The Opioid Response Network (ORN)

The ORN is a SAMHSA-funded coalition led by the American Academy of Addiction Psychiatry (AAAP) and 25 national and professional healthcare partner organizations working together to expand capacity to provide technical assistance (TA) to all 50 states, 9 territories, and tribal communities to address the opioid crisis. TA focuses on applying evidence-based and promising practices to meet locally identified needs related to prevention, treatment, and recovery of opioid use disorders. The Division on Substance Use Disorders provides leadership on implementation TA and treatment TA, including identifying and vetting treatment TA consultants across the country and all treatment-related resources. Dr. Frances Levin serves as the Medical Director and Dr. Aimee Campbell serves as the lead implementation expert. For more information, see: https://opioidresponsenetwork.org.

ORN Initiatives

The Division on Substance Use Disorders is also involved in several initiatives within the ORN, including the following initiatives:

American Indian/Alaska Native (AI/AN) ORN Workgroup

Division on Substance Use Disorders Team: Aimee Campbell, PhD, Associate Professor of Clinical Psychiatric Social Work (in Psychiatry) and Margaret Paschen-Wolff, DrPH, Assistant Professor of Clinical Psychiatric Social Work (in Psychiatry), in partnership with experts from multiple community-based, university, and healthcare settings across the U.S. To help address the opioid crisis in tribal communities, SAMHSA provided ORN with supplemental funding in 2018 to increase access to culturally appropriate and evidence-based education and resources. ORN established an American Indian/Alaska Native (AI/AN) workgroup comprised of Native and non-Native health and behavioral health experts, community stakeholders, and researchers that meets weekly to vet culturally appropriate resources; recruit and vet tribal prevention, treatment and recovery providers; and provide assistance with ORN TA requests received from AI/AN organizations and tribal communities. ORN also coordinates with the National AI/AN Addiction Technology Transfer Center Network at the University of Iowa.

ORN LGBTQ Workgroup

Division on Substance Use Disorders Team: Margaret Paschen-Wolff, DrPH is an Assistant Professor of Clinical Psychiatric Social Work (in Psychiatry) and a Research Scientist. Jeremy Kidd, MD is currently a post-doctoral research fellow in the Division on Substance Use Disorders/Addiction Psychiatry T32 Fellowship Program, as well as board-certified Psychiatrist 1 at the Research Foundation for Mental Hygiene, Inc (RMFH).

The ORN Lesbian, Gay, Bisexual, Transgender, Queer, and other non-heterosexual and gender diverse (LGBTQ) Workgroup will support the enhancement of the ORN’s pool of technical assistance (TA) providers with LGBTQ expertise in order to improve the ORN’s ability to respond to LGBTQ TA requests. The LGBTQ workgroup will also support and facilitate the implementation of medications for opioid use disorder and other evidence-based substance use disorder treatments within LGBTQ organizations and among LGBTQ clients.

Opioid Use Disorder (OUD) Cascade of Care Toolkit for State Agencies and Treatment Systems

Team: Dr. Williams is Assistant Professor of Psychiatry. Co-Investigator Brandy Henry, PhD is a T32 post-doc in the Columbia School of Social Work. Consultant Charlie Neighbors, PhD, MBA is Associate Professor at NYU Department of Population Health. Senior Advisors: Frances R. Levin MD, Professor of Psychiatry and Harold A. Pincus MD, Professor in the Department of Psychiatry at Columbia University.

The Opioid Use Disorder (OUD) Cascade of Care is a public health framework that has been promoted for organizing responses to the opioid epidemic by federal agencies such as NIDA and CDC. Increasingly, state agencies (Single State Agencies overseeing addiction services, Departments of Health, Mental Health, Medicaid, etc.) have been searching for guidance on how to implement the OUD Cascade for their state’s efforts to: 1) Manage data collection and reporting, 2) Design measurement-based initiatives, and 3) Surveil patient-centered outcomes at the population level for each sequential stage of the Cascade. These efforts are especially important for vulnerable groups such as adolescent, justice involved, and pregnant individuals. We will partner with AAAP and the ORN to create an OUD Cascade Toolkit to assist state agencies nationwide and their major treatment systems in applying the OUD Cascade across settings and populations. States can submit inquiries through the ORN to request technical assistance (TA) for improving their data collection and reporting systems under the Cascade framework.

ORN Dental Curriculum

Curriculum Development Team: Frances Levin, MD; Folarin Odusola, DDS; Joshua Kaufman, MD; Jeremy Kidd, MD; Matisyahu Shulman, MD; Margaret Paschen-Wolff, DrPH; Shabnam Shakibaie, MD; Eva Turrigiano, MS

The ORN curriculum for U.S. dental schools is an educational initiative developed by the Division on Substance Use Disorders, Department of Psychiatry, at Columbia University Medical Center and New York State Psychiatric Institute and the American Academy of Addiction Psychiatry (AAAP), as part of efforts to address the public health crisis of opioid and other substance use disorders. Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based approach to supporting patients with or at risk for substance use disorders. This ORN dental school curriculum is a standardized core curriculum in substance use disorders and SBIRT.

The curriculum consists of three self-paced core modules supported by resource and reference material. The methodology employed for this curriculum is designed to achieve a spectrum of continuity in instruction, knowledge acquisition, and skill proficiency in the management of patients with substance use disorders. Educational approaches include a seminar-type presentation, case-based exercises, and an Objective Structured Clinical Examination (OSCE), all organized into modules. Dental students who take and pass the curriculum modules will have achieved an understanding of the knowledge, skills, values, and attitudes needed to carry out SBIRT in a dental setting.