# Addictions treatment organizational response to COVID-19: impact on disparities in quality of care

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2022 · $796,262

## Abstract

Project Summary
The COVID-19 public health emergency gave an extraordinary exogenous shock to SUD treatment
organizations, forcing rapid changes in how they provide care. Before COVID-19, the treatment model relied
heavily on brick-and-mortar clinics to provide in-person medical care and psychosocial treatment, including
specialty outpatient addictions treatment (SOAT) and pharmacotherapy provided through medical office-based
addictions treatment (OBAT). Due to government mandates for physical distancing and relaxation of
restrictions for using telehealth, both SOAT and OBAT providers quickly and fundamentally changed their
workflows, including: new forms of medical screening and medication management; greater flexibility in
allowing patient self-dosing of medication at home; treatment through individualized and group meetings via
telehealth; reduced reliance on drug use screening; and new strategies for treatment engagement. These
changes will have unknown effects on treatment retention, use of pharmacotherapy for addictions, and longer-
term outcomes. The outpatient treatment system responses—both temporary and enduring—to these external
shocks will take many forms depending on the organizational and environmental context in which programs
operate. There is concern that Black/African American and Latinx patients—who are more likely to receive care
in more poorly resourced programs and have lower access to eHealth technology—will receive poorer quality
care and worse outcomes. We will employ a social-ecological framework to examine the conditions under
which outpatient treatment across New York State adapted to the exogenous shock and analyze relationships
between new clinical practices (e.g., use of telehealth) and proximal (e.g., retention, use of pharmacotherapy)
and distal (e.g., overdoses, emergency department visits) markers of patient outcomes. Further, we will
examine racial/ethnic variation that may indicate disparities in care as well as organizational and community
factors that may account for disparities. We propose an explanatory sequential mixed-methods design to study
both short term and longer-term changes to treatment services and outcomes. We will first use administrative
data—joining a state registry of SUD treatment episodes with Medicaid—to study variation in treatment
practices across 545 SOAT clinics and 3100 OBAT providers. We will examine changes to treatment practice:
clinical delivery (e.g., use of telehealth, mix of group versus individual counseling), use of pharmacotherapy
(e.g., remote induction, greater flexibility in methadone self-administration), and retention. We will then
examine the association between these practice changes and treatment outcomes, such as overdoses,
substance-related emergency department visits, and hospitalizations. We will employ qualitative methods to
develop an understanding of the quantitative findings by examining organizational characteristics of programs
representative of those that...

## Key facts

- **NIH application ID:** 10443149
- **Project number:** 1R01DA054141-01A1
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** CHARLES J NEIGHBORS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $796,262
- **Award type:** 1
- **Project period:** 2022-04-01 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10443149

## Citation

> US National Institutes of Health, RePORTER application 10443149, Addictions treatment organizational response to COVID-19: impact on disparities in quality of care (1R01DA054141-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10443149. Licensed CC0.

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