Characterizing Opioid Use Disorder Encounters in the Midwest Region, USA

INTRODUCTION

The opioid epidemic has taken its toll on the Midwest, a census region of the USA. The Midwest includes two census divisions: East North Central and West North Central. This study aimed (1) to characterize patient encounters of opioid use disorder (OUD) in the Midwest using the Health Facts® database; and (2) to compare selected patient and facility characteristics between the two census divisions.

METHODS

This study was a sub-analysis of a retrospective analysis of the Health Facts® database. For the first objective, the unit of analysis was a patient encounter. Selected patient characteristics were age, gender, marital status, race, length of stay, and patient type. Selected facility characteristics were census division and urban versus rural areas. Descriptive statistics were conducted, and population-based rates of OUD were calculated for categorical variables. For the second objective, t tests were performed for age and length of stay, and chi-square tests for categorical variables.

RESULTS

A total of 13,129 (23.7%) encounters were in East North Central, and 42,271 (76.3%) in West North Central. Patient characteristics that were associated with the highest frequency of encounters were Caucasian, male, single, and other patient types. In addition, rural areas had a higher number of encounters than urban areas. Compared with East North Central, West North Central had a greater average age and a longer average length of stay (p < 0.001). West North Central had a significantly higher proportion of patient encounters associated with patients being male, African American, single, and facilities being in rural areas (p < 0.001).

CONCLUSION

Compared to East North Central, patient encounters of OUD were more frequent and the average length of stay was longer than in West North Central. A significantly higher proportion of patient encounters in West North Central were associated with patients being male, African American, and single, and facilities being in rural areas.

Virtual training and technical assistance: a shift in behavioral health workforce access and perceptions of services during emergency restrictions

BACKGROUND

To respond to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration-funded Technology Transfer Centers had to rapidly adapt to ensure that the behavioral health workforce had continuous access to remote training and technical assistance (TTA). Although the Technology Transfer Centers have historically relied partially upon virtual methods for delivering TTA, the shift to a strictly virtual approach necessitated by COVID-19 restrictions has raised new questions for how to best proceed with services when social distancing guidelines are relaxed. The objective of this exploratory paper was to compare TTA provision in the six-month period prior to (9/1/19 thru 2/28/20) and during (4/1/20 thru 9/30/20) early COVID-19 restrictions to determine the extent to which the shift to virtual service provision impacted the behavioral health and medical workforce. Specifically, we examined participants' access to TTA, geographic reach of TTA, and workforce perceptions of satisfaction and utility with TTA provision.

METHOD

Participant and event-level data were analyzed to compare the following metrics before and during the COVID pandemic: number of events and attendees; participant demographics; zip codes reached; coverage of rural, suburban, and urban areas; and perceptions of satisfaction with and utility of training.

RESULTS

Findings showed a 40% increase in the number of events delivered (p < .001) and a 270% increase in the number of attendees (p < .001) during the COVID period when TTCs relied exclusively on virtual delivery. Geospatial analyses linking zip codes to a schematic of rural, suburban, and urban classifications throughout the United States revealed significant increases in the number of zip codes reached during the COVID time period. Satisfaction levels were comparable before and during the pandemic.

CONCLUSIONS

Findings show that expanded access to TTA services via virtual formats resulted in reach to more diverse attendees and regions, and did not come at the expense of satisfaction. Results suggest that virtual TTA should continue to be an important component of TTA offerings post-pandemic.

Dismantling racism against Black, Indigenous, and people of color across the substance use continuum: A position statement of the association for multidisciplinary education and research in substance use and addiction

The Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA) acknowledges that racism profoundly affects persons who use alcohol and other drugs. Racism's deadly effects compounded with other social determinants of health result in a cascade of negative impacts. The AMERSA Board of Directors (BOD) proposes an initial set of strategies to promote diversity, equity, and inclusion using a framework that speaks to four key AMERSA experiences: engagement, education, mentorship, and leadership. Through these strategies, AMERSA commits to promoting equity and inclusion to dismantle the individual, institutional, and structural racism that has permeated the United States for centuries.