We propose to develop a low-cost, easily accessible, online training curriculum about buprenorphine treatment for outreach workers and case managers whose responsibilities include locating, motivating, educating, and/or referring to drug treatment youth and adults dependent upon heroin and other opiates. Increasing enrollment in treatment for heroin and other opioid dependency is critically needed. Recent estimates place the population of heroin and other opiate-dependent users in the U.S. at 980,000 -- the highest number since the late 1970's. These numbers have risen across all sociodemographic groups, and have doubled among youth. The abuse of prescribed opiates such as OxyContin(R) and Vicodin(R) has risen remarkably in recent years and the injection of heroin and other drugs (often in combination with heroin) continues to be associated with one-third of all new HIV cases and the majority of HCV cases in the U.S. Yet, only 20 percent of opiate-dependent drug users in need of treatment are actually enrolled in treatment. Fortunately, new legislation enacted in 2000 by Congress has dramatically changed the way opiate dependency can be treated in the U.S. The Drug Addiction Treatment Act permits qualified physicians to treat opiate dependency with drugs approved by the FDA. After nearly two decades of NIDA-sponsored research and clinical trials, a new drug, buprenorphine, was introduced in 2002. Medication-assisted treatment with buprenorphine holds the potential to revolutionize the treatment of opioid dependency by increasing access to and enrollment in drug treatment. However, in order to increase access and enrollment, it is necessary to address a number of barriers, including the knowledge gap regarding this new medication. While physicians and addiction professionals can easily access training online, no such training exists for outreach workers and case managers-- the frontline workers who are often the first contact with """"""""hard-to-reach"""""""" opiate dependent youth and adults (including many ethnic minorities). The online training curriculum will include relevant information on the use of buprenorphine for special populations (e.g. youth, HIV+ persons). In Phase I, we will: (1) develop the curriculum in a Computer Assisted Instruction (CAI) format;(2) create a self-directed and interactive prototype of two CAI modules;and (3) evaluate the computerized prototype of the two modules. The curriculum will be marketed to a broad range of profit and non-profit organizations and institutions.
This project promises to contribute greatly to public health by creating an on-line training curriculum on buprenorphine for outreach workers and case managers. These frontline workers are often the first contact with hard-to-reach opiate dependent youth and adults (including many ethnic minorities) and play a critical role in locating, educating, motivating and referring heroin and other opioid dependent youth and adults to drug treatment. Training these front-line workers will lead to increasing enrollment in medication-assisted treatment with buprenorphine for heroin and other opioid dependent youth and adults, including homeless youth and HIV+ adults.
