# Workforce and System Change to Treat Adolescent Opioid Use Disorder within Integrated Pediatric Primary Care

> **NIH NIH R33** · INDIANA UNIVERSITY INDIANAPOLIS · 2024 · $1,304,874

## Abstract

SUMMARY
Adolescents are at increasing risk of overdose death. Since 2020, the overdose crisis has expanded most rapidly
among younger populations, largely because of the recent reality that any illicit substance (e.g., counterfeit
pharmaceuticals, methamphetamines) used by adolescents has the potential to contain lethal amounts of
fentanyl. Preventing overdose deaths will require identifying and treating youth with any substance use disorder
(SUD) or occasional opioid use – including but not limited to opioid use disorder (OUD) – due to potential fentanyl
contamination. Access to experienced, qualified SUD/OUD treatment providers for adolescents is far below what
is needed, with an even greater disparity noted than for adults needing treatment. Adding specialists to the
workforce will help, but the urgency of the national overdose crisis requires innovative changes to current
adolescent SUD/OUD care models to improve availability of effective assessment and treatment services.
Primary Care Providers (PCPs) could fill a portion of the gap of the behavioral health workforce, but they often
lack formal SUD training and resources and feel unqualified to diagnose and treat SUDs, particularly in youth.
Integrated care models, where PCPs work closely with behavioral health specialists to deliver appropriate care
to patients with SUD/OUD, are a promising but understudied approach in pediatric contexts. Therefore, with
input from national experts and local stakeholders, the research team will conduct a Hybrid Type 2 effectiveness-
implementation, cluster-randomized trial to study a multifaceted intervention to change the procedural and
cultural norms of pediatric primary settings. This project capitalizes on the infrastructure established through a
large-scale roll out of integrated behavioral health (IBH) in a statewide health system. Intervention components
for this adolescent SUD IBH include task-shifting within primary care to facilitate delivery of brief SUD
interventions, case management, electronic decision support tools, and stigma-reduction interventions. The
primary purpose of the proposed intervention is to formally combine and build on the resources available through
these interventions to shift primary care practice toward delivering effective adolescent SUD care and, ultimately,
to prevent overdose deaths among adolescents.

## Key facts

- **NIH application ID:** 11146202
- **Project number:** 4R33DA059948-02
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Matthew Aalsma
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,304,874
- **Award type:** 4N
- **Project period:** 2023-09-30 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11146202

## Citation

> US National Institutes of Health, RePORTER application 11146202, Workforce and System Change to Treat Adolescent Opioid Use Disorder within Integrated Pediatric Primary Care (4R33DA059948-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/11146202. Licensed CC0.

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