This is the first in a series of Community Forums on topics of immediate relevance to the field of substance abuse treatment and prevention in the Greater New Haven region and beyond. It is intended for audiences interested in our international research as well as practical steps everyday people can take in their networks, families and communities to connect relevant resources where they are needed. We hope you will join us!
These forums will last one-hour and consist of a 15-20 minute stimulus lecture followed by a facilitated discussion. Our first one will be held Thurs, Sept 30th at 2pm. REGISTER NOW.
Opioid Use, Overdose Deaths & COVID-19: a Global Syndemic
Open Access Model and the Urgency of Treatment
Presented by: Lynn Madden, PhD, MPA, CEO & President of the APT Foundation
In the face of grim realities and stark statistics about the harm caused by these overlapping pandemics, we offer a base of evidence for urgently scaling up Medications for Opioid Use Disorder (MOUD). In the APT Foundation Open Access Model, eligible patients are enrolled rapidly in MOUD, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options. Open Access provides a unique resource for the Greater New Haven region. The APT Foundationstaff are currently involved with researchers and clinicians in 5 other states and 4 other countries trying to emulate our model.
What does it take? We’ll review, step, by step, the path we took to build our Open Access Clinics and the way APT is contributing to solutions around the world. REGISTER NOW.
- Madden, L.M., S.O Farnum, K.F. Eggert, A.R. Quanbeck, R. Freeman, S.A. Ball, R.S. Schottenfeld, J.M. Shi, M.E. Savage, D.T. Barry.
An investigation of an open-access model for scaling up methadone maintenance treatment. Addiction. 2018, 113: 1450–1458.
Despite the dramatic rise in the prevalence of opioid use disorder in the U.S., few treatment organizations have scaled up medication-assisted treatment to address the magnitude of the current opioid epidemic. Beginning in May 2007, the CEO and senior staff at APT began developing and implementing an “open-access” model in which prospective patients were enrolled rapidly in methadone maintenance treatment, irrespective of ability to pay, and provided real-time access to multiple voluntary treatment options. Medical and administrative records were abstracted to compare data for one year before and 9 years after initiating the implementation of the open-access treatment model. In the 9 years following the initial implementation, patient census increased by 183% from 1,431 to 4,051, and average wait-time days decreased from 21 to .3 (same day) without apparent deleterious effects on rates of retention, nonmedical opioid use, or mortality. Between fiscal year (FY) 06 and FY 15, net operating margin rose from 2% to 10%, while state-block grant revenues declined 14% and the proportion of total revenue from state-block grant revenue decreased from 49% to 21%. Further investigation of the open-access model is merited as it offers one of the few published models for assisting program managers to scale up medication-assisted treatment.
- Oberleitner, LMS., Madden, LM, Muthulingam, D., Marcus, R., Oberleitner, DE., Beitel, M., Gaeta, M. Tamberelli, JF, Barry, DT.
A qualitative investigation of addiction counselors’ perceptions and experiences implementing an open-access model for treating opioid use disorder, Journal of Substance Abuse Treat. 2020
In an interview study of addiction counselors at APT, participants identified positives and negatives to scaling up treatment. Advantages and disadvantages to clients include reduced barriers to treatment and greater autonomy, and lack of structure. Advantages and disadvantages to counselors include stimulating work environment and fewer demands, and uneven workloads. Participants did not identify any disadvantages to the community; possible advantages to the community include less crime and treatment offered to vulnerable members
- Gaeta, M., M. Beitel, L.M.S. Oberleitner, D.E. Oberleitner, L.M. Madden, J.F. Tamberelli, D.T. Barry.
Correlates of homelessness among patients in methadone maintenance treatment. Med Care. Nov 2020
APT’s open-access model allows treatment access for individuals who are potentially vulnerable, including those who are homeless. In a cross-sectional study of APT patients, we found that those who were homeless (vs. domiciled) were more likely to be male and report higher symptoms of depression.
Learn More About our Research