Illinois Opioid Remediation Advisory Board
Medical & Research Working Group Meeting
May 21, 2024
Virtual Meeting Held Via Zoom
Meeting Minutes
Medical and Research Working Group Members
Adrienne Adams, MD, Rosecrance (Chair)
Nicole Gastala, MD, IDHS, SUPR
Jessica Perillo, Health Management Associates
Katie Unthank, Egyptian Health Department
Michael Dennis, PhD, Lighthouse Research Institute, Chestnut Health Systems
Tamara Olt, MD, Broken No More, Jolt Foundation
Doug Smith, PhD, University of Illinois
Katherine Austman, MD, Gibson Area Hospital and Health Services
Katharine (Kitty) Juul, Southern Illinois University (SIU)
Lindsay Wilson, CDC Foundation
Michael Isaacson, Kane County Health Department
Dan Lustig, PsyD, MA, Haymarket Center
Leslie Wise, PhD, Illinois Department of Public Health (IDPH)
Lia Daniels, Illinois Hospital Association (IHA)
Brent Van Ham, Southern Illinois University School of Medicine
Geoff Bathje, PhD, Sana Healing Collective, Chicago Recovery Alliance
Welcome and Roll Call
Sue Pickett, PhD of Advocates for Human Potential, Inc. (AHP), facilitator, welcomed the group and conducted roll call. All members were present except for Nicole Gastala, Michael Dennis, Tamara Olt, Katharine Juul, and Dan Lustig. Michael Wahl represented Lia Daniels in her absence. Quorum was established.
Review and Approval of March 19, 2024 Meeting Minutes
Dr. Pickett called for a motion to approve the March meeting minutes. Dr. Wise made a motion to approve the March meeting minutes. Dr. Austman seconded the motion. All members present voted in favor of approving the minutes. The motion passed.
April IORAB Meeting Update
Two recommendations developed by the Medical & Research Working Group, opioid treatment programs (OTPs) and contingency management (CM), were approved by the IORAB. A third recommendation developed by the Workforce Development & Infrastructure Working Group was also approved. A working group member asked to see the final version of the CM recommendation as they heard the language did not clarify that CM does not need to be tied to abstinence. Interim Statewide Opioid Settlement Administrator (SOSA) Jim Wilkerson said the recommendation language will be reviewed. However, the information in the notice of funding opportunity (NOFO) is what is most important. The working group member volunteered to give input on the language.
IHA Letter and Proposed Recommendations
The working group discussed Illinois Health and Hospital Association's (IHA) letter and IHA's proposed recommendations:
- Mr. Wahl shared that Ms. Daniels developed the letter based on discussions with multiple behavioral health stakeholders in hospitals.
- Recommendations around CM; opioid use prevention and harm reduction education for youth, parents, educators, and staff; syringe service programs; and evidence-based data collection and research have been addressed through prior approved recommendations or recent legislation.
Priority Recommendations for the IORAB
Of IHA's proposed recommendations, two have not been addressed: 1) the development of innovative program interventions and implementation of evidence-based family support services and 2) recovery groups to enhance the development of teen-focused groups through financially supporting volunteer training, space rental, supporting volunteer time, and providing participant refreshments. The group discussed the following:
- There is a lack of resources for teen substance use. Families need tools to assist teens, and tools are needed to assist families. There is promising evidence on the Community Reinforcement Approach and Family Training (CRAFT) model. One trial demonstrated effectiveness for family members with a loved one who has opioid use disorder (OUD).
- There was a question about whether family support services could include individual work for couples or parents. Some adolescents use substances that their parents use and are thus available in their homes.
- Many Recovery-Oriented Systems of Care (ROSC) offer Smart Recovery. There is a school Smart Recovery group offered by Sauk Valley Voices of Recovery. Harm Reduction Works is a newer harm reduction-focused peer support group. Members expressed support for Smart Recovery, Harm Reduction Works, and a Smart Recovery friends and family program.
- Teens don't use 12-step programs as much as adults, and other peer supports are needed. Many teens don't identify with the word 'recovery'.
- Because there are relatively small numbers of youth with OUD who are geographically dispersed, NOFOs should encourage the use of online platforms for these models. It is also hard to fill an in-person group because of schedules, transportation, and family resources. Teens are often not engaged by online treatment and recovery services. Funds could support provider training to engage clients through online platforms. Mr. Wilkerson said that online engagement involves a different skill set, and the Opioid Training and Technical Assistance Center (OTTAC) could potentially provide this training. Training providers to engage clients online is also an important recommendation for rural areas.
- Online platforms could be used in schools. Schools are trying to get more involved in integrated care, and not all youth have high speed internet access. Dr. Pickett cautioned the group about developing a recommendation only for schools. Sometimes legislation is required to establish services and programs in schools.
- For some teens, in-person groups can trigger for substance use, because they find out where they can get substances. This is another reason to support online programs for teens.
- Libraries may provide private internet access for online support groups. Public health departments may be another location where programs for teens are offered. Mr. Wilkerson believes local public health departments would likely be interested in working with the group on this recommendation.
- Mr. Wilkerson noted that there aren't a lot of services for adolescents. He suggested the group consider a broader recommendation to develop a full system to support for adolescents, including Smart Recovery and a menu of other offerings. Members expressed support for a broader recommendation to support teens and their families. Many broader prevention programs are evidence-based, such as those with a focus on social emotional learning, mental health, relationships, and antibullying. These often have a bigger impact on prevention than those that focus on substance use.
- Programs that engage parents should be included in the recommendation, but there are barriers to parental participation. Data show that youth using opioids are often heavy polysubstance users and have many family risk factors. There is not much literature on evidence-based practices for teens with OUD; Jordan Davis is doing research on this topic. Most evidence-based practices are variations of the community reinforcement approach and adolescent version of the community reinforcement approach.
- Individuals may be located through ROSC grantees, as they work with clients that have teenaged children. Some may have substance use disorder (SUD) as a part of an intergenerational SUD pattern.
- A member asked if the working group could assist Lincoln's Challenge Academy, which requires youth to be stable, in updating their requirements. Dr. Pickett said working with organizations in this way is not a working group charge.
- Dr. Pickett said recovery high schools are an approved use of funds in the Allocation Agreement. A member asked about the research related to recovery high schools. Another member said the research is a quasi-experimental design with matched controls. The two top researchers in this area are Andrew Finch and Alexandre Laudet.
- Sober living homes for adolescents could be included in the recommendation.
- The group could determine the areas with highest adolescent OUD prevalence. A member said that while prevalence estimates from the Illinois Youth Survey may be somewhat underestimated, there aren't enough youth with OUD to warrant a grant to an agency.
- Dr. Pickett said she will start drafting a recommendation for the group to comment on. The recommendation will not be ready for the July IORAB meeting.
Public Participation
Dr. Adams welcomed public participants. A public participant said her team may have comments for the group. These can be sent to Dr. Pickett, who will provide them to the working group.
Adjourn
Dr. Adams called for a motion to adjourn the meeting. Dr. Wahl made a motion to adjourn the meeting. Dr. Austman seconded the motion. Dr. Adams adjourned the meeting. The next meeting of the Medical & Research Working Group will be held on July 16, 2024 from 12:00pm-1:00pm.
