Of­fi­cials dis­cuss grow­ing opi­oid ad­dic­tion epi­demic

Record Observer - - News - By MIKE DAVIS mdavis@kibay­times.com

AN­NAPO­LIS — Med­i­cal and be­hav­ioral health prac­ti­tion­ers and law en­force­ment of­fi­cials, in­vited by U.S. Sen. Ben Cardin (D-Md.) and Con­gress­man John Sar­banes (MD-03), met at Anne Arundel Med­i­cal Cen­ter on Fri­day, April 8, to dis­cuss the grow­ing is­sue of opi­oid ad­dic­tion through­out the state of Mary­land and how to best serve those in need.

“When we think about opi­oid ad­dic­tion and opi­oid over­doses we have to keep re­mind­ing our­selves that ad­dic­tion is in fact a dis­ease. A pa­tient suf­fer­ing from this dis­ease de­serve pa­tient cen- ter and care, they de­serve em­pa­thy, they de­serve at­ten­tion, and the com­mu­ni­ties that we all live in de­serve pre­ven­tion as well,” said Vic­to­ria Bayless, pres­i­dent and chief ex­ec­u­tive of­fi­cer at AAMC. “We also know that with the dis­ease of ad­dic­tion rarely do peo­ple suf­fer from ad­dic­tion alone. They usu­ally have some other men­tal ill­ness they are suf­fer­ing from.”

Pro­fes­sion­als in the fields of men­tal health and sub­stance use is­sues par­tic­i­pated in a round­table dis­cus­sion overview­ing cur­rent prac­tices some or­ga­ni­za­tions and sys­tems have im­ple­mented as well as where pro­fes­sion­als think im­prove- ments could be made.

Men­tion­ing the need for a more in­te­grated care sys­tem in or­der to bet­ter deal with sub­stance use is­sues and men­tal ill­nesses, Cardin said the cur­rent care sys­tem does not have an ad­dic­tion ef­fec­tive sys­tem. He said emer­gency rooms and pri­mary health care sys­tems are not re­im­bursed for “be­ing able to deal with in­te­grated and men­tal health ser­vices.”

“Some­one who is in need to­day will most likely end up in a prison rather than get- ting the type of com­mu­nity care that they need,” he said.

Ray Hof­mann, AAMC divi­sion di­rec­tor for men­tal health and sub­stance abuse, said when there’s a lack in re­im­burse­ment for ser­vices by in­surance groups, ser­vices don’t sur­vive.

“You can pi­lot some­thing but it’s not go­ing to be sus­tained and it’s not go­ing to be wide­spread if it’s de­pen­dent on grant fund­ing,” he said.

Cardin and Sar­banes said a bi­par­ti­san ef­fort is un­der­way in Wash­ing­ton to tackle the opi­oid epi­demic.

In Fe­bru­ary, Pres­i­dent Barack Obama an­nounced $1.1 bil­lion in fund­ing over a two-year pe­riod would be added to his Fis­cal Year 2017 bud­get re­quest to aid in stop­ping sub­stance abuse through­out the country. At the end of March, Obama an­nounced ad­di­tional sub­stance abuse ini­tia­tives, which in­cluded ex­pand­ing ac­cess to treat­ment, es­tab­lish­ing a men­tal health and sub­stance use dis­or­der par­ity task force, pre­vent­ing opi­oid over­dose deaths, ex­pand­ing pub­lic health­pub­lic safety part­ner­ships to com­bat the spread of heroin, in­vest­ing in com­mu­nity polic­ing, tack­ling sub­stance use dis­or­ders in ru­ral com­mu­ni­ties and im­ple­ment­ing sy­ringe ser­vices pro­grams.

Queen Anne’s County Sher­iff Gary Hof­mann said ar­rests are not the so­lu­tion to the na­tional opi­oid epi­demic. With more of a fo­cus on ed­u­ca­tion, aware­ness and en­force­ment, Hof­mann said his de­part­ment is fo­cused on spread­ing the word about opi­oid use and mis­use.

If a com­mu­nity mem­ber has a sub­stance abuse is­sue or a fam­ily mem­ber of a user has ques­tions on what re­sources are avail­able, Hof­mann en­cour­ages in­di­vid­u­als to come into the Of­fice of the Sher­iff for in­for­ma­tion about com­mu­nity out­lets. He said the de­part­ment has reached out to com­mu­nity part­ners in med­i­cal pro­fes­sions to cre­ate a pam­phlet, which will be launched next month, that ev­ery po­lice of­fi­cer who goes out on a call will have. The goal of the pam­phlet is to get in­for­ma­tion to the sub­stance user early on and to help steer them to a med­i­cal fa­cil­ity or treat­ment cen­ter.

Hof­mann spoke about the de­part­ment’s 24-hour drug take back pro­gram where res­i­dents can drop un­wanted medicine off for proper dis­posal. Hof­mann said the de­part­ment will dis­patch an of­fi­cer to a res­i­dent’s house to re­cover sub­stances with no ques­tions asked with­out charg­ing the in­di­vid­ual for pos­ses­sion.

In Anne Arundel County, which has taken a sim­i­lar ap­proach to Queen Anne’s in deal­ing with ar­rests for sub­stance users, a 24-hour cri­sis outreach pro­gram has been es­tab­lished where a men­tal health clin­i­cian as well as a men­tal health trained po­lice of­fi­cer will re­spond to cer­tain calls to­gether.

“An over­dose or prob­lem does not oc­cur from 8 a.m. to 4 p.m.,” said Jen Corbin, Anne Arundel Cri­sis Re­sponse di­rec­tor, about the unique­ness and suc­cess of its pro­gram.

Corbin said the team is find­ing suc­cess in of­fer­ing the sub­stance user in­for­ma­tion about re­cov­ery and pre­ven­tion out­lets be­fore they leave the hospi­tal af­ter be­ing ad­mit­ted.

Once they leave the fa­cil­ity, Corbin said, “do­ing cold calls the day af­ter an over­dose” to give them in­for­ma­tion was yield­ing lit­tle suc­cess. Reach­ing the in­di­vid­ual when they are “clear enough to make a de­ci­sion” is where they are find­ing com­mit­ment for treat­ment from them.

Since July, she said, about 90 peo­ple have been linked to re­cov­ery houses through their ef­forts.

Among the chal­lenges with treat­ing sub­stance use and men­tal ill­nesses from the per­spec­tive of the healthy care provider, He­len Reines, ex­ec­u­tive di­rec­tor at Path­ways (a care fa­cil­ity for teens and adults suf­fer­ing with sub­stance use and men­tal health is­sues), said many users have lit­tle to no in­surance. Be­cause many peo­ple they help are on Med­i­caid, she said, place­ment into other fa­cil­i­ties can be dif­fi­cult, “most of the time im­pos­si­ble,” be­cause the in­surance plan does not have in-pa­tient de­tox ben­e­fits or an in-pa­tient re­hab ben­e­fit in a set acute fa­cil­ity, she said.

In the past 14 months, Path­ways, a 40-bed fa­cil­ity, has alone redi­rected more than 3,000 pa­tients to other re­sources. Many of the pa­tients in Path­ways, Med­i­cal Di­rec­tor El­iz­a­beth Win­ter said, were in­di­vid­u­als ini­tially pre­scribed pain med­i­ca­tion who later be­came de­pen­dent on them. Be­cause th­ese pre­scrip­tion med­i­ca­tions are ex­pen­sive to pur­chase il­le­gally, she said, users turn to heroine for a cheaper al­ter­na­tive.

Though the Cen­ter for Dis­ease Con­trol is rec­om­mend­ing new pre­scrib­ing guide­lines, Win­ter said, many physi­cians feel at­tacked and blamed for over­pre­scrib­ing the med­i­ca­tion ini­tially. As well as ed­u­cat­ing the pa­tients about the med­i­ca­tion, Win­ter said, “We also need to be ed­u­cat­ing other physi­cians about pain man­age­ment and pre­scrib­ing and things like that in a way that’s non­judg­men­tal and non-blam­ing.”

As well as a lack of fa­cil­i­ties through­out the state to place sub­stance users for treat­ment in a timely fash­ion, Dr. Jinlen Chan, Anne Arundel County Health Of­fi­cer, said she be­lieves there is a lack of suf­fi­cient work­force de­vel­op­ment, such as trained coun­selors, psy­chi­a­trists or so­cial work­ers, to pro­vide the needed care. Chan said she and other pro­fes­sion­als have a hard time hir­ing qual­i­fied peo­ple and that the pay rates are not suf­fi­cient for those needed po­si­tions. “That is re­lated back to re­im­burse­ment rates and such.”

“I think all the var­i­ous agen­cies that are con­nected to re­im­burse­ment method­olo­gies out there re­ally have an open mind now about how to start mak­ing some changes,” Sar­banes said. “It’s about tak­ing the health care dol­lar and fig­ur­ing out how to re­dis­tribute it across the con­tin­uum of care.”

Fol­low Mike Davis on Twit­ter: @mike_k­ibay­times.

PHOTO BY MIKE DAVIS

“Opi­oid Abuse: End­ing the Epi­demic” was the topic of dis­cus­sion on the seventh floor of Belcher Pav­il­ion at Anne Arundel Med­i­cal Cen­ter as U.S. Sen. Ben Cardin, Con­gress­man John Sar­banes, med­i­cal pro­fes­sion­als and law en­force­ment of­fi­cials gath­ered to come up with so­lu­tions on Fri­day, April 8.

PHOTO BY MIKE DAVIS

Queen Anne’s County Sher­iff Gary Hof­mann high­lighted his of­fice’s 24-hour drug take back pro­gram as one mea­sure the de­part­ment and county agen­cies have taken to de­ter opi­oid abuse dur­ing a round­table dis­cus­sion at Anne Arundel Med­i­cal Cen­ter on Fri­day, April 8.

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