Opioid Use Disorder (OUD) care often falls short of evidence based practice with highly effective FDA-approved medications. Under 25% of persons with OUD receive specialty care annually and <35% of care episodes initiate medications for opioid use disorder (MOUD). Most patients on MOUD discontinue prematurely. Yet states and the federal government struggle with data collection and reporting efforts to monitor QI efforts. The OUD Cascade of Care is a public health framework that has been promoted for organizing responses to the opioid epidemic by federal agencies such as NIDA and CDC emphasizing key stages of treatment engagement, MOUD initiation, long-term retention, and recovery.
Arthur Robin Williams is an Assistant Professor of Clinical Psychiatry, Columbia University Division on Substance Use Disorders, and Research Scientist, New York State Psychiatric Institute. He attended Princeton University’s Woodrow Wilson School of Public and International Affairs for his undergraduate degree in domestic health policy, completed his medical degree at the University of Pennsylvania where he also earned a Master in Bioethics. He completed psychiatry training at NYU-Bellevue, and a NIDA funded T32 research fellowship in Addiction Psychiatry at Columbia. He is funded by a NIDA K23 and R21. His K23 award addresses the addiction treatment gap and systems-based practice to improve quality of care for the treatment of Opioid Use Disorder through the development of an OUD Cascade of Care. His work on the Cascade of Care has been invited as expert testimony to the NIH HEAL Initiative, NIH HEAL JCOIN, NIDA CTN, APA, and SAMHSA CSAT. For this work, he has been awarded the American Psychiatry Association (APA) Health Services Researcher of the Year, Early Career Scholar (2019). He is also the PI of a NIDA R21 entitled, “Medical Marijuana Program Participation and Changes in Controlled Substance Use.”
Dr. Williams has published ~25 first authored publications and book chapters addressing the opioid epidemic and improving quality of care through the OUD Cascade. He has served as a content expert for the National Council for Behavioral Health for a 6-state learning collaborative to improve the uptake and evidence-based use of MOUD (2015-2016) and has developed symposia at the AAAP and ASAM. He also serves on the APA Expert Work Group: quality of life outcomes for SUD treatment, facilitated by Mathematica (2019), the APA Technical Expert Panel: quality measure development for OUD with NCQA (2019-2021), and on a National Quality Forum (NQF) opioid measure development group (2019-2020). He has also published retrospective survey studies with Bellevue clinic buprenorphine patients in the aftermath of Hurricane Sandy and of clinical trajectories of patients on MOUD with buprenorphine and extended-release naltrexone with a retrospective survey of xr-naltrexone outpatients.
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