News & Updates — Grantee Spotlight

Substance use coercion is a common but underrecognized form of intimate partner violence that affects a significant share of women with opioid use disorder (OUD), yet most clinicians are not trained to recognize these dynamics. They may interpret missed appointments, not taking medication, or returning to use as noncompliance without understanding that a partner may be sabotaging a patient’s care by withholding transportation, tampering with medication, or threatening harm.

A new video released today describes how the National Center on Domestic Violence, Trauma, and Mental Health and clinicians at the University of Pittsburgh Medical Center (UPMC) developed and tested the Beyond Screening Toolkit. The toolkit provides practical guidance for clinicians on how to screen for substance use coercion and integrate safety plans into clinical workflows so that patients can navigate treatment and recovery without risking retaliation from an abusive partner.

“Providers often assume patients are making a choice not to come to the appointment or not take their medication. By using the resources in the toolkit, you start to uncover clues about what’s really going on,” says Ilana Hull, MD, MSc, a UMPC physician specializing in addiction and family medicine.

FORE supported the development of toolkit as part of our efforts to address barriers to treatment and promote innovation in the training of health care professionals. Alongside implementation resources including palm cards and office posters, the toolkit is available free of charge. “We’re making all of these tools and resources available to medical practices and anyone working with people experiencing substance use or OUD because it’s that important,” says Carole Warshaw, MD, Director of the National Center on Domestic Violence, Trauma, and Mental Health. “Our goal is to take this to scale and have it become the standard of care.”

“So often patients don’t even realize what may be happening to them,” says Liz Krans, MD, MSc, Associate Professor of Obstetrics, Gynecology, and Reproductive Services and Director of Addiction Medicine Services at UPMC Magee-Womens Hospital. “To name it, to give it face, to give it a description and diagnosis really helps to incorporate it clinically,” Krans says.