Study identifies gaps and opportunities in Philadelphia’s opioid use disorder treatment system

A new study led by Thomas Jefferson University researchers highlights critical health care gaps that hinder long-term recovery for people living with opioid use disorders (OUD) in Philadelphia. The findings are published in the Journal of Substance Use and Addiction Treatment.

The researchers conducted 13 focus groups with 70 participants accessing various types of OUD treatment. Participants reported several challenges, such as lengthy and restrictive assessment processes, inadequate operating hours and lack of sufficient withdrawal management. Participants also reported broader socio-economic needs, such as housing and income support, as barriers to their recovery.

Meghan Reed, Ph.D., MPH, senior author of the study and harm reduction researcher, says, “Doing qualitative work with the people who are most impacted by local policies, the drug supply, and understanding how these things interact can help us to understand somebody’s risk for overdose or opportunities for treatment.”

Lara Carson Weinstein, MD, MPH, a study co-author, emphasized that a key area for improvement is reducing the places where patients slip through the cracks during multiple handoffs, for example, from emergency departments to recovery programs. “We need to find more seamless ways to connect patients with care.”

The study indicates the need for a larger workforce with lived experience and improved access to expanded OUD treatment services. One promising approach the researchers suggest involves having certified peer recovery specialists engage with patients early and throughout their treatment journey, particularly during the most vulnerable period of withdrawal.

Moving forward, the research team plans to evaluate Philadelphia’s grassroots responses to the opioid epidemic to identify scalable solutions, reduce transitions between providers and ensure continuity of care through trusted relationships. This study is part of a mixed-methods investigation, including Geographic Information Systems (GIS) mapping analysis and surveys that found that Philadelphia’s OUD treatment system is fragmented and difficult to navigate.

Erin Kelly, Ph.D., another co-author of the study, suggests that an ideal treatment system should address an individual’s overall needs, including their physical and mental health.

“Hopefully, this project is providing some data on some of the barriers that have been keeping people from being able to more fully engage with treatment,” Dr. Kelly says.