Addiction as a Chronically Relapsing Disease: In 2000 A.Thomas McLellan and others noted the similarities between addiction and other chronically relapsing medical conditions such as asthma, Type II diabetes and hypertension. A controversial proposition at the time, today most experts talk about addiction as a chronically relapsing disease that cannot be cured but can be managed. In 2006, the C3 Center was formed at TRI to investigate chronic care models that continually monitor patient progress during treatment and adapt based on change in patient status.
Policy Making and Addiction: With more than 70% of substance abuse treatment funded by the public sector, governments can promote high-quality treatment through smart policies, procedures and regulations. Since 2006, TRI’s Center for Policy Research and Analysis has worked with state and local governments to implant purchasing practices and other policies to foster performance-based contracting; broader treatment continuums linking specialty addiction care with criminal justice, child welfare, health and other agencies; medication assisted treatment, and medically-based screening, brief intervention and referral to treatment initiatives.
Substance Abuse and Crime: TRI is one of the most active research centers in the nation on problem court models, investigating when alternatives to incarceration work and when they don’t, and for what types of offenders, and is one of several groups translating research findings into policy solutions and science-based products. TRI investigators were the first to show that involvement of judges in drug courts is critical to good outcomes for high-risk offenders.
Substance Use, Adolescents and Parents: In 2005 TRI entered into a collaboration with the Partnership for a Drug Free America (now the Partnership at Drugfree.org) to develop science-based tools for parents trying to prevent drug/alcohol use by their kids or intervene effectively when they know or suspect their children are using. The collaboration spawned such science-based, multi-media tools as “A Parents Guide to the Teen Brain,” “Time to Act!” and “Time to Get Help!” In 2010, based partially on this collaboration, NIDA funded The Parents Translational Research Center at TRI to empirically develop tools helping parents and other caregivers contend with drug and alcohol use as they navigate new challenges that can arise when raising a teenager.
Addiction in Primary Health Care: In a field where 90% of patients known to need treatment don’t receive it, and countless others are loathe to seek treatment out of shame or stigma, addiction professionals have long sought to broaden detection/intervention opportunities by engaging doctors and other medical specialists. The field got a big boost in December 2008 with release of the final report of “PRISM” (Program to Integrate Substance Use Issues into Mainstream Healthcare), a project launched in 2002 by TRI and the University of Pennsylvania School of Medicine and joined in 2006 by four of the most prestigious medical societies in the nation. The report was replete with evidence of drug and alcohol impacts on chronic medical conditions commonly treated in doctors’ offices, trauma rooms and other primary care sites – providing the first systematically gathered evidence of why substance use and abuse should be of interest to primary care professionals.
The “Business” of Addiction Treatment: In 2006, in a bid to rescue the nation’s struggling substance abuse treatment system, TRI joined The Wharton School at the University of Pennsylvania to apply lessons learned from other industries. The resulting Center on the Organization and Management of Addiction Treatment (“COMAT”) has organized conferences, consulted with state substance abuse directors and other leaders in the addiction field, and convened thought leaders to develop strategies to translate good business practices into addiction treatment
Transforming Science into Products and Services: The Treatment Research Solutions Group, formed officially in 2008, carries forward the original mission of the organization to translate science into useful products and services for the addiction and related fields. TRI’s historic affiliation with the Addiction Severity Index (ASI), the most widely used assessment instrument in the field of addiction, spawned development of a software system along with a training and technical support capacity for researchers and addiction practitioners. Other science-informed products include an electronic system fostering referral of patients to free or low-cost auxiliary services essential to their recovery; several helping tools for parents, and several web-based tools for the criminal justice and substance abuse treatment sectors.