In September 2012, the National Advisory Council on Drug Abuse Workgroup issued a report, Adoption of NIDA’s Evidence-Based Treatments in Real World Settings, in response to a November 2011 charge given by Nora Volkow, MD, Director of the National Institute on Drug Abuse (NIDA). Dr. Volkow asked that the Workgroup “(1) determine how effectively the treatment interventions developed, tested, and evaluated through NIDA’s extramural programs are being transferred and utilized in real world settings (e.g., community treatment centers, primary care settings, criminal justice settings, etc.), (2) explore barriers for moving from research findings to adoption as standard practice, and (3) consider whether and how the organization of NIDA could be best structured to meet these evolving scientific goals.”
The Workgroup found that wide-scale implementation and adoption of evidence-based interventions by community treatment programs remains deficient and that numerous barriers contribute to the paucity of both medical and behavioral treatments at the local level. The report specifically named the Clinical Trial Network (CTN) and its Blending Initiative as one of NIDA’s strategies for bringing together researchers and treatment providers by studying the effectiveness of select interventions in community-based treatment settings. The report cautioned, however, that dissemination activities had not been rigorously evaluated for impact on practices or expansion of implementation.
The Workgroup focused on the adoption of NIDA’s evidence-based treatments in its five recommendations; each recommendation is further illuminated with a rationale and action items:
“Create a new entity for translation and implementation science within NIDA to help bring its scientific findings on treatment efficacy into broad practice.
Establish NIDA guidelines for funding consideration of treatment development research projects that consider the potential for implementation, adoption, scalability, and sustainability in various practice settings.
Establish systems-based research networks within naturalistic settings to evaluate intervention effectiveness, adoption, and sustainability in practice.
Target funding to expand the grant portfolio for implementation science.
Establish a recurring NIDA-based peer review panel charged with evaluating research applications that focus specifically on advancing rapid adoption of evidence-based interventions.”
In summary, the Workgroup concluded that “if implemented, the recommendations in this report will expedite and advance NIDA’s efforts to increase the utilization of NIDA-supported treatments within the variety of settings and systems of care that provide treatment for substance use disorders.” In NC, as a part of the CTN, it is expected that participating community treatment programs will be involved in development, testing, and implementation of science-based protocols that have the potential to improve evidence-based treatments for substance use disorders.
North Carolina has been participating in NIDA’s Clinical Trial Network (CTN) since 2000. Coastal Horizons Center, Inc., in Wilmington; SouthLight, Inc., in Raleigh; and Triangle Residential Options for Substance Abusers, Inc., in Durham are community treatment programs or research sites for the Southern Consortium Node headed by Kathleen Brady, M.D., Ph.D. at the Medical University of South Carolina. Ashwin Patkar, M.D., Duke University is overseeing the CTN initiatives in North Carolina.