Opioid Crisis grant-funded projects through the 21st Century Cures Act. The Ohio Substance Abuse Monitoring (OSAM) Network assessed the implementation and impact of STR project-related activities on four Ohio communities. Data were collected through a mixed research methodology from November 2017 through April 2019, utilizing quantitative and qualitative instrumentation. Regional epidemiologists conducted focus groups and administered surveys. A total of 940 respondents across communities participated in three 6-month cycles of focus groups: 554 clients receiving treatment for opioid use disorder (OUD), 156 family members of persons with OUD, and 230 community professionals whose work involved addressing OUD (e.g. treatment providers and law enforcement). Study objectives included assessments of the following: community messaging related to opioids, level of perceived stigma for OUD, knowledge of available services and processes for accessing them, perception of community treatment service needs and level of compassion fatigue among community professionals. Key findings included: increased naloxone knowledge and experience, increased proportion of persons with OUD receiving medication assisted treatment, and a 2.5 time increase in the number of reported positive observations of community change. INTRODUCTION The Substance Abuse and Mental Health Services recovery supports, workforce development and Administration (SAMHSA) notified Ohio Mental Health addressing secondary trauma among first responders and Addiction Services (OhioMHAS) on April 24, 2017 that (emergency medical technicians [EMTs], law enforcement it had been awarded $26 million dollars a year for FY2017 officers, etc.). and FY2018 through the 21st Century Cures Act. The U.S. Congress passed into law the Cures Act to accelerate As part of the evaluation of Ohio’s STR projects, the Ohio the discovery, development and delivery of new cures Substance Abuse Monitoring (OSAM) Network designed a and treatment for the 21st century1. OhioMHAS’ award targeted response initiative (TRI) to determine the impact was a State Targeted Response (STR) to the Opioid Crisis of STR project activities on individuals, families and local Grant. STR grants were funding to help states address the communities in targeted
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