Impact
Supporting site- and state-based grantees and subrecipients in the implementation of programs and services that reduce substance use and misuse
Objective
To support efforts within jurisdictions working to respond to substance use and misuse by providing access to prevention, harm reduction, treatment, and recovery supports in the community and justice system with the development and delivery of practitioner-centric training and technical assistance (TTA).
Approach
Providing individual and group TTA to Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) site- and state-based grantees; and creating products and resources focused on emerging issues and challenges.
Impact
Since 2019, RTI International has provided unique and tailored TTA to more than 70 COSSUP grantees implementing substance use programming across a variety of settings. RTI also creates an array of resources on relevant emerging topics for grantees and the field at large, including written publications, audio and visual materials, and in-person and virtual trainings or events.
Between 2000 and 2021, more than 1 million people in the United States older than age 14 died of a drug-involved overdose, according to data from the U.S. Centers for Disease Control and Prevention. The number of annual overdose deaths has increased fivefold since 2001, contributing to a declining national life expectancy. Over the past several decades, the landscape of the epidemic has evolved through three distinct phases, with the first phase predominately attributed to prescription opioids, the second to heroin, and the third to fentanyl and other synthetic opioids.
In 2016, the Comprehensive Addiction and Recovery Act (CARA) was passed to establish a comprehensive strategy for addressing the nation’s overdose epidemic through grant programs aimed at expanding prevention and education initiatives. As part of CARA, the Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) Training and Technical Assistance (TTA) Collaborative was developed to support grantees in implementing programs that focused on reducing overdose deaths and increasing access to and use of substance use prevention, harm reduction, treatment, and recovery support services.
Through COSSUP, state and local jurisdictions are awarded grants to amplify efforts to identify, respond to, treat, and support individuals with substance use disorders. Grantees are encouraged to work with local community partners, also known as subrecipients, to extend the impact of the funding.
As the overdose epidemic continues to grow and evolve, so too do the challenges that grantees face in planning and implementing services and programs. To help adapt to a changing landscape, RTI is partnering with the U.S. Department of Justice’s Bureau of Justice Assistance (BJA) and the COSSUP TTA Collaborative to provide tailored, evidence based TTA and expand outreach and dissemination within the COSSUP community and to the broader substance use research field.
RTI’s efforts in the COSSUP TTA Collaborative focus on the following:
- Pretrial, Prosecution, Defense Counsel, and Courts. Help local communities divert justice-involved persons with substance use disorders to community-based treatment, and develop or enhance programming and support services during the pretrial and court adjudication phases of justice processing.
- State-based. Facilitate strategic planning, and provide direct support to state agencies receiving grant funds under all COSSUP site-based solicitations and the local communities served by state COSSUP projects.
- Prevention, Youth, and Families. Support implementation of evidence-based prevention programs within schools and communities; and work to reduce risk factors and strengthen protective factors for children, youth, and families impacted by substance use.
Leveraging an Evidence-Based TTA Approach to Support Grantees
Across all TTA programs, RTI currently supports more than 70 COSSUP grantees with their own site-specific goals and unique challenges in the implementation of programs and services. To account for differences across grantees, RTI uses a TTA approach that includes an initial assessment, multimodal TTA delivery, program implementation support, and monitoring of progress toward objectives and goals.
As part of an initial assessment, each grantee is assigned a coach—a subject matter expert in substance use programming—who provides one-on-one support and ensures timely and responsive TTA. RTI site engagement teams have provided assistance across a variety of topics, including:
- Program implementation and evaluation
- Data collection, analysis, and visualization
- Barriers around stigma
- Multidisciplinary partnerships and data sharing
- Current overdose trends
- Best practices for translating research into practice
- Program sustainability
Each site engagement team also assists COSSUP grantees with tracking implementation tasks and collecting performance measurement data for submission to BJA’s Performance Management Tool and JustGrants.
In addition to individualized support, RTI facilitates three recurring practitioner learning communities where grantees can share their experiences, challenges, and successes with each other. The goal of these forums is to emphasize cross-agency partnerships and cross-state learning to develop sustainable and effective programs at the local level. They also help to identify emerging and persistent challenges among grantees, facilitate program improvements, and promote the dissemination of evidence-based programs and resources.
RTI also established a Naloxone Vending Machine Learning Collaborative focused on the use of naloxone vending machines in local correctional and community settings—such as jails, community centers, and bars—to address the growing concern of opioid overdoses. This initiative addressed various challenges, including identifying appropriate locations for naloxone vending machines, understanding the different types and features of the machines, and managing operational logistics.
Developing Tools and Resources to Address Grantee Knowledge Gaps
As new challenges, gaps, or emerging issues are identified, RTI develops products and resources across a variety of formats to meet the needs of COSSUP grantees, including written publications, audio and visual materials, and in-person and virtual trainings or events. These resources provide grantees and the community at large with best practices and recommendations that are practitioner-centric, achievable, and align with national recommendations.
Resources are housed on the COSSUP Resource Center, alongside those developed by other members of the TTA Collaborative. They cover a wide range of critical research topics, including:
- Effects of the overdose epidemic on children and families
- Data trends surrounding drug use
- Telehealth service provision
- Mobile treatment for opioid use disorder
- Information about harm reduction strategies
Since 2019, RTI has built knowledge and capacity for the field through the creation of more than 60 written products—including 40 publications and 24 newsletters—50 practitioner learning communities, 20 webinars, and 15 podcast episodes via the Just Science Podcast. RTI also developed the Telehealth Implementation Support Tool, which is intended for use by jail facilities to determine whether the needed protocols, policies, technologies, and staffing are in place to support telehealth.
