Journal Section Focuses on Implementing Evidence-Based Interventions for Substance Use Disorders
Although considerable research has been conducted to identify efficacious and effective psychosocial and pharmacological interventions for alcohol and other drug use disorders, the incorporation of evidence-based interventions into routine clinical practice has lagged. Implementing evidence-based practices is not easy. Many substance use disorders (SUD) treatment providers are committed to the treatment they offer because it has been associated with past recoveries. Moreover, organizational barriers (i.e., lack of time or resources for training in a new treatment) also may hinder implementation of evidence-based innovations. This article introduces a special section of Psychology of Addictive Behaviors, which provides an overview of conceptual frameworks for and research on the implementation of evidence-based practices and treatments for SUDs. The types of treatments that are examined range from brief interventions to psychological treatments and continuing care to pharmacological treatment. The settings in which treatments are implemented range from primary care to specialty SUD care settings.
The articles in this special section suggest that successful implementation in treatment programs and systems of care, such as VA, usually requires a multi-faceted approach that considers features of the implementation process and of the environmental contexts in which the evidence-based intervention is to be implemented. Guidance for this multi-faceted approach is provided in an article by Damschroder and Hagedorn that describes conceptual frameworks and important concepts for effective implementation. Several articles address specific types of evidence-based SUD interventions, as well as efforts made to implement them. For example, Williams and colleagues highlight the successes and challenges specific to implementing evidence-based care for unhealthy alcohol use in primary care settings – and offer recommendations for implementing alcohol screening and brief interventions. The final article by Sorensen and Kosten provides a more in-depth overview of the other six articles and discusses implications for future implementation research in the SUD treatment field. Overall, these articles provide a broad introduction to implementation concepts and how they have been applied to evidence-based SUD treatments and practices, particularly for readers not familiar with this research.
This special section was partly funded by HSR&D and VA/HSR&D Substance Use Disorders Quality Enhancement Research Initiative (SUD-QUERI). Drs. Finney and Hagedorn are both part of SUD-QUERI, as are many of the authors who contributed to this special section.
Finney J and Hagedorn H. Introduction to a Special Section on Implementing Evidence-Based Interventions for Substance Use Disorders. Psychology of Addictive Behaviors June 2011;25(2):191-93.
Finney J and Hagedorn H. Introduction to a Special Section on Implementing Evidence-Based Interventions for Substance Use Disorders. p. 191-193.
Damschroder L and Hagedorn H. A Guiding Framework and Approach for Implementation Research in Substance Use Disorders Treatment. p. 194-205.
Williams E, Johnson L, Lapham G, et al. Strategies to Implement Alcohol Screening and Brief Intervention in Primary Care Settings: A Structured Literature Review. p. 206-214.
Gordon A, Kavanaghm G, Krumm M, et al. Facilitators and Barriers in Implementing Buprenorphine in the Veterans Health Administration. p. 215-224.
Manuel J, Hagedorn H, and Finney J. Implementing Evidence-Based Psychosocial Treatment in Specialty Substance Use Disorder Care. p. 225-237.
Lash S, Timko C, Curran G, et al. Implementation of Evidence-Based Substance Use Disorder Continuing Care Interventions. p. 238-251.
Lehman W, Simpson D, Knight D, and Flynn P. Integration of Treatment Innovation Planning and Implementation: Strategic Process Models and Organizational Challenges. p. 252-261.
Sorensen J and Kosten T. Developing the Tools of Implementation Science in Substance Use Disorders Treatment: Applications of the Consolidated Framework for Implementation Research.