Training in Enhancing Structural Solutions in Addictions (TESSA) Program”

Addiction is a growing, ubiquitous threat to health and society. A global pandemic and other large social changes in society have highlighted the importance of culture, strategies, and systems in patterning both addiction and its treatment in the U.S. Policies (e.g., Nixon’s “War on Drugs”) have fundamentally shaped responses to substance use in the U.S. Other structures like education, housing, criminal justice, and healthcare have also contributed to addictions and addictions treatment, as well as differences in both across populations in the U.S. However, structural factors in addictions have received less attention. A new generation of addictions health services scholars is needed to address challenges rooted in structures. Consistent with the goals of NIDA’s mission to advance science on drug use and addiction, next generation scholars will need strong training in policy, structural determinants of health, and related research methods and fields that can alter structures (e.g., critical theory, policy research, and implementation science) in addition to training in traditional health services and addictions-specific content and methodology. As the nation’s premier public university for research—home to a leading doctoral program in health services research, a top-ten medical school, and nationally-recognized programs in implementation science and health policy—the University of Washington (UW) is well positioned to address these training needs. Thus, UW’s Department of Health Systems and Population and Division of General Internal Medicine seek NIDA funding to found the Training in Enhancing Structural Solutions in Addictions (TESSA) Program to: 1) recruit 11 pre- and post-doctoral scholars with interest in addictions , 2) deliver a specialized curriculum fostering a multidisciplinary understanding of addictions and their care, theory, policy, and implementation science; 3) provide TESSA scholars mentored research opportunities focused on addictions and related structures in multidisciplinary research teams, 4) support TESSA scholars in developing research career training plans to enhance their skills and prepare them for research careers; and 5) evaluate the success of the program using explicit benchmarks and pre-defined outcomes. We have developed the TESSA program to train scholars in 17 core competencies addressing critical theory, policy, and implementation science in addition to traditional health services and addictions content and methodology. If we continue to train addictions scholars without such a direct multidisciplinary approach, we are likely to see slow progress and missed opportunities to improve access to care across groups and reduce morbidity, mortality, and suffering associated with addictions. Investment in TESSA will result in a new generation of multidisciplinary and structurally-focused addictions research scholars who are optimally prepared to develop and test novel strategies for prevention, treatment, and recovery, and implement effective strategies and policies into real-world settings, advancing NIDA’s cross-cutting strategic goals to increase access to treatments and reduce stigma and gaps in addictions treatment.