NIATx Buprenorphine Implementation Study underway in Ohio

In Ohio, opioid addiction has reached epidemic proportions. Prescription pain relievers and heroin accounted for nearly 40 percent of the state’s overdose deaths in 2009. According to the Ohio Department of Health, “on average, four Ohioans die each day as a result of drug overdose.”[1] The state’s Department of Alcohol and Drug Addiction Services has intensified efforts to improve access to and retention in effective treatment for opioid addiction, using medication-assisted (MAT) treatments such as methadone and buprenorphine.

The NIATx Buprenorphine Implementation Study is a randomized controlled trial to test ways to increase MAT with buprenorphine in Ohio. The five-year study, funded by the National Institute on Drug Abuse, began recruitment efforts in fall 2012. Fifteen Ohio Alcohol, Drug Addiction, and Mental Health Services Boards (the county-level entities responsible for planning, funding and monitoring public mental health and alcohol and other drug addiction services) signed up to participate in the study. The 15 Boards, which represent 23 Ohio counties, recruited a total of 50 treatment sites to participate. The Boards and their provider organizations have been randomized into two study groups or “arms.” The control group will use the NIATx model alone, which makes changes at the provider level, to increase use of buprenorphine. The intervention group will use the NIATx model plus the Advancing Recovery framework, which also makes changes at the payer level.

The study team includes Todd Molfenter (the principal investigator), Andy Quanbeck, Mark Zehner, Carol Sherbeck, and Klaren Pe-Romashko. Coaches for the project include Linda Frazier, Eric Haram, Mat Roosa, Chuck Ross, Mark Zehner, and Todd Molfenter.

In May 2013, coaches conducted site visits in Ohio to meet with participating provider organizations and intervention arm Boards. Coaches provided guidance on refining NIATx change project charters, activities, and evaluation. Intervention arm Boards and provider organizations discussed ways to improve payer-provider systems for implementing buprenorphine.

The study is offering DATA 2000 waiver training for prescribing buprenorphine to physicians within or associated with participating organizations. The training aims to increase the number of Ohio physicians certified to prescribe the medication.

Read a full description of the study protocol in “Testing use of payers to facilitate evidence-based practice adoption: protocol for a cluster-randomized trial.”