Drug overdose deaths and morbidity from substance use disorder continue to rise despite the fall in opioid prescriptions and the increase in evidence-based screening and use of effective medications for opioid use disorder. In particular, polysubstance use and stimulant use disorders such as cocaine and methamphetamine have steadily increased over the past few years. The continuing rise in the number of patients with substance use disorder places a particular burden on clinicians in ambulatory care settings who need to manage patients’ substance use disorder in the context of other chronic conditions. Furthermore, the recent COVID-19 pandemic has highlighted the fact that the root causes and contributors to substance use disorder have not been adequately addressed and have exacerbated existing disparities in substance use disorder screening and treatment.
The purpose of this Special Emphasis Notice (SEN) is to inform the research community that the Agency for Healthcare Research and Quality is interested in receiving health services research grant applications to advance our nation's understanding of the substance use disorder crisis and provide solutions for addressing it.
In this SEN, AHRQ is interested in health services research to prevent, identify and treat substance use disorders with a high degree of interest in applications that respond to the following three specific areas of focus:
1. Dissemination and implementation of evidence-based, non-pharmacological and behavioral interventions that can treat multiple substances or polysubstance use in ambulatory care and primary care settings, with a particular interest in substances for which pharmacological treatments are not available.
2. Development and testing of healthcare services interventions in primary care and ambulatory care settings to address substance use disorder that consider the social, environmental, economic and psychological factors that contribute to substance use disorder. Examples include care coordination, integration of substance use services in ambulatory care settings, or integration of population health approaches with primary care. Applications that take advantage of the natural experiment caused by the COVID-19 pandemic to examine how changes in service delivery (such as expanded use of telehealth) affect access to care, quality of care, and health inequities are particularly welcome.
3. Understanding and addressing the effect of substance use disorder on whole person health and the development and/or management of other chronic conditions.
AHRQ is especially interested in health services research applications that addressing the following priorities:
- Reducing disparities for racial/ethnic minorities, children and adolescents, women, older adults, low-income communities and rural populations
- Addressing the needs of people with multiple chronic conditions and addressing substance use disorders in the context of whole person health
- Improving healthcare quality, health behaviors, shared decision making and patient experiences