Surrounding Training Environment

A Week in the Life of Opioid Use Disorder in Cincinnati, 2017

Training Sites

Adolescent Substance Abuse Program, Inc.

The Adolescent Substance Abuse Programs (ASAP) is dedicated to providing professional, ethical, and caring outpatient treatment for substance abuse in a family centered environment. Their abstinence based programs are diverse, providing for both outpatient and also two options for Intensive Outpatient Services. Care is backed by interdisciplinary, team-based meetings to optimize outcomes. Family-specific sessions are available, as are on-site 12-step, community-based recovery programs. Additional learning is supported by a physician Board Certified in Child and Adolescent Psychiatry.

Cincinnati VA Medical Center (VAMC)

The primary training site for fellows is the Cincinnati VA Medical Center (CVAMC), a Joint Commission -certified 115 acute bed hospital providing five levels of care: primary, secondary, tertiary, restorative, and extended care. It is a Dean's Committee affiliate for the College of Medicine and is a training site for 26 specialties, including Psychiatry, Internal Medicine, Neurology, Surgery, Ob/Gyn, PM&R, and many Medical/Surgical Subspecialties. Over 500 fellows, residents and medical students are trained at the CVAMC each year.

In addition, the CVAMC supports over 85 other academic affiliations involving dentistry, pharmacy, nursing, social work, and psychology while employing over 2,000 employees and generating over ½ million visits annually across its main campus and 7 outlying tri-state sites, including a dedicated Women’s Clinic. The Mental Health Care Line in particular houses 3 of the 5 fellowships within the UCCOM Department of Psychiatry and Behavioral Neuroscience (Addiction Medicine Research, Addiction Psychiatry, and Geriatric Psychiatry) and has always maintained strong collaborations and support for the UCCOM and the Department of Psychiatry and Behavioral Neuroscience. The CVAMC methadone clinic has received perfect scores for 6 site surveys in a row and provided on-site expert consultation over a 10 year period to create and sustain UCCOM's methadone clinic. The CVAMC's  buprenorphine prescribers were among the first-ever waivered to prescribe in the US, and its Addiction Medicine Research Fellowship is a first fellowship nationally to be accredited in the history of the American Board of Addiction Medicine. The CVAMC provides the widest scope of addiction services among medical facilities in the tri-state region, with 12 different addiction sub-specialty wards and clinics. The CVAMC Research Service oversees an annual budget of approximately $4M involving approximately 80 principal investigators and their support staff of approximately 250. IRB services are provided in coordination with the UCCOM and Cincinnati Children’s Hospital. The CVAMC houses a GCRC (General Clinical Research Center) jointly sponsored by the University of Cincinnati and Cincinnati Children's Hospital Medical Center, as well as a large animal research lab under construction. The CVAMC addiction division typically has several active research protocols ongoing, advancing discovery in the field of addiction practice.

While there exists no widely accepted system for summarizing hospital system performance, the Department of Veterans Affairs (VA) has created SAIL, the Strategic Analytics for Improvement and Learning Value Model. SAIL is a web-based, balanced scorecard model that the VA is developing and continuously improving to measure, evaluate and benchmark quality and efficiency at medical centers. SAIL assesses data in 25 quality measurement areas such as mortality, access, utilization management, avoidable adverse events, mental health, care transitions, patient and employee satisfaction, as well as overall efficiency and performance at individual VA Medical Centers. SAIL data tables are updated every quarter. While other measurement models in VA and the private sector assess and score health care facility performance, SAIL encompasses many more metrics and offers custom views of information to help VA users pinpoint strengths and opportunities for improvement. The CVAMC consistently ranks in the top 10% of VA medical centers nationally on the SAIL Report, earning it a “5 out of 5-stars” ranking in quality. A leading performer for the CVAMC’s 5-star ranking is the Mental Health Care Line which typically ranks in the top ten (with recent #1 and #5 rankings) nationally among 132 VAs. 

University of Cincinnati-related sites

UC Physicians Company, LLC - Opioid Treatment Program

Led by staff from University of Cincinnati College of Medicine/UC Health Psychiatry and Behavioral Neuroscience, the addiction services program began in 2006 and was the first Opioid Treatment Program (OTP) to be certified in the state of Ohio in over 24 years. Methadone assisted treatment is provided for patients with opioid use disorders, backed by a comprehensive multi-disciplinary approach to include physicians who are trained in substance use disorders, nursing assistance, case management and psychosocial counseling. There are approximately 500 active patients receiving methadone as part of their treatment. Patients who have dual diagnoses are assessed and treated accordingly. Clinical services have recently been expanded including co-existing disorders as well as an Intensive Outpatient Program. These services are co-located with highly active research protocols, advancing the discovery of new treatments.

UC Health Maternal-Fetal Medicine

Specializing in the management of high-risk pregnancy and complications of pregnancy, UC Health Maternal Fetal Medicine is a highly skilled, multidisciplinary team of collaborative physicians who provide complete care for women and their babies during pregnancy and beyond. They focus on compassionate continuity of care, from diagnosis of a complication to the birth of a baby, and care of the mother during the postnatal period. Maternal Fetal Medicine physicians see patients in various locations and hospitals throughout the Cincinnati region, including University of Cincinnati Medical Center, The Christ Hospital, Mercy Anderson and Mercy Fairfield. They also work in conjunction with the Fetal Care Team at Cincinnati Children’s Hospital Medical Center in one of the largest fetal surgery programs in the nation.

Ohio Valley Research Node

Since its establishment in 2000, the Ohio Valley Node (OVN) has been one of the most productive of NIDA's Clinical Trials Network (CTN) nodes, both in leading and participating in multisite trials, and has earned more than $40 million in funding. IN 2015 the OVN was expanded to be a node of networks: the Ohio Valley Node-Network (OVNn). The OVNn includes eight original OVN sites, which are located in 6 states and treat more than 225,000 patients per year; and three additional practice based research networks (PBRNs). Two are state-wide primary care PBRNs, the Collaborative Ohio Inquiry Network (COIN) and the Wisconsin Research and Education Network (WREN), which, combined, include more than 350 practices and treat more than 4 million patients per year. The third is a state-wide pharmacy PBRN in Indiana, which includes 168 pharmacies that fill 1.5 million prescriptions annually. The OVNn Research Core is the driving force of the OVNn and is led by Dr. Winhusen, one of the foremost experts in conducting multi-site addiction clinical trials in clinical practice settings. The OVNn co-investigators include experts in primary care (Elder), emergency medicine (Lyons), and pediatric emergency medicine (Grupp-Phelan) practice-based research. The 7 members of the OVN research-implementation team bring 72 years of combined experience conducting CTN clinical trials. A primary goal of the OVNn is to conduct the research needed to inform clinical practice guidelines for effective substance use disorder prevention and treatment in general medical care settings, which are largely lacking but increasingly needed, with a specific focus on research to address the opioid use disorder epidemic.

Cincinnati Psychoanalytic Institute

This is a non-profit educational institution that offers post-graduate training to mental health professionals - one of few in the U.S. The curriculum is geared to mental health professionals who want to become analysts and to professionals in the fields such as social work, counseling, psychology and pastoral care who want to expand their skills to help the people they serve. This is an optional add-on experience the fellow may pursue.