Casa Science Other Studies
Other Projects content
Changing Insurance Practice
Drawing on a broad set of key policy reports and successful strategies, CASAColumbia has begun to develop a strategy to encourage the insurance industry to cover a comprehensive range of critical services for addiction and risky use, prevention and treatment. This project will include engaging partners in the design of products (e.g., guides, white papers, digital presentations) and documenting the benefits (e.g., financial viability, return on investment, improved patient outcomes) of providing full coverage of evidence-based addiction prevention and treatment services.
Curricula for Medical Education
CASAColumbia is developing core curricular materials and competency requirements for physicians starting with undergraduate medical education, and will work with medical schools and educators to help design the materials and integrate them into routine medical education. CASAColumbia will then expand its work to address residency materials, curricula and competency requirements for other health care providers and continuing education.
Guide for States in Addressing Addiction and Risky Substance Use
CASAColumbia is developing a guide for state policymakers. This guide will identify:
- The costs to states of failure to effectively treat and manage addiction and prevent risky substance use
- The systems of state services where the costs are the highest
- Effective strategies for improving health and reducing costs in each area
- General tax, regulatory and enforcement policies that can be used to prevent risky use and assure treatment and management of addiction
Menthol White Paper
CASAColumbia is developing a white paper that will address the science of addiction involving nicotine and the role of menthol in increasing the risk of addiction, the prevalence and consequences of use of menthol products, the economic value to the tobacco industry of menthol products and the estimated health and economic effects of a ban on menthol. Menthol makes smoking more palatable and tobacco products with menthol are preferred by young smokers, female smokers and black smokers. There is reason to believe that menthol products hook smokers at a younger age, and increase the risk of addiction involving nicotine, as well as other substances. Despite calls from a scientific task force and others for the Food and Drug Administration (FDA) to ban menthol cigarettes, there has been little movement in this direction.
New Jersey Division of Addiction Services Grant
This project is made up of a groundbreaking set of programs designed to improve treatment access and recovery among disenfranchised, mostly opiate-dependent individuals who are not currently accessing treatment services. The programs include mobile medication vans, which provide on-the-street outreach. This unique approach seeks to establish treatment that better targets high-need individuals.
Developing Sustainable Screening
This project aims to develop more effective implementation of screening, brief intervention and referral to treatment within medical settings for the poor. Although there are well-established guidelines and recommendations for screening and referral in emergency departments, real-life implementation is a challenge because implementing new behavioral health interventions in medical settings is complex. CASAColumbia will develop and evaluate strategies based on best practices as well as science-based models that can be rolled out throughout the state. The project is a collaboration between CASAColumbia, the New York State Office on Alcoholism and Substance Abuse Services (OASAS) and the Department of Health (DOH).
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. CASAColumbia’s role in this project is to recommend strategies for implementing SBIRT at sites primarily in Jefferson County and New York City. CASAColumbia is working with the New York State Office on Alcoholism and Substance Abuse Services (OASAS) on this project. CASAColumbia provides 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.
Integrated Family-Based Treatment of Co-Occurring Adolescent Substance Use Disorders (SUD) and ADHD
This National Institute on Drug Abuse (NIDA) K02 grant includes components of behavioral intervention science, psychopharmacology and neuro-imaging research related to adolescent substance use. This project will culminate in the development of a family-based treatment model, specifically designed to treat adolescent substance users with co-occurring attention deficit hyperactivity disorder (ADHD).
CASAColumbia is developing a provider guide to assist practitioners in addressing addiction and risky use involving tobacco, alcohol and other drugs. The guide will contain practical, evidence-based information for screening, diagnostic evaluation, brief intervention, assessment and treatment. The guide is written for medical students, resident physicians and practicing physicians, but also can be useful to nurse practitioners, physician assistants and other health care professionals.
Workforce Needs for Addiction Medicine Specialists
In 2009, the American Board of Addiction Medicine (ABAM) estimated that 7,000 addiction medicine physicians will be needed by the year 2020, and that 5,000 new physicians must be trained in addiction medicine in order to meet this demand. However, this estimate is assumed to be low because it was based on limited assumptions and old data. CASAColumbia, in collaboration with addiction physician specialists, is updating this estimate using a more comprehensive methodology and recent data, and plans to submit the manuscript to a peer-reviewed journal for publication.
Select Completed Projects
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. CASAColumbia 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.
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 reduces costs related to extra city/state services used by homeless clients. Key findings of the NY/NY III supportive housing programs include results indicating 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.
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. Key findings included that sessions or therapy with community therapists, who implemented family therapy in routine clinical settings, led to reductions in adolescent substance use and psychological symptoms when compared to benchmarks established by research therapists in clinical trials.
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 looked to develop 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.