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The Power of Team Science in the HEALing Communities Study

March 21, 2025
The Power of Team Science in the HEALing Communities Study

In This Article: 

 

Introduction

Last month, esteemed members of the Columbia School of Social Work (CSSW) community had the privilege of participating in the first three sessions of “Groundbreaking Research in Addiction and Community Engagement: The Power of Team Science in the HEALing Communities Study.” Moderated by Maia Szalavitz, New York Times neuroscience journalist, and Erik Carl Fisher, addiction psychiatrist and writer, the day was broken up into six total sessions to present the intricate and groundbreaking work of the HEALing Communities Study (HCS). Opening remarks began with Dr. Nabila El-Bassel, director of the Social Intervention Group (SIG) at CSSW and principal investigator of the HCS. 

“In the U.S., people are more likely to die from a drug overdose than from gun violence and car accidents,” said Dr. El-Bassel. “In 2023, more than 100,000 people died from a drug overdose – 67% of those deaths were attributed to opioids.” She went on to express her deep gratitude for those with lived experience and thanked her many colleagues that helped bring the study to fruition. Dr. El-Bassel closed with a quote from Jane Addams, a pioneer in the development of the social work profession: “research conducted in isolation, without sincere community involvement, fails to create lasting and meaningful change.”

“This epidemic does not discriminate,” said Dean Melissa Begg following Dr. El-Bassel’s preliminary speech. “It’s a public health crisis that demands, and requires, all of our collective efforts to fix it.” 

Dr. Ann Sullivan, Commissioner of the New York Office of Mental Health, wrapped up the opening remarks by stressing the importance of mental health as it relates to addiction. “I think it speaks to the ways in which this study looks at the whole person,” she said. 

Session 1: HEALing Communities Study: A Groundbreaking Approach to Tackling the Opioid Crisis

To kick off the first session, audience members heard from Scott Walters, HCS steering committee chair and regents professor of population and community health at the University of North Texas Health Science Center. “From my heart, it has been the honor of my career to serve as steering committee chair for the last five years.” 

Panelists discussed the primary outcome of the study: reducing opioid overdose deaths. The six additional, secondary outcomes included reducing non-fatal opioid overdoses, reducing deaths for non-opioid drugs, increasing naloxone education and distribution, increasing access and utilization of medication for opioid-use disorder (OUD), decreasing high-risk prescribing, and reducing overall stigma. Of the 67 communities across New York, Massachusetts, Kentucky, and Ohio, 50% were randomized into the intervention arm of the study, while the other 50% received the usual-care control arm. 

According to Dr. Jeffrey Samet, John Noble professor of medicine and vice chair of public health at Boston University, intervention communities had no statistically significant overdose death reduction compared to control communities, even though the intervention did have less deaths overall. 

“These evidence-based practices (EBPs) were complicated to set up and to grow – they take time, and we had insufficient time,” said Dr. Samet. “We were also dealing with COVID-19 and competing priorities that the pandemic presented.” That said, the research also showed significance in other outcomes, including a 37% decrease in overdose deaths involving an opioid combined with a non-cocaine psychostimulant.

“Leaders from communities that received the intervention reported greater decreases in stigma towards people treated for OUD and toward medication for OUD than leaders from communities who did not receive the intervention,” said Dr. Alissa Davis, associate professor at CSSW. “Stigma has really negative impacts on people with OUD – not only mental health impacts, but also on access to and uptake of treatment services.” 

Session 2: HCS Community Coalitions in Action: Lessons from the HEALing Communities Study in Selecting and Delivering EBPs

The Communities that Heal (CTH) intervention was a seven-phase, data-driven approach in which community ownership was critical to succeed in promoting EBPs that are known to have impacts on overdoses. The primary components included community coalition engagement, opioid overdose reduction continuum of care, and a strong communications campaign. 

“I feel honored to represent the work of hundreds in this room, as well as those that we have lost during this study,” said Dr. Timothy Hunt, associate director of SIG and associate research scientist at Columbia University. 

Dr. Elwin Wu, co-director of SIG and associate professor at CSSW, highlighted the lessons learned from in-depth data analysis throughout the study. He and his colleagues helped create data dashboards that were available to anyone with web access, engaging in landscape analysis of the demographics within each community. 

“We wanted to democratize the data,” said Dr. Wu. “We didn’t want to just throw data at folks, but rather help them process it.” The dashboards continue to provide crucial information regarding the accessibility of various services in these communities; for example, showing how many miles to the nearest pharmacy that distributes naloxone. 

In Massachusetts, people who use drugs were incentivized to distribute naloxone within their communities. They were trained and received a cash stipend which resulted in over 3,000 naloxone kits administered in the state. 

“People who use drugs have a long history of protecting one another,” said Dr. Alexander Walley, professor at Boston University School of Medicine and medical director of the Bureau of Substance Addiction Services.

Session 3: Implementation Science in Action: Evaluating Fidelity, Attitudes, and Costs to Improve Outcomes 

“Implementation science helps us unpack that black box between launching the intervention and getting to the desired outcomes,” said Dr. LaShawn Glasgow, senior director at the Center for Program & Policy Evaluation to Advance Community Health and chair of the HCS Data Coordination Center (DCC). 

Compared to control communities, CTH coalition members within intervention communities reported lower levels of perceived community-level stigma towards people with OUD as well as increased coalition functioning and capacity. 

“We examined coalition members’ level of engagement and satisfaction with different components of the CTH intervention,” said Dr. Louisa Gilbert, co-director of SIG and professor at CSSW. “Interviews suggested that safer prescribing could be best achieved through culture change around pain expectations, awareness of safe disposal of opioids, and increased access to non-opioid treatments.” 

HCS researchers wanted to understand exactly how the characteristics of each coalition they worked with were influencing various evidence-based practices (EBPs). “We found a strong correlation between coalition racial & ethnic diversity and opioid overdose education and naloxone distribution (OEND) adoption,” said Dr. Dawn Goddard Eckrich, associate director of SIG and associate research scientist at Columbia University. 

Experts also conducted surveys on pharmacists’ attitudes and stigma towards naloxone and medication for opioid-use disorder (MOUD). Social factors such as race, gender, pharmacy size, and setting influenced pharmacists’ views and actions related to OUD. 

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In subsequent sessions, HCS experts presented information on community decision making, administrative data partnerships, and sustaining & disseminating the Communities that Heal (CTH) intervention. For more information on the entire study and the HCS teams that made it all possible, click here. 

“⅓ of the US population knows someone who died from an overdose,” said Dr. El-Bassel. We need to reach as many communities as possible to ensure treatment for all.”