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Oregon researchers discover significant gaps in state’s substance use disorder services

Findings show a 49% gap in select services for substance use disorder prevention, harm reduction, treatment and recovery
People talking in an office with a counselor.
Counseling is one effective option for substance use disorders. (Getty Images)

OHSU-PSU School of Public Health researchers collaborated with the Oregon Health Authority and the Oregon Alcohol and Drug Policy Commission to lead an unprecedented study that inventoried and analyzed the gaps in select services for substance use disorder prevention, harm reduction, and treatment and recovery, bringing health equity issues to the forefront in Oregon.

The data shows the state would need to double its services to adequately address the current health needs of Oregonians struggling with addiction and also highlights significant gaps in healthy equity, including access to services and availability of culturally relevant care.

Oregon ranks sixth in the nation for deaths due to alcohol and second in the nation for deaths due to drug use. The gap analysis was led by Elizabeth Needham Waddell, associate professor in the OHSU-PSU School of Public Health.

“This research was a response to the urgent call for population-level estimates of need and service capacity described in the ADPC’s 2020-2025 Oregon Statewide Strategic Plan,” Waddell says.

“This report is a critical first step toward documenting currently available services, identifying the need for substance use disorder prevention, harm reduction, treatment, and recovery services across the state, while assessing gaps in services at the state, regional, and county levels,” says Katie Lenahan, author of the report and research project manager in Waddell’s group in the OHSU-PSU School of Public Health. “Although this research shows the disparities in our current system, we hope our recommendations, based on our research, will ignite a path forward for all Oregonians.”

The OHSU-PSU research team highlight three significant needs across Oregon’s continuum of care:

● There is a 49% gap in substance use disorder services needed by Oregonians – substantial need for services persist statewide across substance-use disorder continuum of care, including prevention, harm reduction, treatment and recovery services.

● Most substance use disorder service providers lack capacity to meet demand for services.

● Statewide gaps in equity and access include insufficient provision of culturally relevant services to protected classes, language interpretation and translation services, and a workforce that does not represent the demographics of the state.

The team employed two main research methods for this report: the Calculating for Adequate System Tool (CAST), developed by Dr. Brandon Green and the Substance Abuse and Mental Health Services Administration, and a substance use disorder services survey, developed by Lenahan and the OHSU-PSU research team. CAST provided estimated gaps in services across select categories, and the survey added additional data to address gaps in health equity as well as challenges to accessing adequate care.

This first-of-its-kind analysis will serve as a baseline for OHA and ADPC moving forward.

“The inventory and gap analysis are a companion document to the strategic plan helping determine the current state of SUD continuum of care and future state. Without this information it is impossible to build the right size system,” says Reginald C. Richardson, Ph.D., executive director of the Alcohol and Drug Policy Commission.

This analysis demonstrates the urgent need for an increase in the number of services and assure access to Oregonians, while expanding the workforce to meet the needs.

“We hope these findings will reinforce the need to build a sustainable infrastructure for SUD services across the lifespan of the patient and continuum of care," says Lenahan.

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