Silwal Anita, Bohler Robert, Hunt Timothy, Olvera Ramona G, Lofwall Michelle R, Cook Christopher D, Marks Katherine R, Bridden Carly, Freeman Patricia R, Nouvong Monica, Fanucchi Laura C, El-Bassel Nabila, Frazier Lisa A, Walsh Sharon L, Talbert Jeffery C
School of Community Health Sciences, Counseling, and Counseling Psychology, Oklahoma State University, 441 Willard Hall, Stillwater, OK 74078, United States; Substance Use Priority Research Area (SUPRA), University of Kentucky, Lexington, KY, United States.
Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States; Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States.
Int J Drug Policy. 2025 Aug;142:104851. doi: 10.1016/j.drugpo.2025.104851. Epub 2025 May 22.
The HEALing (Helping to End Addiction Long-Term®) Communities Study (HCS) aimed to reduce opioid-involved overdose deaths across four states (Kentucky, Massachusetts, New York, and Ohio) via community-engaged implementation of three evidence-based practices (EBPs): (1) opioid overdose education and naloxone distribution, (2) medication for opioid use disorder expansion/linkage/retention, and (3) safer opioid prescribing and dispensing practices. A policy workgroup (PWG) was convened and developed a procedure to identify and address policies potentially impacting EBP implementation.
A five-step method was developed to identify, track, and respond to relevant policies at three of the research sites (Kentucky, Massachusetts, and New York) in collaboration with community partners and stakeholders. Policies possibly impacting EBPs were reported, reviewed, and documented, including any actions taken to address the policy issue. Policies were discussed with local, state, and federal level stakeholders in attempts to resolve barriers, clarify misunderstandings, and disseminate facilitators.
A total of 87 (Kentucky = 37; Massachusetts = 19; New York = 31) policies were identified and addressed; 42 were identified as barriers, 24 as facilitators, and 21 as misunderstandings. PWG efforts resolved over 73 % (n = 31) of policy barriers, clarified 90 % (n = 19) of policy misunderstandings, and disseminated 100 % (n = 24) of policy facilitators.
A community-driven approach in policy surveillance identified, addressed, and disseminated several different types of policy issues that could impact implementation of EBPs for opioid-involved overdose prevention. Many policy barriers persisted during the HCS study, which may have adversely affected study outcomes.
长期治愈成瘾（HEALing[帮助终结长期成瘾®]）社区研究（HCS）旨在通过社区参与实施三项循证实践（EBPs），减少四个州（肯塔基州、马萨诸塞州、纽约州和俄亥俄州）涉及阿片类药物的过量用药死亡：（1）阿片类药物过量用药教育及纳洛酮分发；（2）阿片类药物使用障碍治疗药物的扩大使用/联系/留存；（3）更安全的阿片类药物处方和配药实践。一个政策工作组（PWG）召开会议并制定了一个程序，以识别和解决可能影响循证实践实施的政策。
与社区合作伙伴和利益相关者合作，开发了一种五步方法，以识别、跟踪和应对三个研究地点（肯塔基州、马萨诸塞州和纽约州）的相关政策。报告、审查并记录了可能影响循证实践的政策，包括为解决政策问题所采取的任何行动。与地方、州和联邦层面的利益相关者讨论了政策，试图消除障碍、澄清误解并传播促进因素。
共识别并解决了87项政策（肯塔基州 = 37项；马萨诸塞州 = 19项；纽约州 = 31项）；42项被确定为障碍，24项为促进因素，21项为误解。政策工作组的努力解决了超过73%（n = 31）的政策障碍，澄清了90%（n = 19）的政策误解，并传播了100%（n = 24）的政策促进因素。
政策监测中采用的社区驱动方法识别、解决并传播了几种可能影响预防涉及阿片类药物过量用药的循证实践实施的不同类型政策问题。在长期治愈成瘾社区研究期间，许多政策障碍仍然存在，这可能对研究结果产生了不利影响。
