An intern’s call to engage in the fight against opioid addiction

Three years ago, if anyone had used the word ‘epidemic,’ it would not have occurred to me to preface it with the word ‘opioid.’ It is a bit disturbing to hear and read news reports on the extent to which opioids have affected families across the United States. Just recently, the Centers for Disease Control and Prevention (CDC) reported that 42,000 people died in 2016 due to opioid overdose and nearly 40 percent of those deaths involved a prescription opioid. Although Texas is currently posting a lower overdose death rate than the national average, overdose deaths in our Lone Star State are on the increase, going from 1.5 to 4.2 deaths per 100,000 people in 2016. Bringing it closer to home, four of the country’s 25 worst cities for opioid use rates are in Texas: Texarkana (#10), Amarillo (#13), Odessa (#15) and Longview (#17). As a healthcare policy intern in the Policy & Advocacy Department at Methodist Healthcare Ministries, I am interested in learning more about what types of initiatives, both local and statewide, are being mobilized to get ahead of this epidemic.

To better understand the systems in place to support communities affected by opioids, I first looked at the ways Methodist Healthcare Ministries combats opioid use. Two strategic pillars became clear very quickly — the first being strategic grantmaking. Guided by its vision to be the leader for improving wellness of the least served, Methodist Healthcare Ministries provides grants to numerous community stakeholders across South Texas in five categories — one of which is Social Services & Behavioral Health. In 2018, Methodist Healthcare Ministries allocated nearly $7.7 million for Social Services & Behavioral Health programs which includes counseling and recovery services that are important in treating opioid addiction. The second approach Methodist Healthcare Ministries employs to combat opioid addition is through its Community Counselors, stationed throughout South Texas, who provide direct access to behavioral health services.

I then turned my attention to statewide initiatives. What I found made me feel hopeful that state policymakers have acknowledged the urgency of the crisis and are working diligently towards a solution. Within the last couple of years, Texas has developed targeted initiatives and partnered with various community stakeholders to tackle opioid addiction. In 2017, the Texas Health and Human Services Commission (HHSC) received $27.4 million in Federal State Targeted Opioid Response grants to create the Texas Targeted Opioid Response (TTOR) Grant. The two-year grant aims at increasing outreach and general education regarding opioid treatment and training, hoping to reduce opioid related deaths and overdoses in Texas. HHSC plans to expand opioid prevention and treatment services through its existing partners and the recruitment of new providers to expand networks, all with the assistance of Local Mental Health and Behavioral Health Authorities and university partners.

In 2015, the Texas Legislature created the Texas Maternal Mortality and Morbidity Task Force to investigate high maternal mortality trends in Texas and revealed new data showing that drug overdose was the leading cause of pregnancy-associated deaths between 2012-2015, with 37 out of the 64 drug overdose maternal deaths in that period being due to an opioid. Connecting an opioid overdose as the cause of death for a young pregnant mom is something that leaves you a bit unsettled and sad. Two young lives are lost to the world before they had a chance to start. The Task Force points to existing programs aimed at preventing and treating opioid use in pregnant women as a key intervention strategy. To prepare lawmakers for the 2019 legislative session, Texas House Speaker Joe Straus (San Antonio) took action in October 2017 to create the House Select Committee on Opioids and Substance Abuse, directing the committee to study both the impact of addiction and effectiveness of the programs and treatment options and develop concrete principles and action items. Two of the 13 members of the Select Committee represent districts within Methodist Healthcare Ministries’ service area. 

Closer to the place I’ve called home for the past five years, I’ve learned that Bexar County leads the state in Neonatal Abstinence Syndrome (NAS) and has the third-highest per-capita rate of overdose deaths in Texas, as reported by the Rivard Report. In the summer of 2017, Bexar County Judge Nelson Wolff and San Antonio Mayor Ron Nirenberg created the Bexar County Joint Opioid Task Force to decrease the overall deaths due to opioids. Members of this task force — including experts in public health, medical and pharmaceutical professionals, first responders, educators and policy makers — will develop strategies to address the opioid crisis in a comprehensive manner with an aim to decrease the number of opioid deaths in Bexar County. The proposed strategies will include: increasing the use of overdose reversal drugs by first responders; improving provider training on evidence-based practices; increasing access and awareness of treatment options; and increasing public knowledge regarding the increase use and disposal of opioids.

My review of recent national and state reports on the impact of opioid addiction on our Texas families leaves me concerned, but even more importantly, it’s made me informed and aware. This epidemic has no boundaries, and shows no sign of slowing down. A recent Vital Signs report from the CDC reported that there has been a 30 percent increase in emergency department visits due to opioid overdose between July 2016 and September 2017 – a reminder that we need to engage and we need to do it now.

For my part, I look to join my Policy & Advocacy team in learning how Methodist Healthcare Ministries can continue to assist state efforts and how we can increase awareness of the problem in our communities. Our department will be following state and local policy initiatives over the legislative interim in preparation for the state’s 86th Legislative Session, scheduled to convene on January 8, 2019. Together we can ensure that Texas families are empowered to overcome this epidemic and future generations will have the tools to battle similar struggles.

For those suffering from opioid use, it is important to identify community resources that are available to treat their addiction as soon as possible. The Center for Healthcare Services and the San Antonio Council on Alcohol and Drug Awareness provides services for opioid addiction in Bexar County. The Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Alliance on Mental Illness (NAMI) also provide helplines for those seeking help for opioid addiction. SAMHSA provides a treament finder of Opioid Treatment Programs throughout Texas. These programs offer counseling and medication assisted treatments for opioid addiction.