CHERISH Workshop Addresses an 'Unfortunate Reality' of the Addiction Treatment Industry

CHERISH Workshop Addresses an 'Unfortunate Reality' of the Addiction Treatment Industry

Gathering of National Experts Ponders How to Expand Adoption of Evidence-Based Methods
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Photos: Hoag Levins

Moderating a workshop panel on de-adopting low-value addiction care was Joshua Sharfstein, MD (inset), of Johns Hopkins University School of Public Health. Other panelists (l to r) were Katherine Hobbs Knutson, MD, MPH, Chief of Behavioral Health at Blue Cross and Blue Shield of North Carolina; Brendan Saloner, PhD, Assistant Professor in the Department of Health Policy and Management at Johns Hopkins School of Public Health; and Chinazo Cunningham, MD, MS, Professor and Associate Chief of the Division of Internal Medicine at Albert Einstein College of Medicine. The Achieving Value in Substance Use Disorder Treatment workshop was the latest gathering of national addiction treatment experts organized by the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV and HIV (CHERISH). (Click images for larger)

Funded by the National Institute on Drug Abuse and established in 2015, CHERISH is a five year collaboration of researchers from the Leonard Davis Institute of Health Economics (LDI) of the University of Pennsylvania, Weill Cornell Medical College, Boston Medical Center, and the University of Miami. Their work is focused on studying the health economics of substance use treatment as well as the treatment of Hepatitis C and HIV in that population.

This latest CHERISH workshop at the University of Pennsylvania was characterized by unusually lively and frank debates around the single most contentious issue in today's drug addiction treatment industry -- whether or not to include the use of agonist drugs such buprenorphine or methadone in the treatment.

Recapping a major workshop topic in an article published in News@JAMA, two of the workshop's key players -- former Maryland Secretary of Health and Mental Hygiene Joshua Sharfstein and Director of Penn Medicine's Center for Emergency Care Policy and Research, Zachary Meisel, wrote: "One of the unfortunate realities of the opioid epidemic is that some of the most heavily advertised services offering addiction treatment actually provide little in the way of evidence-based care and may actually increase the risk of fatal overdose."

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Taking notes at the workshop were (l to r) Julia Orchinik, MPH, Research Coordinator at the Penn Injury Science Center and Zachary Meisel, MD, MPH, MSHP, Co-Director of the Policy and Dissemination Core of CHERISH, and LDI Senior Fellow.
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The opening session featured Colleen Barry, PhD, MPP, Professor and Chair of the Department of Health Policy and Management at the Johns Hopkins University School of Public Health, Director of the Hopkins Center for Mental Health and Addiction Policy Research, and LDI Adjunct Senior Fellow. Her presentation reviewed the political and social environment that influences much of current treatment policy. Two points of interest were that only 49% of the U.S. public believes there is a treatment for opioid addiction that is effective long-term; 34% believe there is no long-lasting treatment for opioid addiction.

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Welcoming attendees to the event in the conference room of the Study at University City in Philadelphia was Rachel Werner, MD, PhD (above, left), Executive Director of LDI and Professor of both Health Care Management at Penn's Wharton School and Medicine at the Perelman School of Medicine. Above right, CHERISH Director and Professor of Healthcare Policy & Research at Weill Cornell Medical College Bruce Schackman, PhD, acknowledges a question from the audience.

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Moderating a panel on overcoming barriers to effective treatment was broadcast journalist Dan Gorenstein, the former Senior Health Care Reporter for NPR's Marketplace radio show. Other panel members were (l to r) Michael Botticelli, MEd, Executive Director of the Grayken Center for Addiction Medicine at Boston Medical Center and former Director of National Drug Control Policy in the Obama administration; Rebecca Boss, MA, Director of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals; Hilary Jacobs, LICSW, LADCI, President of the Beth Israel Lahey Health Behavioral Services and former Vice President for Addiction, Youth Residential and Educational Services at the same organization; and Alexander Walley, MD, MSc, Associate Professor of Medicine at Boston University School of Medicine and the Medical Director of the Massachusetts Department of Public Health Opioid Overdose Prevention Program.

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Keeping the workshop schedule on track was Zachary Meisel (above, left). Making a point from his long years of experience is Roland Lamb, Deputy Commissioner of the Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS).

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Discussing how payment and reimbursement models play into the picture of encouraging wider use of evidence-based treatment methods is Kathleen Noonan (above, left), JD, Chief Executive Officer of the Camden Coalition of Healthcare Providers and LDI Adjunct Senior Fellow. Noonan is former Co-Director of PolicyLab at the Children's Hospital of Philadelphia (CHOP). Above, right, one of many audience members who took part in the debate was LDI Senior Fellow Molly Candon, PhD, Research Assistant Professor of Psychiatry at the Perelman School of Medicine.

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An innovation tournament-like session challenged table teams to come up with new ideas for advancing the use of evidence-based methods throughout the addiction treatment industry. The discussions were enthusiastic and passionate. Engaged, above left, are (l to r) Colleen LaBelle, MSN, RN, BC, CARN, of Boston University School of Medicine Clinical Addiction Research & Education (CARE) Unit; Jeffrey Samet, MD, MA, MPH, Chief of General Internal Medicine at Boston Medical Center and Vice Chair for Public Health in its Department of Medicine; and Marilyn Schapira, MD, MPH, Professor of Medicine at Philadelphia's Crescenz VA Medical Center and LDI Senior Fellow. Above, right, are (l to r) Alexander Walley, MD, MSc; Corey Coleman, MBA, Vice President for External Affairs for the UnitedHealthcare Community Plan of Pennsylvania; Bruce Schackman, CHERISH Director; and Yuhua Bao, PhD, Associate Professor at Weill Cornell Medicine Graduate School of Medical Sciences.

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Gathering for a group photo is the CHERISH team (top row): Daniel Polsky, PhD, MPP, Professor of Health Economics at the Johns Hopkins University Bloomberg School of Public Health; Joshua Sharfstein; Zachary Meisel; Brandon Aden, MD, MPH, Assistant Professor at Weill Cornell Medicine; Bruce Schackman; and Jeffrey Samet. (Seated) Jared Leff, MS, Research Manager in the Department of Healthcare Policy & Research at Weill Cornell Medicine; Yuhua Bao; Janet Weiner, PhD, MPH, Co-Director for Health Policy, LDI; Sean Murphy, PhD, Associate Professor of Research, Weill Cornell Medical College; Caroline Savitzky, MSW, Program Manager in the Section of Infectious Diseases at Boston Medical Center; and Sarah Gutkind, MSPH, Research Coordinator in the Department of Healthcare Policy & Research at Weill Cornell Medicine.