The Florida Node Alliance, one of the longest-running and highest-funded programs housed at and managed by the University of Miami Miller School of Medicine, has been renewed for an additional five years. The node is a 20-year, $73.7 funded node of the National Institute on Drug Abuse Clinical Trials Network (CTN) framework, which consists of 16 nodes.
The CTN framework links a variety of treatment providers and patient populations throughout the country. The nodes allow the CTN to provide a broad and powerful infrastructure for rapid, multi-site testing of promising science-based therapies and the subsequent delivery of these treatments to patients in a variety of treatment settings.
In the five-year renewal period, the Florida Node Alliance aims to apply their expertise in implementation science, data science, and the use of electronic health records to promote learning health care systems that build on precision medicine principles by implementing and refining methods to predict individual response to treatment.
“We propose to continue to bring considerable expertise in various areas, including adolescent treatment, the HIV and HCV care continua in substance-using populations, mental health comorbidities, e-Health, data science, cultural science, health economics, training, implementation science, and Hispanic populations,” said José Szapocznik, Ph.D., professor and chair emeritus of the Department of Public Health Sciences, who is one of the principal investigators of the node.
Substance use interventions
The FNA will develop, test, and implement interventions that address the service delivery continuum in the node’s clinical and research networks. These networks consist of substance use disorder treatment and general medical settings, health systems, clinical research networks, and practice-based research networks.
Public health experts who serve as principal investigators of the Florida Node Alliance include Dr. Szapocznik, Daniel Feaster, Ph.D., professor of public health sciences, and Lisa Rosen-Metsch, Ph.D., dean of the Columbia University School of General Studies and professor of sociomedical sciences at the Columbia University Mailman School of Public Health. Previously, Dr. Rosen-Metsch was with the Miller School of Medicine. Viviana Horigian, M.D., M.H.A., professor of public health sciences, serves as the executive director of the node.
“We are very happy that we will continue this important work, addressing the public health issues that our country is facing today surrounding addiction,” Dr. Feaster said. “The clinical trials run by the Florida Node Alliance have provided, and will continue to provide, opportunities for our public health students to be actively involved with research.”
The node has had a record of success in leading and implementing trials in health care settings and integrating substance use treatment into the mainstream of health care. It covers Florida, Georgia, and Puerto Rico — areas in the United States that have suffered from high rates of drug overdoses and continuing epidemics in opioid, cocaine, and methamphetamine use.
Today, these areas continue to have treatment needs and experience disparities in the implementation of evidence-based treatments. In the newly renewed period, the Florida Node Alliance will build on its record of success in research, leading and implementing trials in health care settings, and integrating substance use into mainstream health care.
An epidemic of drug overdoses
“The U.S. is experiencing an unprecedented epidemic of drug overdoses that has contributed to a decrease in life expectancy,” Dr. Horigian said. “Yet although several interventions have demonstrated effectiveness, their adoption lags in mainstream health care. Many factors have prevented the integration of substance use disorder prevention and treatment services into mainstream health, such as provider stigma, time and workflow constraints, education, and challenges in treating co-morbidities, such as mental health disorders, HIV and Hepatitis C.”
For the past 20 years, the node has brought together research scientists, clinicians, and community-based medical and specialty practices to advance practice delivery and address patient needs through research on substance use disorder treatment and its implementation in a variety of clinical settings.
Studies led by the node have also significantly improved substance use disorder treatment and health care services for persons with the disorder.
A few examples include the node’s contributions to adolescent substance use disorder research, which led to the widespread use of family-based treatment for behavioral problems and at-risk youth. Its HIV research has also demonstrated the effectiveness and cost-effectiveness of on-site HIV testing in substance use disorder treatment, modifying counseling practice when HIV testing, and developing interventions for engaging in the treatment of non-adherent patients to substance use disorder and HIV care. The expertise of the Florida Node Alliance in data science is also being used as part of the Healing Communities Study, which has been implemented to combat the opioid epidemic.
In the past five years, the node has led and/or participated in 16 multi-site randomized trials of the Clinical Trial Network. Its investigators have also made significant scholarly contributions, with over 77 publications, 25 posters, and 51 presentations over the project period.
“We are excited to continue to leverage our center’s strength to advance and bring about equity in drug abuse treatment,” Dr. Horigian said. “Innovations in our work will be centered around digital therapeutics, the use of data science, the use of context and culture in our approach, and continuing to reach to individuals that are non-treatment seekers.”