Abstract: What Can We Learn from COVID-19 to Improve Opioid Treatment? Expert Providers Respond (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Friday, January 12, 2024

Liberty Ballroom I, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Lesley Harris, MSW, PhD, Associate Professor, University of Louisville, Louisville, KY

Jeanne Marsh, PhD, MSW, George Herbert Jones Distinguished Service Professor, University of Chicago, Chicago, IL

Tenie Khachikian, PhD, Research Associate, University of Chicago, Chicago

Veronica Serret, MSW, Research Coordinator, I-Lead Institute, Los Angeles, CA

Yinfei Kong, PhD, Associate Professor, California State University, Fullerton, Fullerton, CA

Erick Guerrero, PhD, Research Director / Faculty, Research to End Healthcare Disparities Corp, Los Angeles, CA

Background: The COVID-19 pandemic has had devastating effects on drug abuse treatment
systems already stressed by the opioid crisis. Providers within Opioid Use Disorder (OUD)
outpatient treatment programs have had to adjust to rapid change and respond to new service
delivery provisions such as telehealth and take-home medication. Using the COVID-19
pandemic and subsequent organizational challenges as a backdrop, this study explores
provider perspectives about strategies and policies that, if made permanent, can potentially
improve access to and quality of OUD treatment.

Methods: This qualitative study was conducted in Los Angeles County, which has one of the
largest substance use disorder (SUD) treatment systems in the United States serving a diverse
population, including communities impacted by the opioid crisis. We collected qualitative
interview data from 30 high-performing programs (one manager/supervisor per program)
where high performance was based on empirical measures of access, retention, and program
completion outcomes. Data collection and analysis were completed using constructivist
grounded theory (CGT) to describe the social processes the participating managers engaged
in when faced with the pandemic and subsequent organizational changes. We developed 14
major codes and six minor codes with definitions. The interrater reliability tests showed
pooled Cohen’s kappa statistic of 93%.

Results: Our results document the impacts of COVID-19 on SUD treatment systems, their
programmatic responses, and the strategic innovations they developed to improve service
delivery and quality and which managers plan to sustain within their organizations.

Conclusion: Providers identified three primary areas for strategic innovation designed to
improve access and quality: (1) designing better medication utilization, (2) increasing
telemedicine capacity, (3) improving reimbursement policies. These strategies for system
transformation enable us to use lessons from the COVID-19 pandemic to direct policy and
programmatic reform, such as expanding eligibility for take-home medication and enhancing
access to telehealth services.