June 19, 2018, 12:03 pm Chris Crawford – In response to the federal government's declaration that the U.S. opioid epidemic is a national public health emergency, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded a two-year grant to the American Academy of Addiction Psychiatry (AAAP) to bring together a coalition of 22 health care organizations, including the AAFP, to address the problem at the state and territory level.
Known as the State Targeted Response Technical Assistance (STR-TA) Consortium, the coalition seeks to leverage the expertise of individual clinicians in forming technical assistance teams (prevention, treatment and recovery) in each U.S. state and territory. The teams are intended to build clinical proficiency among prescribers and others that will enable them to address chronic pain, opioid use disorders (OUDs) and delivery of medication-assisted treatment (MAT).
As a member of the consortium, the AAFP is recruiting family physicians who have expertise and/or experience in OUDs and use of medications in treating them or who are interested in obtaining a waiver to prescribe MAT to participate in the STR-TA program.
Physicians selected to serve on the technical assistance teams are expected to have a minimum of two years' experience treating patients with OUDs and prescribing medications. These physician team members will be given the opportunity to train/mentor other physicians in their state or territory in evidence-based practices and will be paid a contractual hourly rate for services after they have been approved as technical assistance consultants.
Kathryn Cates-Wessel, CEO of the AAAP, told AAFP News that ideal family physician candidates for the STR-TA teams would be comfortable educating/training others and working in multidisciplinary teams.
"The opioid epidemic is a huge problem for all families and communities, starting from children to older adults, and family physicians are ideally positioned to cover that lifespan," she said.
As STR-TA team members, family physicians can help stop the opioid problem between generations of a family. "Plus, they can help other family physicians become aware of prevention and screening to prevent opioid use disorders and other substance use disorders from ever starting," Cates-Wessel said. "So, there is a huge opportunity to make a difference with individuals, families and communities as a whole."
In addition to having a physician as a technical assistance consultant in prescribing and treating, each STR-TA team will include prevention and recovery consultants, as well as technology specialists. When possible, technical assistance teams will have an addiction specialist as a senior clinical lead, but this is not required.
In some regions, there might not be any physicians who have been prescribing MAT for the minimum requirement of two years or who have the waiver to do so at all. In these situations, the treatment consultant positions may be filled by local nurse practitioners and physician assistants working with a physician who has expertise in addictions, Cates-Wessel said.
The Addiction Technology Transfer Center (ATTC) has partnered with the STR-TA and has identified a technology transfer specialist (TTS) for each state and territory. The ATTC is working closely with the single state agency/STR grantees and individuals to help identify and provide oversight for technical assistance consultations and manage each state's or territory's technical assistance team.
Cates-Wessel said within a month of launching the program, STR-TA received more than 100 requests for assistance from a variety of groups.
"It's important to note that this resource is not only for states with STR grants but also for individuals, clinical practices, community groups, and prevention and recovery programs looking for help in learning more about how to address the opioid crisis in their community with local resources and expertise," she added.
Cates-Wessel noted that based on experience, implementing MAT in a clinical setting can be a huge barrier to treatment.
"Therefore, having technical assistance to help with defining systems and approaches to implementation (of MAT) is critical to provide clinicians the ability to work with multidisciplinary teams to more effectively address their needs," she said.
"This is a great opportunity for us all to come together in medicine in the prevention, identification and treatment of opioid use disorders, but more importantly, all substance use disorders and co-occurring mental disorders to address this public health priority."
Family physicians interested in getting involved in their state's or territory's STR-TA team can start by completing a questionnaire about their experience, expertise and interests.
If family physicians would like to learn more about OUDs and training to become better educated on how to prevent, identify and treat these conditions, they can submit a request for assistance from the STR-TA teams.
Julie Wood, M.D., AAFP senior vice president of health of the public and interprofessional activities, told AAFP News that the Academy is pleased to partner with the AAAP as a part of the STR-TA Consortium.
"Family physicians are on the frontline of care and, given their ability to care for the individual and the entire family, can make a significant impact for those struggling with OUD," she said. "Participation in the STR-TA program will allow us to develop broader teams for comprehensive and compassionate care as we address this public health crisis together."
Related AAFP News Coverage
AAFP, Other Groups Issue Joint Principles on Opioid Crisis
Organizations Call for Congressional Action to Fight the Epidemic