Collaborative, community-driven initiatives can help mitigate the impact of opioid misuse and overdose deaths, according to a research team that includes Brandy Henry, assistant professor of rehabilitation and human services and Social Science Research Institute cofunded faculty member at Penn State.
That finding, published in the journal BMJ Public Health, was concluded from data collected by the larger HEALing Communities Study (HCS). Launched in 2019 by the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration, HCS was the largest addiction prevention and treatment implementation study ever conducted in the United States. It spans the four states hit particularly hard by the opioid crisis — Kentucky, Massachusetts, New York and Ohio — covering 67 communities. The study’s primary objective was to evaluate the effectiveness of the Communities That HEAL intervention, which is an implementation intervention that uses community engagement to select and apply evidence-based practices across health care, justice and behavioral health settings to reduced opioid overdoses. For this paper, the research team examined how perspectives of community coalition members on opioid policies influence their ability to implement life-saving interventions.
"This paper describes perspectives of the community coalition members related to how opioid policies impacted their ability to deliver evidence-based practices," Henry explained. “By documenting these insights, the research contributes to a deeper understanding of how policies shape public health responses and offers recommendations for strengthening community-based efforts.”
Substance use services in the U.S. are often delivered through a fragmented network of agencies and organizations, Henry said, with limited coordination and data sharing. This lack of cohesion impedes continuity of care, she added, creating service gaps that can lead to poor health outcomes, including increased overdose rates.
According to Henry, community-based coalitions serve as a crucial link in bridging these gaps. By fostering collaboration among public health officials, health care providers and community organizations, she pointed out, coalitions create a more integrated and effective response to opioid addiction.
"Community-based coalitions bring service organizations together to establish a tighter network of care which can improve service access and continuity," Henry said.
To evaluate the effectiveness of these coalitions, Henry and her colleagues analyzed data from 304 coalition members through semi-structured interviews conducted between April and June 2021. The researchers identified key themes related to opioid policy challenges and coalition strategies for overcoming them.
The team found that community coalitions often face significant barriers when implementing substance use services. Chief among these challenges is a lack of understanding and knowledge among the coalition members about opioid-related policies within their communities. The researchers discovered that misconceptions about policy and perceived policy restrictions frequently hinder the ability of coalition members to enact meaningful change.
Despite these challenges, the study highlights the resilience of community coalitions and their ability to adapt. Participants reported employing several strategies to navigate and mitigate policy-related obstacles, including:
- Knowledge sharing: Coalitions facilitate the exchange of vital information among stakeholders, ensuring that all parties are well-informed about existing policies and best practices.
- Innovation: Many coalitions develop creative, community-specific approaches to implementing opioid interventions, even within restrictive policy environments.
- Policy advocacy: By engaging with policymakers and advocating for evidence-based policy reforms, coalitions work to create more supportive environments for opioid prevention and treatment.
These findings underscore the importance of equipping service providers with not only evidence-based interventions, according to Henry, but also the tools and information necessary to navigate the complex policy landscape that shapes how those interventions are implemented.
Historically, according to the researchers, many community-based coalitions emerged as grassroots initiatives aimed at fostering inter-agency collaboration. However, HCS introduced a top-down approach to coalition development, demonstrating how governmental strategies can actively support and sustain these efforts.
"Our research highlights how governmental policies could be used to encourage community coalition creation and financially support their activities to promote development and longevity," Henry said.
For policymakers and health care providers seeking to scale up community-driven opioid treatment programs, Henry said, the study offers valuable insights.
“It highlights the need for a dual approach — combining evidence-based interventions with policy navigation training — to give service providers the knowledge and skills to implement effective services within the landscape of existing policies,” she said.
Looking ahead, Henry said, further research is needed to refine and strengthen the role of community coalitions in opioid prevention and treatment. She emphasized the importance of bridging the gap between research and practice, noting that her work serves as a "boundary spanner" between the two worlds.
"The study highlights the importance of including policy training within a practitioner program like the rehabilitation and human services program at Penn State, so that students can understand how to navigate the policy context in which they will practice," she added.
Henry’s co-authors on the paper are Ramona Olvera, postdoctoral scholar at The Ohio State University Wexner Medical Center; Allyson G. Cogan, research project manager at Boston Medical Center; Mary Bartkus, research project manager at Boston Medical Center; Shoshana N. Benjamin, project administrator for the HEALing Communities Study at the Social Intervention Group; Jill Davis, post-doctorate clinical scholar at CATALYST, The Ohio State University College of Medicine; Lisa A. Frazier, senior researcher at the Battelle Center for Science, Engineering and Public Policy at The Ohio State University; Timothy Hunt, associate research scientist at Columbia University School of Social Work, associate director with the Social Intervention Group, the Global Health Research Center of Central Asia, and Columbia’s Center for Healing of Opioid and Other Substance Use Disorders-Enhancing Intervention, Development and Implementation; Elizabeth N. Kinnard, associate program officer-monitoring, evaluation, and learning at RIZE Massachusetts; Hallie Mattingly, implementation facilitator for HEALing Communities Study at University of Kentucky; Ann Scheck McAlearney, professor of family medicine at The Ohio State University; Dean Rivera, postdoctoral research scientist at the Columbia University School of Social Work; Mari-Lynn Drainoni, research professor in the Section of Infectious Diseases in the School of Medicine in the Chobanian and Avedisian School of Medicine and in the Department of Health Law, Policy & Management at the Boston University School of Public Health; and Daniel M. Walker, associate professor, vice chair for research in the Department of Family and Community Medicine at The Ohio State University.