Latest round of Opioid Innovation Fund grants will bring more resources to Ohio communities

May 24, 2019

In its second annual round of funding, Ohio State’s Opioid Innovation Fund has awarded eight multidisciplinary teams a total of nearly $500,000 for prevention, treatment and recovery projects designed to mitigate the crisis racking Ohio and the nation.

The two largest grants, $100,000 each, reflect the diversity of the proposals. One will review five years of death records to identify characteristics that mark certain populations as having a heightened risk of dying from drug overdose. The other proposal supports young children of opioid users through a reading intervention program.

Researchers involved in the project to identify at-risk populations will work with counties in northeast Ohio to coordinate community response plans to prevent opioid deaths. “By using traditional public health data in innovative ways, the project will help community organizations to align strategies and rapidly respond to risk,” said Andrew Wapner, the director of the Center for Public Health Practice and the leader of the research team.

The reading intervention program will support young children who are now being cared for by grandparents, family, friends or neighbors.

“Doing this work through a partnership with OIF provides many supports to facilitate the success of our project and ensure that the intervention, if proven efficacious, can be rolled out to families at the local and national level,” said Kelly Boone, who leads the reading intervention study and serves as associate director of research at the Crane Center for Early Childhood Research and Policy.

The six other winning proposals in this year’s round of funding were each awarded grants of approximately $50,000. The projects will:

  • Develop easy screening tools to identify infants born with neonatal abstinence syndrome so they can be quickly referred to developmental specialists. NAS is a group of withdrawal problems experienced by newborns exposed to narcotics in the womb.
  • Investigate the effects and potential risks of drug interactions that can result when patients being treated with medications for opioid use are also taking prescriptions to treat chronic health conditions.
  • Study whether families would be more likely to get rid of leftover opioids prescribed to their children if provided with a drug-disposal bag.
  • Develop a curriculum to foster greater empathy in emergency department physicians who treat patients at risk for opioid abuse.
  • Evaluate the effectiveness of Sudarshan Kriya yoga — a type of cyclical controlled breathing practice — as a supplemental intervention for people who experience psychological disorders and are being treated with medications for opioid use.
  • Investigate whether financial coaching for recovering opioid users can reduce risks that can lead to discontinuing treatment and relapse.

“Because of the scope of the university’s disciplines and resources, and because of the partnerships we’ve formed over the years throughout the state, we are well suited to attack the many problems associated with addiction,” said William J. Martin, dean of the College of Public Health, which administers the fund. “The Opioid Innovation Fund connects creative minds to help us do that and squarely aligns with our land grant mission.”

Created by Executive Vice President and Provost Bruce A. McPheron in October 2017, the fund has distributed nearly $1 million to 16 teams over two rounds. Projects serve one of two goals: to develop products that community partners can use right away or to answer research questions that inform the scientific community, practitioners and policymakers.

According to the most recent statistics from the Centers for Disease Control and Prevention, 4,293 Ohioans died from opioid-related overdoses in 2017. That breaks down to 39.2 opioid-related overdose deaths per 100,000 people, a rate that is second only to West Virginia.

The Wexner Medical Center, Ohio State Extension and colleges throughout the university are all involved in addressing the substance abuse and the opioid crisis.

Last month, the National Institutes of Health awarded a $65.9 million grant to Ohio State to lead a statewide consortium charged with reducing opioid overdose deaths by 40% over three years. The award for HEALing Communities Study is the university’s largest research grant ever.

Grant Summaries

Amount

$100,000

Authors

Abstract

Unintentional drug overdose is the leading cause of injury-related death in Ohio, and the state has the fourth highest drug overdose death rate in the nation. Similar to statewide trends, Lake County has experienced a number of resident drug-related overdose deaths, with 329 drug-related overdose deaths occurring amongst Lake County residents between 2013 and 2017. Despite a variety of county-specific efforts, overdose deaths continue to increase. This proposal aims to enhance and disseminate two specific elements of Lake County’s response: sociodemographic risk profiling and community response planning. Lake County General Health District’s Office of Health Policy and Performance Improvement, in conjunction with the Ohio State University’s Center for Public Health Practice, propose the application of a county-specific drug overdose death profiling methodology, based upon a five-year compilation of vital statistics data, to generate community risk profiles across a 16-county region in Northeast Ohio. County-by- county comparisons of drug overdose decedents, and the incorporation of geospatial analysis tools and visual aids to assist in dissemination, will provide for a targeted, informative, and generalizable drug-related overdose prevention data. These profiles will identify county-specific socio-demographic characteristics associated with drug-related overdose death and inform multidisciplinary response planning. Teams from each county will be led through a tested process in multidistrict strategic planning to integrate this data into community response plans targeting the identified population with evidence-based harm reduction strategies. Plan implementation progress and qualitative data collection will assess understanding and use of the new data, success in resource allocation, and overall impact.

Amount

$99,998

Authors

Abstract

Parental substance use is the second leading cause of foster care placement. As a result, nearly 100,000 Ohio grandparents, family, friends, and neighbors are providing kinship care for children. Kinship caregivers are more likely to be of lower socioeconomic status, report less warmth and respect in their parenting attitudes, and exhibit higher levels of caregiver-child conflict, relative to traditional foster parents. These characteristics, in addition to the trauma associated with exposure to parental drug use, contribute to a significant risk for reading difficulties and lower overall academic achievement for affected children. The objective is to pilot an evidence-based reading intervention in a group of kinship caregivers and children affected by parental opioid use. This work is significant because we aim to improve reading outcomes of children who may otherwise experience substantial difficulty with reading development, and to support kinship caregivers who may otherwise have few resources to promote the reading skills of children placed in their care. Our approach will use a randomized (1:1) waitlist controlled trial design to examine the effects of a 15-week kinship caregiver-implemented Sit Together and Read (STAR) intervention for 4-5 year old children being raised by kin as a result of parental opioid use. Experimental work consistently shows positive effects of STAR on the reading skills of at-risk children in the short- and long-term. The rationale is that once the feasibility and effectiveness of STAR is established in this population, we will be poised to pursue funding to implement the intervention on a larger scale.

Amount

$50,000

Authors

Abstract

Primary care providers and community health organizations often lack the knowledge and resources needed to ensure appropriate follow-up of infants with a history of neonatal abstinence syndrome (NAS) with developmental problems. Our overarching goal is to improve neurodevelopment for these infants and children by developing tools to facilitate screening and referral to developmental specialists and local resources in a timely, evidence-based, and specific manner.

Amount

$50,000

Authors

Abstract

To improve emergency department (ED) care for patients at risk for opioid abuse by developing a new curriculum (EMPATH) that cultivates emergency physician behavioral empathy, enhances patient-centered communication skills and promotes ED practice improvement: The EMPATH Curriculum Development Project. This planning proposal will produce a robust educational product enhancing the care of patients seen in Ohio State University (OSU) EDs. Its completion will lead to a future implementation project delivering EMPATH to EDs throughout Ohio. Future dissemination will occur in collaboration with the Ohio American College of Emergency Physicians and will leverage EMPainline, our team’s 2015 web-based program promoting prescription drug monitoring and opioid storage and disposal.

Amount

$50,000

Authors

Abstract

Ohio is facing an opioid epidemic with a significant increase in opioid related deaths in the past five years. Rates of psychological comorbidity and opioid addiction have been estimated to be as high as 65% of patients with opioid use disorder (OUD). While Medication Assisted Therapy (MAT) is the treatment of choice, its efficacy is limited in individuals with psychological comorbidity. There is a need for innovative adjunctive therapies to address this issue. Sudarshan Kriya Yoga (SKY) program, a standardized, instruction manual based mind-body intervention has shown clinical benefits in opioid, alcohol and tobacco addiction, psychological disorders and stress management. However, SKY has only just begun to be studied in individuals living with OUD and psychological comorbidities. SKY differs from mindfulness and other meditation processes in that it is a more physiological rather than cognitive process. It involves controlled breathing techniques that can be easily mastered, and do not require mental effort. With support from Center for Clinical and Translational Science, we recently completed a feasibility study on SKY as an adjunctive intervention for people with comorbidity (OUD on MAT and with psychological disorders). This program was well-received both by participants and the partner organization (Signature Health). Seven out of eight participants successfully completed the study and the preliminary effects on a variety of psychological parameters are currently being analyzed. Our goal for this project is to conduct a randomized control trial to evaluate the efficacy of the SKY program in improving depression in people living with opioid use disorder. As secondary outcomes, we will also examine for effects on anxiety, stress and opioid addiction severity. The study will be conducted at the Maryhaven clinic in Ohio. The efficacy of SKY will be measured using a mixed methods study comprising of qualitative measures and quantitative psychometric tests.

Amount

$49,531

Authors

Lang Li, team lead, lang.li@osumc.edu / 614-685-4685

Pengyue Zhang, pengyue.zhang@osumc.edu / 614-293-6140

Abstract

Currently, over half million opioid use disorder (OUD) patients receive methadone and/or buprenorphine through medication-assisted treatment (MAT). While these patients receive the benefit of MAT, they are often co-prescribed with other medications to treat chronic conditions. Therefore, some of these patients are subject to increased risks of opioid adverse drug events (ADEs) including opioid overdose/poisoning, opioid adverse effects (e.g. opioid-induced psychotic disorder, sexual dysfunction, and sleep disorder etc.), cardiac arrest, and sudden death, which may due to drug-drug interaction (DDI). Knowledge for DDI involving methadone and buprenorphine, with respect to both pharmaco-epidemiology and pharmacology, is still insufficient. In order to allow OUD patients receive the benefit of MAT, and prevent unnecessary ADEs, evidence based learning of DDI involving methadone and buprenorphine is of urgent need to address the challenges in clinical practice. In this grant application, we aim to address the aforementioned challenge by investigating the DDIs involving methadone and buprenorphine with respect to their pharmacology mechanism and clinical consequence. Specifically, in aim 1, we investigate the pharmacology of DDI involving methadone and buprenorphine. We utilize physiologically-based pharmacokinetic (PBPK) model to compute the area under the concentration-time curves (AUCs) of methadone and buprenorphine, and methadone and buprenorphine with co-prescribed medication(s). DDIs that increase exposure of methadone and buprenorphine will be predicted by using the AUC ratio (AUCR). In aim 2, we investigate the clinical consequence of DDI involving methadone and buprenorphine. The analysis will be performed on a health insurance claims data including 90 million people from 2012 to 2017 which is named as the MarketScan database. We conduct high-throughput pharmaco-epidemiologic screening to identify DDIs involving methadone and buprenorphine that increased the risks of opioid overdose/poisoning, opioid ADEs, and cardiovascular ADEs.

Amount

$49,391

Authors

Abstract

The financial resources needed to obtain and complete recommended treatment for opioid addiction are a critical public health problem, and a better understanding of the pathways linking opioid users’ personal financial security with successful treatment outcomes is needed. We propose to investigate the treatment-relevant impact of a prevalent but understudied factor – the economic situation of individuals recovering from opioid use disorders and their families – in a pilot study that blends a personalized financial coaching intervention with an assessment of the financial situation of patients and their families at treatment facilities across the state of Ohio. Our project is novel in three ways: First, we build on our expertise in financial coaching, and we leverage our existing relationships with treatment facilities in 10 Ohio counties to test financial coaching as a means of increasing treatment adherence and completion. Second, we adapt a recent, innovative financial coaching program to fit individuals recovering from opioid use disorders and their holistic financial needs by bringing together medical, rehabilitation, and financial expertise. Third, we employ a novel, longer-term approach to coaching for patients whose needs are particularly pressing because their earnings potential is severely compromised during peak wage-earning years. By pinpointing financial challenges that place individuals at greater risk for discontinuing treatment, and to relapse, and by unpacking the patients and their families’ financial circumstances in the context of different treatment environments, we lay the groundwork for the design of targeted, yet scalable and impactful financial support services.

Amount

$41,618

Authors

Jennifer Cooper, team lead, jennifer.cooper@nationwidechildrens.org / 614-355-4526

Katherine Deans, katherine.deans@nationwidechildrens.org / 614-722-2945

Sonya Sebastian, sonya.sebastian@nationwidechildrens.org / 614-722-2455

Jessica Fischer, jessica.fischer@nationwidechildrens.org / 614-722-2181

Abstract

Opioids are an important component of acute pain management in children with severe injuries or who are recovering from surgery. They are also an important component of pain management in children with conditions involving chronic or recurrent pain such as sickle cell disease and juvenile arthritis. However, opioids are often prescribed in excess1-3 and rarely disposed of appropriately2,4,5. The lack of prompt and proper disposal of leftover opioids prescribed to children contributes to the opioid crisis in Ohio by placing young children at risk of accidental ingestion of these drugs and by facilitating the diversion of opioids for non-medical use. We propose to reduce the burden of the opioid crisis in Ohio by implementing an evidence-based strategy to increase opioid disposal by families of children served by Nationwide Children’s Hospital’s (NCH) three outpatient pharmacies. We recently completed a randomized controlled trial evaluating whether providing a Deterra® drug disposal bag6 to the families of children undergoing outpatient otolaryngologic or urologic surgery at NCH increased their rate of opioid disposal. In that trial, 85% of families randomized to receive a disposal bag reported properly disposing of their child’s opioids whereas only 68% of parents who did not receive a disposal bag reported proper opioid disposal. We now propose to study the impact of providing Deterra bags on the rate of opioid disposal among all families filling opioid prescriptions at NCH. The proposed study will provide evidence for the effectiveness of this intervention among all pediatric and young adult patients prescribed opioids.