Session: Increasing the Reach of Addiction Treatment Beyond Traditional Treatment Settings (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Background and Purpose: Effective psychosocial and pharmacological interventions exist to ameliorate substance use problems, but few individuals ever initiate, engage in, or adhere to appropriate treatment services. Identifying new ways to increase the proportion of individuals with addiction who receive quality treatment is necessary to achieve one of social work’s Grand Challenges: to reduce and prevent the burden associated with unhealthy alcohol use.

Reducing the burden that addiction has on society requires new approaches that can reach the broader population of individuals with substance use problems. Because few individuals seek services from traditional addiction treatment centers, there is a need to identify and treat individuals in non-traditional venues, such as medical settings or over the internet. One model of treatment, substance use screening, brief intervention, and referral to treatment in primary care settings, has received much attention in the field of social work. However, the evidence for this intervention model remains mixed. New interventions are needed to augment, expand, or replace it. This symposium focuses on identifying innovative approaches to improve the delivery of health services for substance use disorders.

Methods: Four papers are presented in this symposium, each of which focuses on the efficacy or feasibility of addiction treatment services that attempt to reach beyond the walls of traditional specialized treatment centers. A theme throughout these presentations is the use of innovative strategies to adapt or tailor services with a known evidence base to address addiction problems.

Results: To our knowledge, the meta-analytic study presented here provides the first known synthesis of evidence for using brief alcohol interventions to identify and link individuals with unhealthy alcohol use to specialty addiction treatment. There is an overall lack of efficacy of brief alcohol interventions, as currently implemented, in increasing the initiation of specialized alcohol treatments. However, multi-session brief interventions should be evaluated as a means to link individuals to more intensive treatments for alcohol use disorder. Results from the second study show that it is feasible for primary care-based social workers to proactively identify and reach out to individuals in primary care settings who are newly diagnosed with alcohol or drug use disorder. In the third study, the online intervention for middle aged and older adult drinkers was feasible and desirable (for at least individuals who are computer savvy), potentially providing an important affordable adjunct to treatment that occurs in medical settings. The fourth study provides preliminary evidence that a revised Medication Management manual for medications to treat addiction was useful in detecting early warning signs of medication nonadherence, increasing clinician and patient awareness of such problems and providing directions to forestall medication nonadherence particularly as the pertain to issues associated with intentional nonadherence. 

Conclusions and Implications: Innovation is needed to expand the delivery of addiction treatment services to more people in need. The presentations in this symposium offer several innovative approaches to intervening with substance use outside of the walls of traditional treatment centers.