As the opioid epidemic approaches its second decade of devastating impact, some health care providers are integrating evidence-based research into their clinical practice to combat this persistent crisis.

Nonprofit substance use disorder (SUD) provider Caron Treatment Centers has taken the approach of integrating research into care. Caron’s Chief Medical Officer, Adam Scioli, said having research in a treatment facility makes sense.

“One of the biggest challenges of conducting research, aside from getting the participant there, is controlling for all the factors that might interfere with the data you seek. Having one participate in a research study while in residential treatment at a provider like Caron really presents an opportunity to control for all those external factors,” Scioli told Behavioral Health Business. “And for someone who has a mental health condition or a substance use disorder, the factors are multiple. What time does somebody go to sleep? What time do they wake up? What do they eat? Are they using? … We are in a position, when we have them in residential treatment with us, to know exactly what is going on at various times.”

Wernersville, Pennsylvania-based Caron Treatment Centers is a nonprofit provider that serves patients with substance use disorders. It operates in Pennsylvania, Florida, Washington, D.C., Georgia and New York. The company employs roughly 755 people.

Conducting research onsite also means that patients can access cutting-edge treatment that can be tailored to their needs.

Recruitment and retention

Onsite research at an SUD treatment facility isn’t just a positive thing for patients; it can also be an effective tool for recruiting and retaining talent. Physicians at the practice are frequently publishing findings.

“I just had a conversation with our CEO earlier about the importance of retaining people who are interested in research as well as treatment,” Scioli said. “This is one of the few places I know where you can be a physician, conduct research and do treatment at the same time.

Caron offers a physician fellowship program that includes opportunities for concurrent research and clinical practice, a feature that has attracted candidates to the program over the years.

“It’s exciting to be able to watch a patient benefit from something that has typically already passed through at least an animal model,” Scioli said.

What’s hot in SUD research right now?

The addiction treatment industry is just one of the many concentrations in health care that have seen the benefits of GLP-1s.

Scioli noted that Caron teamed up with Penn State College of Medicine to look at the use of GLP-1 receptor agonists in the treatment of opioid use disorder.

“What we ultimately found was that this the use of the GLP-1 receptor agonist in combination with medication-assisted-treatment (MAT) was particularly effective in significantly reducing cravings compared to placebo, also being used independently of traditional MAT with success at lower doses than the FDA publishes for efficacy with diabetes or obesity, which is also great because it’s much better tolerated at lower doses,” Scioli said.

And while this research directly relates to treating certain SUDs, such as opioid use disorder, researchers also discovered some additional potential benefits from GLP-1s.

“What we’ve seen, which the rest of the world is beginning to see, is that it’s having a positive impact on not only what we were hoping it would, which is a reduction of cravings opioid use disorder, but on a number of areas of the reward center that we weren’t necessarily expecting it to,” Scioli said. “For example, reduction in cravings for smoking or tobacco and other impulsive behaviors, such as gambling, sexual acting out.”

Caron has now begun to incorporate GLP-1s into care in addition to other modalities of care, including MAT and therapy.

But GLP-1s aren’t the only promising advancement in SUD care. Caron has also been involved with research on genetic markers, which could help predict if a person has an increased susceptibility to developing an OUD.

This type of research could be helpful in preventative care. For example, if a care team knew that a patient was susceptible to OUD before surgery, they could plan an appropriate course of action for pain management in regard to opioid analgesics.

Funding considerations

Funding for research has been in the news a lot lately, particularly in regard to federal cuts.

Still, Scioli said the bulk of federal research funding goes to the National Institutes of Health and often will trickle down to universities that are in a position to conduct research.

Caron has historically benefited from private philanthropic funding and, more recently, partnered with universities to combine resources to conduct research. Still, that could be changing as the organization looks to demonstrate the impacts of its research.

“Our hope would be that as we begin to, as we continue to publish these outcomes,” Scioli said, “whether independently, at Caron, or in concert with our academic partners, that the federal government would begin to recognize that funding research in this particular setting can be beneficial.”