ABSTRACT

Opioid use and overdose deaths have reached epidemic proportions in the U.S. Despite the opioid epidemic being broad, pervasive and multi-faceted, it has been addressed with a disaggregated acute care model. The opioid crisis requires a coordinated, multi-pronged approach that utilizes available evidence to develop and sustain robust clinical expertise, prevention efforts and community engagement, extending from prevention to research to systems realms. This endpage outlines a community-based expansion of the Hub-and-Spoke ecosystem of opioid use disorder care in which social workers are well-positioned to support individuals and communities impacted by the opioid epidemic in achieving healing and long-term recovery.

VIDEO ABSTRACT SCRIPT

McCormick, K.A. & Holleran-Steiker, L. (in press). A social work perspective on the opioid solution: A community-based expansion of the Hub-and-Spoke Ecosystem. Journal of Social Work Practice in Addictions.

At present, Substance Use Disorders are one of the most critical issues in the U.S., with opioid use and overdose deaths reaching epidemic proportions. However, the statistics available are likely a gross underrepresentation of the true extent of the problem due to insufficient data collection and reporting practices.

While the traditional Hub-and-Spoke model of opioid use disorder care has substantially increased treatment capacity, it does not capture people who are not yet ready to pursue medical treatment or who resist medical settings for various reasons.

Because the epidemic is broad, pervasive and multi-faceted, it requires a coordinated, multi-pronged approach that utilizes available evidence to develop and sustain clinical expertise, prevention efforts and community engagement across systems.

To develop such a system, we partnered with national legal, economic and clinical opioid experts, scoped existing peer-reviewed research literature and consulted with community stakeholders to design a robust ecosystem for addressing the opioid epidemic.

We propose an expanded Hub-and-Spoke ecosystem that consists of six major components, including prevention, treatment, harm reduction interventions, grief therapy, a health information technology system, and an overarching research and evaluation structure to support successful implementation of the ecosystem.

The opioid epidemic is the deadliest drug epidemic in the history of the U.S. and one of the worst systemic crises in the Nation’s history. To successfully and substantially address the epidemic, we must develop a robust, multi-pronged community-based ecosystem that facilitates seamless coordination among systems. This community-based expansion of the Hub-and-Spoke ecosystem acts as one such model, and we are excited to share it with the research and practice communities.

摘要

阿片类药物的使用和过量死亡在美国已达到流行程度 尽管阿片类药物的流行范围广泛、普遍和多方面，但它已通过分解的急性护理模型得到解决。阿片类药物危机需要一种协调的、多管齐下的方法，利用现有证据来发展和维持强大的临床专业知识、预防工作和社区参与，从预防到研究再到系统领域。本页尾概述了阿片类药物使用障碍护理的中心辐射生态系统的社区扩展，其中社会工作者处于有利地位，可以支持受阿片类药物流行影响的个人和社区实现治愈和长期康复。

视频摘要脚本

McCormick, KA 和 Holleran-Steiker, L.（印刷中）。阿片类药物解决方案的社会工作视角：以社区为基础的中心辐射生态系统扩展。成瘾社会工作实践杂志。

目前，物质使用障碍是美国最关键的问题之一，阿片类药物使用和过量死亡达到流行病的程度。然而，由于数据收集和报告实践不足，可用的统计数据可能严重低估了问题的真实程度。

虽然传统的阿片类药物使用障碍护理中心辐射模式大大提高了治疗能力，但它并没有涵盖尚未准备好寻求医疗或因各种原因抵制医疗环境的人。

由于该流行病是广泛、普遍和多方面的，因此需要采取协调、多管齐下的方法，利用现有证据来发展和维持跨系统的临床专业知识、预防工作和社区参与。

为了开发这样一个系统，我们与国家法律、经济和临床阿片类药物专家合作，对现有的同行评审研究文献进行了调查，并与社区利益相关者进行了磋商，以设计一个强大的生态系统来应对阿片类药物的流行。

我们提出了一个扩展的 Hub-and-Spoke 生态系统，它由六个主要组成部分组成，包括预防、治疗、减少伤害干预、悲伤治疗、健康信息技术系统以及支持生态系统成功实施的总体研究和评估结构。

阿片类药物流行是美国历史上最致命的毒品流行，也是美国历史上最严重的系统性危机之一。为了成功和实质性地应对这一流行病，我们必须建立一个强大的、多管齐下的基于社区的生态系统，以促进系统之间的无缝协调。Hub-and-Spoke 生态系统的这种基于社区的扩展就是这样一种模式，我们很高兴与研究和实践社区分享它。