1. Assess the data needed to design the program and collection method.

Opioid use disorder has become a growing concern in the United States. The Centers for Disease Control and Prevention have declared it a public health epidemic due to the rise in accidental overdose deaths from opioid use, particularly the increase of fentanyl and synthetic opioids (Langabeer, et al, 2020). Treatment for opioid use disorder through medication-based methods has been recommended, but many individuals with the disorder do not seek treatment voluntarily, even after an overdose. Cognitive theories suggest that patients who have survived an overdose may be more willing to engage in treatment if presented with options (Langabeer, et al, 2020; Curley, 2020).

Outreach programs involve deploying specialized teams to the homes of high-risk populations to motivate them to engage in treatment. Pilot studies have shown that peer outreach networks can improve the linking of individuals to treatment. Using data surveillance systems between hospitals and first responders can provide useful information to guide outreach efforts (Langabeer, et al, 2020; Curley, 2020). A study has been conducted in a major metropolitan city to pilot an intervention that combines outreach efforts guided by the hospital and first responder data to engage and retain patients in a treatment program. The objective is to find innovative ways to motivate individuals with opioid use disorder into treatment and improve access to healthcare services. The data needed to design the outreach program will be assessed, and a collection method will be established. The inclusion criteria for the program will focus on serving uninsured and underinsured low-income clients in Philadelphia. However, the city does not support another free clinic.

2. Summarize the steps in the process that will identify the priority needs of the program.

A program was established to provide outreach services to individuals in Philadelphia who struggle with opioid use disorder. The program is a non-profit that aims to serve uninsured and underinsured low-income clients who cannot access the necessary healthcare services. Despite objections from the city, the program is still in the design phase, with an interdisciplinary team leading the effort. The inclusion criteria for the program are centered around individuals who have recently experienced an opioid overdose and have not enrolled in any opioid use disorder treatment. Participants must be adults over 18 years old, able to speak/write English, motivated to begin treatment, and not incarcerated (Langabeer, et al, 2020).

Potential participants are identified through two sources, the emergency department of the local Hospital and the Philadelphia Fire Department emergency medical services. The program aims to reach those in the community who have experienced an overdose but may not have received treatment. Patients who overdose in the emergency department are approached by their treating physicians or on-duty research associates. Their readiness for change is assessed through a visual analog scale, and a minimum level of 3 has been established as a cutoff for lack of readiness. Participants who have consented and have been discharged from the emergency department are entered into the surveillance system for next-day home outreach (Langabeer, et al, 2020).

Patients who overdosed and were treated with naloxone (Narcan) were recorded in a surveillance system. An outreach team consisting of a peer recovery coach and a licensed paramedic was dispatched to their locations. The peer recovery coaches provided non-clinical support and were certified by the National Association of Alcoholism and Drug Abuse Counselors. At the same time, the paramedics were part of the agencys community paramedicine team (Langabeer, et al, 2020).

Outreach was performed directly to the individuals homes, where motivational interviewing techniques were used to screen, inform, and motivate them to choose treatment. Patients had to present themselves to the primary research office for all enrollment paperwork and a no-charge medical examination. The medical examination confirmed the diagnosis of OUD and obtained baseline clinical information such as vital signs and drug use history. All patients underwent the enrollment process, which included the medical examination and collection of data on demographics, contact information, and prior history of OUD treatment, family, and mental health (Langabeer, et al, 2020).

The team followed up on individuals regularly to monitor progress and provided them with information about local treatment programs, opioid use disorder, Naloxone reversal medication, and contact information. Participants provided signed informed consent forms before enrolling in the program. Enrolled individuals were rapidly inducted into the program using buprenorphine by emergency medicine physicians who were waivered by the 2000 Drug Addiction Treatment Act. The type of ongoing treatment was not limited to buprenorphine and could include any of the three approved medications. The physicians, who were part of the HEROES research team, provided same-day prescriptions to prevent a prolonged physical withdrawal period and increase the likelihood of success (Langabeer, et al, 2020).

The program offered free services, including weekly counseling sessions that included one-on-one meetings with addiction counselors, group counseling led by peer recovery coaches, and educational groups that discussed addiction and strategies for rcovery. Participants were encouraged to utilize these resources for support. After enrollment, research coordinators facilitated placement into an ongoing, outpatient-based MOUD treatment clinic. Patients and their outpatient providers decide which medication to use for ongoing treatment. The studys social worker assisted with linkage to care, and in case of delays, the physician would provide a bridge prescription to prevent withdrawal. The model for utilizing emergency medicine physicians to initiate MOUD was developed at Yale School of Medicine (Langabeer, et al, 2020).

In addition to the counseling and treatment services, a peer recovery specialist and social worker assisted participants in finding stable, free housing. The team helped find employment opportunities and provided financial literacy training for those without employment. The program was designed to support individuals in their journey to recovery and help them achieve stability and independence (Langabeer, et al, 2020).

The program aims to have a high engagement rate with patients, defined as their willingness to participate and attend the medical and behavioral treatment program and to have a high retention rate through the 30- and 90-day endpoints. The program will also measure the number of subsequent relapses and overdoses among enrolled patients. The data for engagement and retention will be collected through attendance records and follow-up evaluations. In contrast, data on relapse incidents will be collected through patients reports during interviews and phone surveys. The priorities of the outreach program are to increase patient engagement and retention in the medication and behavioral treatment program. This is done to ensure that patients receive the care they need and can stay in the program long enough to achieve their desired outcomes. Additionally, the program aims to reduce the number of subsequent relapses and overdoses among enrolled patients, as these incidents can seriously harm the health and well-being of those who struggle with opioid use disorder (Langabeer, et al, 2020).

3. Compare and contrast models that guide program development, select a model for this program, and support your decision.

Medication-assisted treatment...…aim is to find a balance between preventing opioid misuse and supporting patient needs for pain medications. Providers should advise patients about the adverse effects of opioids and screen for opioid use disorder. Policies can be enacted related to written instruction, such as the detailed labeling of opioids. One strategy to prevent opioid misuse is to require opioid manufacturers to fund continuing medical education for providers. These programs are voluntary and aim to increase knowledge about opioid use and prevent harm. Another approach is to expand access to treatment for opioid use disorder through the Affordable Care Act and Medicaid expansion. This will help individuals receive the necessary care and support to overcome their addiction (Hoffman, Ponce Terashima, & McCarty, 2019).

The outreach program should consider the limitations and consequences of opioid use and promote effective treatment options. The operational and support issues should be addressed through a comprehensive action plan (Hoffman, Ponce Terashima, & McCarty, 2019). The program should aim to be inclusive and meet each clients unique needs while also considering the citys stance on another free clinic.

6. Develop a program justification for stakeholders. Include well-defined expectations and value propositions.

The COVID-19 pandemic has had a far-reaching and profound impact on the lives of people who use opioids (PWUOs). The pandemic has added to an increase in overdose rates. It has exacerbated the existing challenges that PWUOs face, such as isolation, decreased access to treatment and harm reduction services, and increased comorbidities (Krawczyk, Fawole, Yang, & Tofighi, 2021).

Given the urgency of the challenges, access to treatment for opioid use disorder (OUD) must be improved. Medications for opioid use disorder (MOUD) and harm reduction services, such as naloxone administration and syringe services programs, have been proven effective in reducing overdose risk and improving health outcomes. MOUD, such as methadone and buprenorphine, can help PWUOs manage their opioid cravings and withdrawal symptoms. In contrast, harm reduction services can help prevent overdoses and the spread of blood-borne diseases (Krawczyk, Fawole, Yang, & Tofighi, 2021).

However, despite their proven effectiveness, these programs face several barriers that limit their impact. Strict regulations, inadequate funding, and stigma associated with substance use disorder are some major challenges preventing PWUOs from accessing these life-saving services (Krawczyk, Fawole, Yang, & Tofighi, 2021).

In light of this, the outreach program in Philadelphia must develop a strong program justification to win support from stakeholders and demonstrate its value proposition. This justification must highlight the pressing need for support for PWUOs, the effectiveness of MOUD and harm reduction services, and the benefits these programs can bring to the community. With a well-crafted program justification, the outreach program in Philadelphia can overcome these barriers and provide much-needed support to PWUOs during this difficult time. The COVID-19 pandemic has intensified the challenges faced by PWUOs, and improving access to OUD treatment, and harm reduction services are crucial in reducing overdose rates and improving health outcomes. The outreach program in Philadelphia must create a strong program justification to secure support from stakeholders and address the pressing needs of PWUOs (Krawczyk, Fawole, Yang, & Tofighi, 2021).

In conclusion, the COVID-19 pandemic has significantly affected the lives of people who use opioids (PWUOs), contributing to increased overdose rates and exacerbating existing challenges such as isolation, decreased access to treatment and harm reduction services, and increased comorbidities. Given the pressing need for support, improving access to OUD treatment is crucial. Medications for opioid use disorder (MOUD) and harm eduction services like naloxone administration and syringe services programs have…