Foreword to: Indiana University’s Response to the Addictions Crisis: A Grand Challenge Initiative

Abstract

Use of heroin, prescription painkillers, methamphetamines, and fentanyl led to a national health crisis in 2017, resulting in 1852 overdose deaths in Indiana. Governor Eric J. Holcomb made tackling substance use in the state one of his highest priorities, calling on all Hoosiers to collaborate. In October 2017, Indiana University (IU) President Michael A. McRobbie responded, announcing that the University would be initiating the Responding to the Addictions Crisis Grand Challenge (AGC). Partners included Governor Holcomb, IU Health, and Eskenazi Health. Leveraging the university’s research strengths and partnering with more than 160 community organizations across the state, the AGC sought to address substance use facing Indiana and beyond. Fifty interdisciplinary research projects were created through the AGC, focusing on IU’s greatest strength in five areas: (1) education, training, and certification; (2) data science and analysis; (3) policy analysis, economics, and law; (4) basic, applied, and translational research; (5) community engagement and workforce development. Diversity, equity, and inclusion implications were often considered. This supplement describes the IU approach to address the health of the people of the State, investigator initiated projects and research conducted to inform practice, strategy and policy.

This special collection summarizes a university’s response to the addiction crisis, a public health emergency in Indiana. In October 2017, Indiana University (IU) President Michael A. McRobbie announced that the university’s teams of faculty experts would address this urgent health crisis and work to improve health across the state. Responding to the Addictions Crisis Grand Challenge (AGC) was formed in partnership with Governor Holcomb, IU Health, and Eskenazi Health. The AGC sought to address substance use by leveraging the university’s research and practice strengths from its 7 campuses and partnering with more than 160 community organizations across the state. In honor of IU’s bicentennial, the second issue of ENGAGE! showcased community engagement, which became a central tenet of our efforts. We collaborated to co-create knowledge and innovative approaches to address our community’s health, creating an engagement framework for public health and promoting health and well-being.

The misuse of heroin, prescription painkillers, methamphetamines, and synthetic opioids, such as fentanyl, created a national crisis affecting millions of Americans. The use of substances was devastating to people, families, and communities in Indiana. Indiana’s Governor Eric J. Holcomb responded by tackling substance use as one of his highest priorities and called on all Hoosiers to collaborate to recover from this crisis.

Many IU faculty and staff had well aligned areas of research or practice, enabling the AGC to quickly launch interdisciplinary research projects reflecting areas of IU’s greatest strength: (1) education, training, and certification; (2) data science and analysis; (3) policy analysis, economics, and law; (4) basic, applied, and translational research; (5) community engagement and workforce development; and (6) diversity, equity, and inclusion. The AGC statewide initiative was one of the nation’s largest and most comprehensive state-based responses to the substance use crisis and the largest led by a university.

Thousands of Indiana healthcare providers, community members, and others participated in AGC-sponsored education and training through video conferencing or viewing resources available on the AGC website. Project ECHO (Extension for Community Healthcare Outcomes) sought to connect local providers with specialists to improve health care. Through Project ECHO, we developed greater capacity to recognize and treat substance use-related health problems among local communities.

Professional development courses related to substance use were available for clinicians and members of the community. The community member course has been highly subscribed, and remains available at: https://expand.iu.edu/browse/iunursing/agc/courses/in-this-together-community-conversations-to-reduce-stigma-of-substance-use-disorder?_gl=1*brg97n*_ga*MTAyNzMxMDQwNS4xNjM0OTE3ODky*_ga_61CH0D2DQW*MTcxNDI1NDI0OC4xMTQuMS4xNzE0MjU0NDQ2LjYwLjAuMA

This special collection of 8 papers highlights a selection of AGC projects demonstrating diverse settings and populations, novel methodological approaches and measurement of outcomes that transcend health system delivery, workforce, treatment options, and data sources. Papers include:

• Green and Kaminski use medical claims data for regional targeting and intervention delivery strategies to increase Office Based Opioid Treatment

• Maxey, Vaughn, Dickinson, and Newhouse explore the Medication Assisted Treatment variations by demographic and professional characteristics of Physicians and Nurse Practitioners

• Yakovlkeva, Griffin, Worden et al. use survey data from the CARE study mixed method analysis to describe characteristics of peer recovery coaches (PRC) engaged in the AGC and attributes of enrollment and retention of women enrolled in CARE to examine opioid prescriptions prior to Emergency Department visits

• Campbell, Naz, Gharbi et al. describe the concordance of electronic health record diagnoses and substance use self-report of reproductive age women enrolled in a community-based addiction reduction program

• Qaurooni, Herr, Zappone et al. apply visual analytics to improve interpretation of data for people with substance use disorder

• Cyders, Fry, Fox et al. use a mixed method approach to explore the use of sobriety date as the recovery start date

• Brown provides a narrative review to examine the promising use of non-invasive transcranial electrical and magnetic neurostimulation to treat SUD

• Dreyer, Shukla, Sabadee et al. explored whether the receipt of opioid prescriptions prior to seeking emergency care for dental conditions differs in geographical areas that are underserved by health care professionals (Dental Professional Shortage Areas, DPSAs) compared to other areas.

To date, 27 projects are complete, and the remaining will be completed in 2025. Importantly, community relationships and partnerships continue. Valuable information continues to be generated to address addiction and the care of people with SUD. IU’s Responding to the Addictions Crisis Grand Challenge demonstrates the importance of partnering with our communities and how our research and clinical efforts can serve as a model for universities to respond to public health needs.