# A systems science approach for improving continuity of service in substance use disorder treatment

> **NIH NIH SC2** · CALIFORNIA STATE UNIVERSITY NORTHRIDGE · 2020 · $145,000

## Abstract

Project Summary/Abstract
Increasing access to substance use disorder (SUD) treatment is an important public health
priority because substance abuse and dependence is associated with significant morbidity and
mortality. While evidence-based treatments are available to care for people with SUDs, only 11%
of individuals who need professional treatment receive it. One major service gap in the treatment
of SUDs, particularly alcohol and opioid use disorders, is the engagement of patients in treatment
or rehabilitation after an initial detoxification (detox). At the point of discharge from detox,
patients are at high risk of relapse and therefore vulnerable to system failures. Detox alone
increases patients' risk of mortality from overdose if they do not transition to rehabilitation after
discharge. To date, research on the problem of continuity of service after detox has focused on
patient characteristics and attributes of organizations with no consideration to the dynamic
contexts within which SUD treatment occurs. What has not been explored to date is the impact of
referral networks between service programs on entry into SUD treatment after detox. The goal
of this pilot study is to determine the impact of systems-level predictors such as network
structures on continuity of service in the SUD treatment system in Los Angeles County. The
central hypothesis will be tested by pursuing three specific aims: 1) Describe the ecology of the
publicly-funded SUD treatment system in Los Angeles County using social network analysis, 2)
Determine the impact of network structure on continuity of service from detox to SUD treatment
using computer simulation models, and 3) Design a protocol for a service implementation
network intervention to increase continuity of service after detox. The unique strengths of the
study are the experienced research team, theory-driven approach, and application of systems
science methodologies such as social network analysis and agent-based modeling. Achieving the
study aims will create greater understanding of the interdependency of programs within the
treatment systems and demonstrate how partnerships and referral patterns at a system level can
impact patient outcomes. The results of the study will be used to plan an R34 study to test the
implementation and effectiveness of a service implementation network model for SUD treatment.

## Key facts

- **NIH application ID:** 9982290
- **Project number:** 5SC2DA047839-03
- **Recipient organization:** CALIFORNIA STATE UNIVERSITY NORTHRIDGE
- **Principal Investigator:** Suzanne Evelyn Spear
- **Activity code:** SC2 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $145,000
- **Award type:** 5
- **Project period:** 2018-08-15 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9982290

## Citation

> US National Institutes of Health, RePORTER application 9982290, A systems science approach for improving continuity of service in substance use disorder treatment (5SC2DA047839-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9982290. Licensed CC0.

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