Social Work Practice In Addictions Research Articles

A social work perspective on the opioid solution: a community-based expansion of the hub-and-spoke ecosystem

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.

The Future of Social Work Practice in Addictions

Few social workers specialize in addictions practice. That number may grow in the years ahead due to demographic changes in the population, an expanding definition of addiction, and other factors. Social workers in all areas of practice see clients with addictions and their family members, but there is a large gap in the numbers who need treatment and receive it. The social work workforce of the future must be better equipped to develop and identify prevention and treatment services that are both appealing to clients and effective. These services may need to be offered in other setting where clients are seen. There is also much work to be done in the years ahead in the political environment to make treatment available and to see that individuals with addictions are treated fairly. Substantial research is being conducted on genetics and the brain chemistry of addiction. Psychosocial factors are also believed to play a substantial role in the development of addictions, thus ensuring social workers place in the addictions field in the years ahead.