When a pandemic and epidemic collide: Lessons learned about how system barriers can interrupt implementation of addiction research

Amanda Sharp, Melissa Carlson, Enya B. Vroom, Khary Rigg, Holly Hills, Cassandra Harding, Kathleen Moore, Zev Schuman-Olivier

Research output: Contribution to journalArticlepeer-review


Background: Telehealth technologies are now featured more prominently in addiction treatment services than prior to the COVID-19 pandemic, but system barriers should be carefully considered for the successful implementation of innovative remote solutions for medication management and recovery coaching support for people with opioid use disorder (OUD). Method: The Centers for Disease Control and Prevention funded a telehealth trial prior to the COVID-19 pandemic with a multi-institution team who attempted to implement an innovative protocol during the height of the pandemic in 2020 in Tampa, Florida. The study evaluated the effectiveness of a mobile device application, called MySafeRx, which integrated remote motivational recovery coaching with daily supervised dosing from secure pill dispensers via videoconference, on medication adherence during buprenorphine treatment. This paper provides a participant case example followed by a reflective evaluation of how the pandemic amplified both an existing research-to-practice gap and clinical system barriers during the implementation of telehealth clinical research intervention for patients with OUD. Findings: Implementation challenges arose from academic institutional requirements, boundaries and role identity, clinical staff burnout and lack of buy-in, rigid clinical protocols, and limited clinical resources, which hampered recruitment and intervention engagement. Conclusions: As the urgency for feasible and effective telehealth solutions continues to rise in response to the growing numbers of opioid-related deaths, the scientific community may use these lessons learned to re-envision the relationship between intervention implementation and the role of clinical research toward mitigating the opioid overdose epidemic.

Original languageEnglish (US)
JournalImplementation Research and Practice
StatePublished - Jan 1 2023


  • addiction treatment
  • implementation
  • opioid use disorder
  • system barriers
  • telehealth

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Neurology


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