The prospects for sustaining evidence-based responses to the US opioid epidemic: state leadership perspectives

Lauren Caton, Mina Yuan, Dexter Louie, Carlos Gallo, Karen Abram, Lawrence Palinkas, C. Hendricks Brown, Mark McGovern*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: The US 21st Century Cures Act provided $7.5 billion in grant funding to states and territories for evidence-based responses to the opioid epidemic. Currently, little is known about optimal strategies for sustaining these programs beyond this start-up funding. Methods: Using an inductive, conventional content analysis, we conducted key informant interviews with former and current state leaders (n = 16) about barriers/facilitators to sustainment and strategies for sustaining time-limited grants. Results: Financing and reimbursement, service integration, and workforce capacity were the most cited barriers to sustainment. Status in state government structure, public support, and spending flexibility were noted as key facilitators. Effective levers to increase chances for sustainment included strong partnerships with other state agencies, workforce and credentialing changes, and marshalling advocacy through public awareness campaigns. Conclusions: Understanding the strategies that leaders have successfully used to sustain programs in the past can inform how to continue future time-limited, grant-funded initiatives.

Original languageEnglish (US)
Article number84
JournalSubstance Abuse: Treatment, Prevention, and Policy
Issue number1
StatePublished - Dec 1 2020


  • Barriers and facilitators
  • Grant funding
  • Health policy
  • Opioid use disorder
  • Opioid use disorder treatment
  • Sustainability
  • Sustainment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Health Policy


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