Assessing challenges and solutions in substance abuse prevention, harm reduction, and treatment services in New York State

Drug overdose is a leading cause of death in New York State, with opioid-related deaths increasing by more than 300 % from 2010 to 2020. Survey respondents ( N = 392) for organizations providing a wide range of substance misuse related services rated the importance of barriers to accessing services, the helpfulness of strategies in addressing challenges, and priorities for further scientific study. Difficulties in obtaining funding were rated the highest barrier to accessing substance use services, insufficient skills in the workforce were rated as the second most important barrier, and stigma towards addiction was rated third. An analysis of wages and scale-up strategies to provide competitive workforce opportunities was rated as the most helpful strategy in addressing workforce challenges. The most helpful strategy in addressing stigma was to work in partnership with other organizations to enhance the continuum of substance misuse related services. Most of the strategies that were surveyed were rated as very helpful overall, which may not be surprising given that they were nominated by experts as very important. Customized prevention, treatment, harm reduction, and recovery services based on individual characteristics and integrating medications for opioid use disorder into other medical settings were rated as the most important strategies in prioritizing further scientific study. The pattern of ratings showed only a few differences based on organizational role and geographic region, for example respondents in New York City considered increasing the availability of telemedicine as a higher priority. • Funding difficulties are the greatest barrier to substance abuse service access. • Insufficient workforce skills and stigma towards addiction are also important. • Strategies to provide competitive workforce opportunities would be helpful. • A continuum of substance abuse services across organizations would be helpful. • Scientific study is needed on individualized services and medication integration.