Study Of Barriers To Effective Addiction Treatment By UGA Researchers Funded By $9 Million In Grants

Main Category: Alcohol / Addiction / Illegal Drugs
Article Date: 05 Jan 2008 - 7:00 PDT

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More than 23 million Americans aged 12 or older need treatment for substance abuse and addiction, yet only a fraction - less than 10 percent - actually receive it. Worse, among those who do get treatment, very few have access to the treatments that are known to work.

"We have treatments that work, and we have people who want treatment," said Paul Roman, University of Georgia Distinguished Research Professor of Sociology and director of UGA's Center for Research on Behavioral Health and Human Services Delivery, a component of the Institute for Behavioral Research (IBR).

"The problem now is getting treatment providers to adopt new, promising practices so that substance abusers can get the best treatment available."

Roman and a team of researchers based in the IBR have been awarded multiple grants totaling $9 million from both federal and private sources to improve the quality of substance abuse treatment. Last fall, Roman was awarded a five-year $3.2 million grant from the National Institutes of Health (NIH) to study the diffusion, adoption and implementation of effective substance abuse treatment practices in a network of clinical treatment providers across the country. Co-investigators are research scientists Lori Ducharme, Aaron Johnson and Hannah Knudsen. This grant follows a five-year $2.85 million grant from NIH in 2006 to continue a 15-year study tracking organizational changes and development in the national substance abuse treatment system.

"It is hard to overestimate the societal value, both in dollars and in quality of life, of identifying effective ways to disseminate research-based treatments. It is a source of pride for UGA that we have such a strong research group working in this area," said David Lee, UGA vice president for research.

"The intellectual impact of Roman's group over the past 15 years has been tremendous," said Steven Beach, director of the UGA Institute for Behavioral Research. "It is critically important that we foster the dialogue between treatment providers and those providing innovative, cost-effective, treatment improvements - and Roman's work has done precisely that."

Roman has observed the evolution of alcohol abuse and drug addiction treatment for over 25 years. New validated treatments available in recent years include FDA-approved pharmacotherapies for the treatment of addiction, psychosocial counseling and behavioral therapies. However, as Roman's research has uncovered, individual, organizational and systemic barriers can get in the way of delivering those treatments to substance abusers.

The platform for Roman's latest grant was laid in 1999 when the National Institute on Drug Abuse (NIDA), a division of NIH, launched its Clinical Trials Network (CTN) with the goal of testing scientifically-sound treatment practices in treatment settings to determine whether these practices will work in the "real world," and what, if any, modifications may be needed. Beginning in 2001, NIH added funding to Roman's research program to examine the adoption of CTN-studied practices within the network of CTN providers and compare them to programs outside the CTN, including public-sector treatment programs where increasing numbers of patients seek treatment. Over 1,350 treatment centers are included in the study.

Complementing his NIH funded-research, Roman also has a $1.9 million grant to evaluate Advancing Recovery, an $11 million national program funded by The Robert Wood Johnson Foundation to improve the quality of addiction care by supporting partnerships between treatment provider organizations and states. States are both the largest purchaser of publicly funded treatment services and regulators and licensers of those services. The evaluators will study how these partnerships can reduce barriers to adoption of evidence-based practices, ranging from variability in staff experience and education to purchasing and regulatory practices and adoption of consistent standards across state agencies.

Other IBR investigators have been awarded funding for complementary projects. In 2005, Lori Ducharme received a two-year $400,000 grant to study the diffusion of two evidence-based practices tested in the CTN: use of buprenorphine, a new medication for opiate dependence, and a behavioral therapy known as "motivational incentives." In 2006, Lillian Eby, psychology (in collaboration with the IBR team), received a five-year grant totaling $2.55 million to examine the roles of clinical supervisors in substance abuse treatment centers. Her work will provide insights into the role that mentoring plays in reducing the turnover rate in the treatment workforce. Also in 2006, Amanda Abraham, IBR, received a $160,000 post-doctoral fellowship to focus specifically on the processes of adoption and implementation of the medications designed to treat alcohol dependence.

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UGA's Center for Research on Behavioral Health and Human Services Delivery encompasses many research issues associated with behavioral health, including the cause of various types of illness conditions, studies of health-related preventive interventions, and research on the organization of human services delivery such as substance abuse treatment.

Source: Terry Hastings
University of Georgia

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