The United States is amid an opioid epidemic. The overall annual cost to society is more than $1 trillion. TheCOVID-19 pandemic appears to have accelerated the problem, with more than 81,000 individuals dying fromoverdose in the year ending May 2020. Astonishingly, while more than 2 million individuals have opioid usedisorder (OUD), fewer than 35% of these adults received treatment in 2019. Stigma is one major reason forthis treatment gap. For individuals with OUD, internalized negative beliefs may limit their engagement withhealthcare systems. Furthermore, stigma among clinicians may limit implementation of lifesaving treatment.For all the tactics tried to deal with the opioid epidemic, one greatly underused element is contemporaryapproaches to teaching and learning. Although COVID-19 massively disrupted educational systems, thepandemic has highlighted the importance of and opportunity for innovation through technology. C4 Innovations (C4) and partners at Yale University (Yale) and the West Haven VA Medical Center(WHVA) propose to develop and test OASIS (Overcoming and Addressing Stigma in Substance UseDisorders). OASIS is a web-based educational platform for primary care clinicians and individuals with OUD.We believe that OASIS will decrease barriers to care and enhance OUD treatment outcomes. Our teamincludes experts in education, the neuroscience and treatment of OUD, the effect and management of stigma,and product development and testing. The platform will help patients and clinicians to engage with a diverseset of high-quality educational materials according to their personal needs, including synchronous andasynchronous opportunities to interact with experts and peers. We designed the platform to assist individualsin the pre-contemplative or contemplative stages of addiction, targeting the stigma that limits engagement withcare, and helping initiate evidence-based treatment. Two specific aims guide our Phase I pilot study:AIM 1: Develop a prototype of OASIS for patients with OUD and primary care clinicians; conduct usability testing.AIM 2: Pilot OASIS with a small sample of individuals with untreated OUD and their clinicians to determinefeasibility, acceptability, and preliminary product effectiveness for a Phase II effectiveness trial. The C4-Yale-WHVA team will test OASIS with patients (N = 30) and clinicians (N = 5) using validatedmeasures and qualitative interviews. The team will assess usability, satisfaction, knowledge, empowerment,and stigma. A future Phase II project would include a controlled trial of the final product demonstrating itsefficacy for empowering patients to engage in dialogues with their primary care clinicians and initiate OUDtreatment, with the ability to expand the tool for future products addressing a broader array of substances. Our team is confident that healthcare systems will be interested in purchasing a tool for patients andclinicians that reduces stigma, improves outcomes, and reduces high costs associated with untreated OUD.
Public Health Relevance Statement: PROJECT NARRATIVE
Opioid use disorder (OUD) affects more than 2 million Americans, resulting in more than 80,000 overdose
deaths last year and an estimated annual societal cost of $1 trillion. Despite these significant harms, fewer
than 35% of affected individuals receive treatment. The OASIS platform will engage both patients and their
primary care clinicians with a set of innovative educational resources specifically designed to counter the
insidious effects of stigma and to empower individuals on both sides of the clinical encounter to initiate
evidence-based treatment. We believe OASIS has the potential to improve outcomes for patients with an OUD
and produce significant cost savings across the healthcare system.
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