Perspectives on a Newly Implemented State Targeted Opioid Response Initiative (STORI) Program

Background & Purpose: New Jersey has seen a significant increase in heroin and illicit opioid use, and consequently, a drastic increase in the number of opioid overdose deaths. The National Survey on Drug Use and Health (2013-2014) indicated that 6.42% of New Jersey residents reported using illicit drugs in the past month and 2.73% reported using an illicit drug other than marijuana in the past month. The number of suspected overdose deaths increased from 1,336 in 2013 to 2,221 in 2016.  From January 1, 2018 to November 30, 2018, naloxone was administered to overdose patients more than 14,827 times in New Jersey (NJDMHAS, 2019). As part of a national initiative to address opioid misuse, New Jersey was awarded a $26 million STORI grant by SAMHSA to improve and expand its substance abuse prevention and treatment systems. The goal of STORI is to increase access to treatment, reduce unmet treatment need, and reduce opioid overdose related deaths by providing prevention, treatment, and recovery activities. Thus, a variety of initiatives under these three major categories were implemented in New Jersey. These new programs include peer recovery support systems offering in-person case management services and statewide telephone recovery support, regional family support centers, and trainings for healthcare professionals and older adults on best practices for prescribing opioids and non-opioid management of pain. This paper explores stakeholder perspectives about these newly implemented opioid response initiatives.

Methods: As part of a larger mixed method evaluation study, in-depth phone interviews were conducted with key stakeholders (n=24) from 18 different agencies. Purposeful sampling was utilized to include providers, trainers, and state employees. Interviews focused on the implementation progress, accomplishments, and challenges of the various STORI programs. With the exception of one, all interviews were audio recorded, transcribed, and analyzed using NVivo 12. This paper presents a preliminary overview of themes from the qualitative data.

Results: Stakeholders noted that these new programs filled important gaps in services, offering novel and innovative methods to addressing opioid misuse. Partnerships were key to the success of most programs, as they depended heavily on both formal and informal partnerships for outreach and coordination of services. There were challenges in coordinating across programs and some client barriers related to transportation, housing, and communication. Some programs experienced challenges with implementation due to the short funding time frame, delays in staffing, and lack of guidance for new program models. Overall however, stakeholders noted that program goals were generally met, and responses to the various programs were overwhelmingly positive. Most emphasized a sense of accomplishment in developing new models of services that engage and empower individuals and families dealing with opioid use disorder.

Conclusions & Implications: Overall, stakeholders reported successful implementation of the various STORI programs and positive responses to the programs in their communities. Although there were challenges in coordination of services, these programs offer social workers and other professionals innovative ways to address a much-needed gap in services for opioid misuse.