ATLAS Tool Facilitates Access to Evidence-Based Addiction Treatment

Recent data released by the CDC show that a record number of drug overdose deaths occurred in the United States last year, following a dip in 2018. In 2019, nearly 71,000 Americans died from overdosing on fentanyl, synthetic opioid, cocaine, and methamphetamine, and 30 states reported overdose death increases.

Experts believe the US opioid crisis is rooted in prescription opioid painkillers and that despite eased government restrictions for buprenorphine and methadone enabling recovery, the coronavirus disease 2019 (COVID-19) pandemic could be increasing demand because more people are experiencing despair and anxiety.

“The nation’s continuing increase in drug overdoses is fueling the evolution of a more dangerous and complicated epidemic,” a report released by the American Medical Association reads.

According to the Office of the Surgeon General, 1 in 7 people is expected to develop a substance use disorder at some point in their lives. In addition, of the 21 million Americans estimated to have suffered from a substance use disorder in 2017, only 4 million (19%) received treatment.

In 2017, HHS declared the opioid epidemic a public health emergency and announced a 5 point strategy to combat the crisis including: improved access to prevention, treatment, and recovery support services; targeting the availability and distribution of overdose-reversing drugs; strengthening public health data reporting and collection; supporting cutting-edge research on addiction and pain; and advancing the practice of pain management.

Over 14,500 specialized drug treatment facilities provide counseling behavioral therapy, medication, case management, and other types of services to persons with substance use disorders in the United States. But for many families, determining the best intervention or treatment for their loved ones can be a stressful and confusing endeavor. Navigating different types of therapeutic intervention, payment restrictions, and cost can add undue burden to an already difficult time.

To help improve access to and ease utilization of recovery support systems, Shatterproof, a nonprofit organization committed to reversing the addiction crisis, today launched an Addiction Treatment Locator, Assessment, and Standards Platform (ATLAS).

The tool, developed with RTI International, aims to connect those in need with high-quality addiction treatment through evaluating treatment facilities’ use of evidence-based best practices and allowing patients to provide feedback on their experiences via a free online interface. This way, patients will be able to search for and compare facilities based on location, services offered, and insurance provider.

“Starting today, families in 6 states looking for treatment for themselves or a loved one will be able to use this free, online platform to take a short anonymous assessment to receive a recommendation on the most appropriate level of care, and then locate treatment facilities that provide treatment based on the most recent science,” said Gary Mendell, founder and CEO of Shatterproof, during a livestreamed demo of the platform.

Mendell, who lost his son in 2011 to addiction, was inspired to start the organization after realizing the plethora of published research on best practices in the field of addiction treatment that were rarely implemented in real-world rehab centers. A 2012 report conducted by the National Center of Addiction and Substance Abuse at Columbia University echoed these concerns when it concluded, “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care,” The Washington Post reported.

“ATLAS is the first and only resource in our nation to offer the level of transparency and trustworthy information on the quality of care I needed as a parent, and my son needed as patient,” Mendell said.

ATLAS is currently available in Delaware, Louisiana, Massachusetts, New York, North Carolina, and West Virginia. The website, which is accessible on computers and mobile devices, lists all of the states’ addiction treatment facilities for any substance use disorder and offers individuals the option to provide anonymous reviews of the treatment they receive. The tool was funded in part by Arnold Ventures, the Robert Wood Johnson Foundation, and a coalition of healthcare companies including Aetna, Anthem, Cigna, and others.

Shatterproof plans to make secure access to ATLAS’ data available to state policy makers, providers, and insurance payers by the fall of 2020, in addition to increasing implementation in states across the country. Payers can thus assess the performance of providers, while policy makers can use the data to target policy change and distribute necessary resources to support facilities.

“In many cases, the lack of trustworthy, reliable information also perpetuates the stigma and misconceptions around [substance use disorder],” said Lipi Roy, MD, an internal medicine doctor, during the livestream. “We know that there are dedicated, evidence-based providers who want to help those with addiction recover and lead healthier lives, and who want to advance the quality of addiction treatment.”

The platform currently includes data contributions from more than 1200 addiction treatment facilities, 8600 patients, and several commercial insurers. All facilities listed on the platform have completed a survey as to what services they offer and what insurance they accept. Information received from facilities is vetted through a multiprocess validation and is updated every year, whereas data amassed from patient experience surveys are updated and monitored every 24 hours.

US Surgeon General Jerome Adams joined the livestream demo to endorse ATLAS and its mission. In 2018, the Office of the Surgeon General released its first public health advisory in 13 years, urging Americans to carry naloxone, a lifesaving medication which can reverse the effects of an opioid overdose.

“Addiction can happen to anyone of us and any one of our families,” Adams said, touching on his own experience helping a relative with substance abuse disorder, and highlighting the destructive power stigma has on those with the disease.

“I want to note, as an African American male, that in my experience stigma is particularly apparent in communities of color and in rural communities.…It’s no coincidence that these are the same communities that are the hardest hit in many cases by substance abuse issues,” Adams said. It is also not a coincidence that these same communities have also been hard hit by the COVID-19 pandemic, he continued.

“We know more than 30 states have reported increases in opioid-related mortality coincident with the COVID-19 epidemic,” Adams said, urging governors, legislators, and local policy makers to support safe access to high-quality addiction treatment programs.

Between January and April 2020, there was a roughly 11.4% year-over-year increase in overdose deaths in the United States, according to Politico. In Kentucky alone, overdose deaths increased by an estimated 25% between January and March.

However, STAT News reports that many states tight on cash have slashed budgets for opioid crisis programs in the wake of the pandemic. Colorado, Georgia, New Jersey, Florida, and Utah have already cut millions of dollars for future substance use disorder programs. The cuts come as treatment facilities struggle to comply with capacity reductions and social distancing requirements.

While addressing COVID-19 remains a top priority for many Americans, “we must not forget about the other health issues that not only exacerbate the virus but will also be exacerbated by the virus and will be present long after this pandemic ends,” Adams said.

As new COVID-19 cases continue to surge across the country, Adams implored individuals to wear face masks, practice regular hand hygiene, and maintain social distancing measures, to prevent prolonging of the pandemic. “[Masks] really are an instrument of freedom, because if enough people wear them, and practice…social distancing and practice good hygiene, then we can keep more places open, including substance use disorder, addiction, and treatment recovery programs,” Adams said.

“We’re facing an unprecedented challenge, fighting a global pandemic while continuing to expand access to life-changing and life-saving treatment to individuals fighting substance use disorders,” he concluded.