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Ongoing Projects

Evaluating Healthcare Outcomes Among Adolescents with ADHD & Substance Use

Center on Addiction is conducting this study to help determine what treatment options for Attention-Deficit/Hyperactivity Disorder (ADHD) and co-occurring problems are best for which kinds of teens and families (considering ethnicity, gender, age, and if they are using substances or not). The study will also look to determine whether medication for ADHD provides a substantial boost for adolescents over and above the educational support and family counseling options they usually receive. Funding for the study comes from the Patient-Centered Outcomes Research Institute (PCORI), a non-profit organization that funds comparative clinical effectiveness research. The study was one of 46 proposals, selected from 490 applications, approved for funding.

Read grant press release.

Collaborative care for alcohol use disorders in the patient-centered medical home

Center on Addiction is working with Northwell Health to develop and test a collaborative care model to treat excessive drinking in primary care practices. Collaborative care models use a team of primary care practitioners, care managers, and specialists to monitor and treat behavioral health issues within primary care practices, instead of referring patients for care outside of the practice. This study will develop a collaborative care model for excessive alcohol use and provide preliminary evidence on its effectiveness, particularly compared to a screening, brief intervention, and referral to treatment model (SBIRT). This new model could transform the treatment for excessive drinking, particularly in light of the recent changes in the healthcare system.

Curricula for Health Care Providers

We are developing core curricular materials for physicians and other healthcare providers and will work with educators to help design the materials and integrate them into medical and professional school education.

LOCADTR: Digital Care Determination Tool

In collaboration with the New York State Office of Alcoholism and Substance Abuse Services (OASAS), Center on Addiction is designing, building and testing a digital tool that will aid substance abuse treatment providers to determine which treatment setting is best for a patient with a substance use disorder (commonly referred to as substance abuse and addiction). The LOCADTR—which stands for Level of Care for Alcohol and Drug Treatment Referral— is meant to ensure that all patients in need of treatment for a substance use disorder have access to care and are placed in the least restrictive, but most appropriate level of care available. In addition to helping providers and patients, the data collected by the tool will also be studied and analyzed to provide further insights into its effectiveness and allow for adjustments and updates to be made.  

More about LOCADTR.

Health Homes in New York

This 5-year study is evaluating New York’s health home program. It tests whether health homes improve quality of care, reduce inefficient health care and lower costs among the 120,000 individuals per year with addiction who are eligible for health homes in New York. Health homes are a federally funded Medicaid program in which all of an individual’s health care providers communicate with one another to coordinate care so that all of his or her needs are addressed in a comprehensive manner. The goal is to improve quality of care and reduce inefficient spending. Findings from this study will be useful as other states expand Medicaid coverage and use similar efforts for chronic conditions targeting the costliest and neediest populations.

Learn more about New York State health homes.

Improving HIV/AIDS Care

This 5-year research project in New York is investigating whether Health Homes and supportive housing for homeless persons living with HIV improves their adherence to HIV treatment, reduces their overall health costs and leads to an increase in viral suppression. For many HIV-positive persons, factors such as low income, lack of health insurance, homelessness, substance use disorders and mental illness can act as barriers to receiving quality health care. However, it is essential that HIV-positive persons undergo treatment to achieve viral suppression, which is reducing the function and replication of a virus. Undergoing treatment will also help lower the person’s risk of disease transmission. Health Homes can be a powerful tool to support Governor Andrew Cuomo’s plan to end the AIDS epidemic in New York State. Health Homes are an important provision within the Affordable Care Act that attempt to redesign the fragmented, crisis-driven and costly care received by the Medicaid enrollees. They have received funding to create health care networks that include medical, behavioral health, social service and case management programs.

Read more Governor Cuomo’s plan to end the AIDS epidemic in New York State.

Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-Trials)

Many teens involved in the juvenile justice system do not get the treatment they need for mental health or substance use problems. Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) is a 5-year study involving universities across seven states, Center on Addiction is part of a Columbia University team working with juvenile justice agencies to help improve the way they work with adolescents struggling with mental health or substance use issues. The study assesses the strengths of the juvenile justice agencies’ process for identifying mental health and substance use problems, getting teens into treatment, and helping them develop goals for improvement. The team also provides training on mental health and substance use-related topics and best practices, and training staff on the utilization of data to determine what works (and what doesn’t) in their agency’s procedures so they can make effective changes. Agencies work with an implementation facilitator who guides the staff in using what they’ve learned to improve their practices.

Core Elements of Family Therapy (CEFT) Project

Family therapy is widely supported by researchers in the field as an effective treatment for adolescent substance use and behavior problems. Clinical research demonstrates that several models of family therapy that use very specific steps, protocols and practices have better outcomes than other kinds of treatment. Center on Addiction’s Core Elements of Family Therapy (CEFT) project started in 2015 and attempts to distill the active ingredients of these models so as to enable community therapists to adopt effective, family therapy practices outside of a research setting in the real world. The CEFT project, which is funded by the National Institute on Drug Abuse (NIDA), will observe, identify and describe common, core, and fundamental family therapy techniques. The goal of the project is to garner a better understanding of effective family therapy for adolescent substance users and assess practical ways to implement and assure quality treatment.

Building Sustainable SBIRT in Integrated Hospital Systems in New York (NYSBIRT-II)

Center on Addiction, in partnership with the New York State Office of Alcoholism and Substance Abuse Services (OASAS) and Northwell Health, is working on a 5-year grant to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) into health care settings. SBIRT is an evidenced-based practice to identify and intervene with people who may be using substances in ways that increase their risk for physical health, mental health and other problems. Since the project started in 2013, SBIRT services have been implemented in eight health care sites, over 175,000 screens for risky substance use have been conducted and hundreds of individuals have been connected with treatment providers. The project included the development of a distance learning program for health care providers. To date, over 400 providers in New York have been trained. Over the next two years, we will be conducting an evaluation of the project, developing technology products to aid in implementation and maintenance of SBIRT, and providing guidance for expanding SBIRT services across New York State. We also will be working with other health systems across New York State to implement SBIRT services.

Managed Care Technical Assistance Center (MCTAC)

In response to New York State’s Medicaid Redesign initiative, the Office of Addiction and Substance Abuse Services (OASAS) and the Office of Mental Health (OMH), created the Managed Care Technical Assistance Center (MCTAC) to address the needs of their service providers transitioning to a Managed Care Medicaid reimbursement system. MCTAC is a partnership of Center on Addiction and New York University’s McSilver Institute, along with a number of participating organizations throughout the state. MCTAC provides training and intensive support on quality improvement strategies including business, organizational and clinical practices. Within MCTAC’s targeted training and guidance, Center on Addiction provides support for addiction-specific topics and leads the work on providing assistance for clinical operations and innovations specific to the addictions treatment system. MCTAC delivers in-person, video and web-based trainings as well as on-going learning communities and intensive workshops throughout New York State in order to maximize accessibility for providers.

Select Completed Projects

Integrated Family-Based Treatment of Co-Occurring Adolescent Substance Use Disorders (SUD) and ADHD

This National Institute on Drug Abuse (NIDA) grant includes components of behavioral intervention science, psychopharmacology and neuroimaging research related to adolescent substance use. This project has culminated in the development of two behavioral protocols aimed at treating adolescent substance users with co-occurring attention deficit hyperactivity disorder (ADHD):

  • Changing Academic Support in the Home for Adolescents with ADHD (CASH-AA): a family-based protocol designed to improve school performance that is derived from three evidence-based approaches for adolescent behavior problems: family psychoeducation, clinical family interventions to heighten adolescent and caregiver motivation to change, and training interventions for homework planning and organization skills. Download the PDF.
  • Medication Integration Protocol (MIP): A family-based protocol comprised of three evidence-based behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. Download the PDF.

CASALEAPSM (Learning Effective Approaches to Prevention)

CASALEAP looked at long-term outcomes of effective practices for adolescent substance use in the real world. The study evaluated treatment benefits and cost-effectiveness for adolescent substance use and related mental health problems in hospital-based behavioral health clinics, private addiction counseling clinics and community mental health centers.  Study analyses contrasted treatment effectiveness and fidelity demonstrated by therapists utilizing family therapy versus non-family approaches. Main findings indicate that both kinds of approaches demonstrated improvements in behavioral symptoms and delinquent acts. However, family therapy produced greater reductions in youth-reported behavioral symptoms among the whole sample, in delinquent acts among substance-using youth, and in alcohol and drug use among substance-using youth. The degree to which family therapy outperformed non-family treatment was consistent with effect sizes from controlled trials of manualized family therapy models.

Reported findings:

New York State Screening, Brief Intervention and Referral to Treatment (SBIRT)

This project works to implement screening, brief intervention and referral to treatment statewide. SBIRT is an evidence-based practice that modifies the substance use patterns of at-risk substance users and identifies individuals who need more extensive, specialized treatment. SBIRT is a comprehensive, integrated, public health approach that provides opportunities for early intervention before more severe consequences occur. Our role in this project is to recommend strategies for implementing SBIRT at sites primarily in Jefferson County and New York City. Center on Addiction is working with the New York State Office on Alcoholism and Substance Abuse Services (OASAS) on this project. We provide guidance to OASAS on evaluating SBIRT outcomes and offers technical support to a statewide policy advisory committee, which oversees a broader adoption of SBIRT throughout the state.

Download SBIRT guide

New Jersey Division of Addiction Services Grant

Center on Addiction conducted an extensive evaluation of an innovative program for disenfranchised, mostly opioid-dependent individuals not accessing treatment services. This program focused on improving access to treatment through use of mobile services and additional treatment supports. The program includes mobile medication vans and on-the-street outreach for high-need individuals. Additionally, the program included a pilot test of supportive housing for, mostly, women with families. Our evaluation found that the program increased treatment participation among the targeted population. In the context of the current increase in opioid use, this program helped greater numbers of those affected access care.

Download related report.

CASASARDSM II (Substance Abuse Research Demonstration)

This project was a comprehensive economic analysis of a state-run case management program for families with children on welfare. In conjunction with the state of New Jersey, it developed a state-of-the-art behavioral intervention for high-cost, high-needs clients. A potential taxpayer benefit included reducing the drain on publicly financed services, such as public welfare, emergency or crisis services, which was a focus of the analysis.

Download CASASARDSM report

CASACCARESM (Chronic Care Approaches to Recovery)

A joint initiative with the New York State Office on Alcoholism and Substance Abuse Services (OASAS), CASACCARE provided addiction treatment case management to the most costly users of Medicaid. Unlike the treatment for virtually any other health care problem, the overwhelming majority (about 75%) of treatment costs for addiction involving alcohol and other drugs are drawn from public funding. Our Center analyzed large sets of government addiction treatment and health care services data, using advanced statistical methods. Researchers then evaluated the effectiveness of the program—from both a health outcome and cost-benefit perspective. Researchers created evidence-based strategies for improving care. The study evaluated 1,760 individuals from 22 counties in New York State over a two-and-a-quarter-year period.

CASAHOPESM (Housing Opportunities Program Evaluation)

This project was an evaluation of a program that provides supportive housing to chronically homeless individuals with ongoing substance use. The CASAHOPE program documented best practices, evaluated 1-year outcomes and conducted a comprehensive cost-benefit analysis to see if supportive housing reduced costs related to extra city/state services used by homeless clients. Key findings of the NY/NY III supportive housing programs indicated that individuals who actively used drugs or alcohol could achieve housing, health and substance-use stability when housed without a precondition of addiction treatment attendance.

Download CASAHOPE I report
Download CASAHOPE II report (full report)
Download CASAHOPE II report (brief version)
Download CASAHOPE III report
Download CASAHOPE IV report

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