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Translating Science to Practice: Lessons Learned Implementing Evidence-Based Treatments in US Substance Use Disorder Treatment Programs

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Abstract

Despite significant effort devoted to developing and testing treatments for substance use disorders (SUD), most individuals who receive treatment in the United States (USA) do not receive evidence-based care. In this article, we summarize the emerging body of descriptive research that focuses on the question of why SUD treatment programs in the USA do not use evidence-based treatments (EBT) more and highlight initiatives that have shown promise as ways to facilitate their use. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, we provide an overview of how various factors promote or inhibit the use of evidence-based treatments in SUD treatment settings in the USA. We then discuss how promising approaches to facilitate the use of EBT build upon many CFIR concepts and constructs. The article concludes with a discussion of the implications of the USA experience with EBT implementation for non-Western nations as they develop SUD services, highlighting three main lessons learned: (1) historical and cultural factors impact EBT implementation; (2) studies that test both clinical effectiveness and implementation outcomes can enhance implementation; and (3) multilevel implementation approaches may have greater impact than strategies that address just one level of change (e.g., individuals, organizations, systems).

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References

  • Alanis-Hirsch, K., Croff, R., Ford, J. H., Johnson, K., Chalk, M., Schmidt, L., & McCarty, D. (2016). Extended-release naltrexone: A qualitative study of barriers to routine use. Journal of Substance Abuse Treatment, 62, 68–73.

    Article  Google Scholar 

  • Aletraris, L., Shelton, J. S., & Roman, P. M. (2015). Counselor attitudes toward contingency management for substance use disorder: Effectiveness, acceptability, and endorsement of incentives for treatment attendance and abstinence. Journal of Substance Abuse Treatment, 57, 41–48.

    Article  Google Scholar 

  • Amodeo, M., Lundgren, L., Fernanda Beltrame, C., Chassler, D., Cohen, A., & D’Ippolito, M. (2013). Facilitating factors in implementing four evidence-based practices: Reports from addiction treatment staff. Substance Use & Misuse, 48(8), 600–611.

    Article  Google Scholar 

  • Bauer, M. S., Damschroder, L., Hagedorn, H., Smith, J., & Kilbourne, A. M. (2015). An introduction to implementation science for the non-specialist. BMC Psychology, 3, 32.

    Article  Google Scholar 

  • Becker, S. J., Squires, D. D., Strong, D. R., Barnett, N. P., Monti, P. M., & Petry, N. M. (2016). Training opioid addiction treatment providers to adopt contingency management: A prospective pilot trial of a comprehensive implementation science approach. Substance Abuse, 37(1), 134–140.

    Article  Google Scholar 

  • Bride, B. E., Abraham, A. J., & Roman, P. M. (2011). Organizational factors associated with the use of contingency management in publicly funded substance abuse treatment centers. Journal of Substance Abuse Treatment, 40(1), 87–94.

    Article  Google Scholar 

  • Bride, B. E., Kintzle, S., Abraham, A. J., & Roman, P. M. (2012). Counselor attitudes toward and use of evidence-based practices in private substance use disorder treatment centers: A comparison of social workers and non-social workers. Health & Social Work, 37(3), 135–145.

    Article  Google Scholar 

  • Carroll, K., & Onken, L. S. (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry, 162(8), 1452–1460.

    Article  Google Scholar 

  • Condon, T. P., Miner, L. L., Balmer, C. W., & Pintello, D. (2008). Blending addiction research and practice: Strategies for technology transfer. Journal of Substance Abuse Treamtent, 35, 156–160.

    Article  Google Scholar 

  • Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012). Effectiveness-implementation hybrid designs: Combining elements of clinical effectiveness and implementation research to enhance public health impact. Medical Care, 50(3), 217–226.

    Article  Google Scholar 

  • Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4, 50.

    Article  Google Scholar 

  • Damschroder, L. J., & Hagedorn, H. J. (2011). A guiding framework and approach for implementation research in substance use disorders treatment. Psychology of Addictive Behaviors, 225(2), 194–205.

    Article  Google Scholar 

  • Duncan, L. G., Mendoza, S., & Hansen, H. (2015). Buprenorphine maintenance for opioid dependence in public sector healthcare: Benefits and barriers. Journal of Addiction Medicine and Therapeutic Science, 1(2), 31–36.

    Article  Google Scholar 

  • Dutra, L., Stathopoulou, G., Basden, S. L., Leyro, T. M., Powers, M. B., & Otto, M. W. (2008). A meta-analytic review of psychosocial interventions for substance use disorders. The American Journal of Psychiatry, 165(2), 179–187.

    Article  Google Scholar 

  • Ferri, M., Amato L. & Davoli, M. (2006). Alcoholics Anonymous and other 12-step programmes for alcohol dependence. The Cochrane Library.

  • Finney, J. W., & Hagedorn, H. J. (2011). Introduction to a special section on implementing evidence-based interventions for substance use disorders. Psychology of Addictive Behaviors, 25(2), 191–193.

    Article  Google Scholar 

  • Flynn, P., Brown, M., & B.S. (2011). Implementation research: Issues and prospects. Addictive Behaviors, 36, 566–569.

    Article  Google Scholar 

  • Forman, R. F., Bovasso, G., & Woody, G. (2001). Staff beliefs about addiction treatment. Journal of Substance Abuse Treatment, 21(1), 1–9.

    Article  Google Scholar 

  • Fuller, B. E., Rieckmann, T., Nunes, E. V., Miller, M., Arfken, C., Edmunson, E., et al. (2007). Organizational readiness for change and opinions toward treatment innovations. Journal of Substance Abuse Treatment, 33, 183–192.

    Article  Google Scholar 

  • Garner, B. R. (2009). Research on the diffusion of evidence-based treatments within substance abuse treatment: A systematic review. Journal of Substance Abuse Treatment, 36(4), 376–399.

  • Guerrero, E. G., He, A., Kim, A., & Aarons, G. A. (2014). Organizational implementation of evidence-based substance abuse treatment in racial and ethnic minority communities. Administration and Policy in Mental Health, 41, 737–749.

    Article  Google Scholar 

  • Guerrero, E. G., Padwa, H., Fenwick, K., Harris, L. M., & Aarons, G. A. (2016). Identifying and ranking implicit leadership strategies to promote evidence-based practice implementation in addiction health services. Implementation Science, 11, 69.

    Article  Google Scholar 

  • Hartzler, B., Donovan, D. M., Tillotson, C. J., Mongoue-Tchokote, S., Doyle, S. R., & McCarty, D. (2012a). A multilevel approach to predicting community addiction treatment attitudes about contingency management. Journal of Substance Abuse Treatment, 42, 213–221.

    Article  Google Scholar 

  • Hartzler, B., Lash, S. J., & Roll, J. M. (2012b). Contingency management in substance abuse treatment: A structured review of the evidence for its transportability. Drug and Alcohol Dependence, 122, 1–10.

    Article  Google Scholar 

  • Henggeler, S. W., Chapman, J. E., Rowland, M. D., Halliday-Boykins, C. A., Randall, J., Shackelford, J., & Schoenwald, S. K. (2008). State-wide adoption and initial implementation of contingency management for substance-abusing adolescents. Journal of Consulting and Clinical Psychology, 76, 556–567.

    Article  Google Scholar 

  • Humphreys, K., & Frank, R. G. (2014). The affordable care act will revolutionize care for substance use disorders in the United States. Addiction, 109, 1057–1058.

    Google Scholar 

  • Kirby, K. C., Benishek, L. A., Dugosh, K. L., & Kerwin, M. E. (2006). Substance abuse treatment providers’ beliefs and objections regarding contingency management: Implications for dissemination. Drug and Alcohol Dependence, 85(1), 19–27.

    Article  Google Scholar 

  • Knudsen, H. K., & Roman, P. M. (2014). Dissemination, adoption, and implementation of acamprosate for treating alcohol use disorders. Journal of Studies on Alcohol and Drugs, 75, 467–475.

    Article  Google Scholar 

  • Knudsen, H. K., & Roman, P. M. (2016). The diffusion of acamprosate for the treatment of alcohol use disorder: Results from a national longitudinal study. Journal of Substance Abuse Treatment, 62, 62–67.

    Article  Google Scholar 

  • Lehman, W. E. K., Simpson, D. D., Knight, D. K., & Flynn, P. M. (2011). Integration of treatment innovation planning and implementation: Strategic process models and organizational challenges. Psychology of Addictive Behaviors, 25(2), 252–261.

    Article  Google Scholar 

  • Ling, W., Amass, L., Shoptaw, S., Annon, J. J., Hillhouse, M., Babcock, D., & Ziedonis, D. (2005). A multicenter randomized trial of buprenorphine–naloxone versus clonidine for opioid, detoxification: Findings from the National Institute on Drug Abuse clinical trials network. Addiction, 100(8), 1090–1100.

    Article  Google Scholar 

  • Martino, S., Brigham, G. S., Higgins, C., et al. (2010). Partnerships and pathways of dissemination: The NIDA-SAMHSA blending initiative in the clinical trials network. Journal of Substance Abuse Treatment., 38(S1), S31–S43.

    Article  Google Scholar 

  • McCambridge, J., Witton, J., & Elbourne, D. R. (2014). Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Journal of Clinical Epidemiology, 67(3), 267–277.

    Article  Google Scholar 

  • Miller, W. R., Sorenson, J. L., Selzer, J. A., & Bingham, G. S. (2006). Disseminating evidence-based practices in substance abuse treatment: A review with suggestions. Journal of Substance Abuse Treatment, 31(1), 25–39.

    Article  Google Scholar 

  • Molfenter, T. (2014). Addiction treatment centers’ progress in preparing for health care reform. Journal of Substance Abuse Treatment, 46(2), 158–164.

    Article  Google Scholar 

  • Molfenter, T., McCarty, D., Capoccia, V., & Gustafson, D. (2013). Development of a multilevel framework to increase use of targeted evidence-based practices in addiction treatment clinics. Public Health Frontier, 2(1), 11.

    Article  Google Scholar 

  • Morgenstern, J. (2000). Effective technology transfer in alcoholism treatment. Substance Use & Misuse, 35, 1659–1678.

    Article  Google Scholar 

  • National Center on Addiction and Substance Abuse. (2012). Addiction medicine: Closing the gap between science and practice. New York: The Author.

    Google Scholar 

  • O'Malley, S. S., Garbutt, J. C., Gastfriend, D. R., Dong, Q., & Kranzler, H. R. (2007). Efficacy of extended-release naltrexone in alcohol-dependent patients who are abstinent before treatment. Journal of Clinical Psychopharmacology, 27(5), 507–512.

    Article  Google Scholar 

  • Pating, D. R., Miller, M. M., Goplerud, E., Martin, J., & Ziedonis, D. M. (2012). New systems of care for substance use disorders: Treatment, finance, and technology under health care reform. Psychiatric Clinics of North America, 35(2), 327–356.

    Article  Google Scholar 

  • Prendergast, M. L., Podus, D., Chang, E., & Urada, D. (2002). The effectiveness of drug abuse treatment: A meta-analysis of comparison group studies. Drug and Alcohol Dependence, 67(1), 53–72.

    Article  Google Scholar 

  • Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health, 36, 24–34.

    Article  Google Scholar 

  • Rawson, R. A., Rieckmann, T., & Gust, S. W. (2014). Addiction science: A rationale and tools for a public health response to drug use. Public Health Reviews, 35(2).

  • Rieckmann, T. R., Kovas, A. E., Cassidy, E. F., & McCarty, D. (2011). Employing policy and purchasing levers to increase the use of evidence-based practices in community-based substance abuse treatment settings: Reports from single state authorities. Evaluation and Program Planning, 34, 366–374.

    Article  Google Scholar 

  • Roman, P. M., Abraham, A. J., & Knudsen, H. K. (2011). Using medication-assisted treatment for substance use disorders: Evidence of barriers and facilitators of implementation. Addictive Behaviors, 36(6), 584–589.

    Article  Google Scholar 

  • Roy, A. K., & Miller, M. M. (2012). The medicalization of addiction treatment professionals. Journal of Psychoactive Drugs, 44(2), 107–118.

    Article  Google Scholar 

  • Saunders, E. C., & Kim, E. (2013). Substance abuse treatment implementation research. Journal of Substance Abuse Treatment, 44(1), 1–3.

    Article  Google Scholar 

  • Simpson, D. D., & Flynn, P. M. (2007). Moving innovations into treatment: A stage-based approach to program change. Journal of Substance Abuse Treatment, 33(2), 111–120.

    Article  Google Scholar 

  • Simpson, D. D., Joe, G. W., & Rowan-Szal, G. A. (2007). Linking the elements of change: Program and client responses to innovation. Journal of Substance Abuse Treatment, 33, 201–209.

    Article  Google Scholar 

  • Smith, B. D., & Manfredo, I. T. (2011). Frontline counselors in organizational contexts: a study of treatment practices in community settings. Journal of Substance Abuse Treatment, 41(2), 124–136.

  • Squires, D. D., Gumbley, S. J., & Storti, S. A. (2008). Training substance abuse treatment organizations to adopt evidence-based practices: The addiction technology transfer Center of new England Science to service laboratory. Journal of Substance Abuse Treatment, 34, 293–301.

    Article  Google Scholar 

  • Stein, B. D., Gordon, A. J., Dick, A. W., Burns, R. M., Pacula, R. L., Farmer, C. M., et al. (2015). Supply of buprenorphine waivered physicians: The influence of state policies. Journal of Substance Abuse Treatment, 48, 104–111.

    Article  Google Scholar 

  • White, W. L. (1998). Slaying the dragon: The history of addiction treatment and recovery in America. Bloomington, IL: Lighthouse Training Institute.

    Google Scholar 

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Authors and Affiliations

  1. Integrated Substance Abuse Programs, University of California Los Angeles, 11075 Santa Monica Boulevard, Suite 200, Los Angeles, CA, 90025, USA

    Howard Padwa

  2. School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA, 90089, USA

    Charles D. Kaplan

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  1. Howard Padwa
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Correspondence to Howard Padwa.

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Padwa, H., Kaplan, C.D. Translating Science to Practice: Lessons Learned Implementing Evidence-Based Treatments in US Substance Use Disorder Treatment Programs. Eur J Crim Policy Res 24, 171–182 (2018). https://doi.org/10.1007/s10610-017-9360-3

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