KCODE Hears About State Initiatives To Combat Drug Use
KCODE Hears About State Initiatives To Combat Drug Use
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David Slone-dslone@timesuniononline.com
KCODE Hears About State Initiatives To Combat Drug UseRunning through a “highlight reel” of the work the state of Indiana is doing to combat substance use disorder, Douglas Huntsinger provided a lot of information to those attending KCODE’s 30th anniversary celebration as the event’s keynote speaker.
Huntsinger is the executive director for Drug Prevention, Treatment and Enforcement and chairman of the Indiana Commission to Combat Substance Use Disorder.
“As all of you know, Governor (Eric) Holcomb declared the drug epidemic a top priority of his administration in 2017. He did so knowing it would require a comprehensive community-braced approach. At the heart of our three-prong framework is to attack the epidemic through prevention, treatment and enforcement with the goal of leading Hoosiers into recovery,” Huntsinger said.
He said the state has dedicated millions of dollars in programs and initiatives in each of the three areas to help the most vulnerable Hoosiers with substance abuse disorder and mental health issues.
“Under the governor’s leadership, we’ve built a statewide framework and recovery infrastructure, strategically placing intervention points for maximum impact along the way,” he stated.
Running through some of their achievements, Huntsinger said they’ve worked to provide treatment “for our 2 million Hoosier Medicaid members. Prior to January of 2018, there was no payer source for individuals who were on Medicaid. And since that time, 374,000 individuals in our state have received treatment through the Medicaid program. Our opioid prescriptions are down 25% since 2017. They’re down 48.5% since 2012.”
He said the state has increased residential treatment beds by 273%, or about 2,600 beds, “which shows you just how dire the situation for bed capacity was prior to 2017.”
The number of data waive positions - the waiver that physicians need to prescribe buprenorphine, an opioid partial agonist - has increased by 35% since July 2021. “And we have over 2,000 physicians who have a waiver to prescribe one of the three medications for opioid use disorder,” Huntsinger said.
“Five years into this battle, there’s still gaps that exist and we know that we need to do much more to help those with addiction and substance use mental health issues,” he said.
In line with the onset of Covid-19 in 2020 and the scourge of illicit fentanyl on the market, Huntsinger reported overdoses have climbed nationwide, surpassing 107,000 last year. Indiana accounted for 2,700 of those deaths.
“Fentanyl is the major driver behind our overdose deaths. In Indiana, 85 to 90% of overdoses involve fentanyl. And we know that because the Department of Health has a grant through the CDC, which works with our coroners, to find any time a coroner suspects a drug overdose, the state is paying for that funding to provide the toxicology. So we have very good results on what substances are present. Most of the time, fentanyl is not the only substance present, but we do know that is the driver behind our deaths,” Huntsinger said.
What they find, he continued, is that most of the time the individuals weren’t seeking fentanyl to begin with and didn’t know it was present. “Many times when we’ve done toxicology in our emergency departments on overdoses, individuals say that they did not know that fentanyl was present,” he said.
Given the overwhelming presence of synthetic opioids in Indiana, he said the state is focused on its harm-reduction strategy.
“So first and foremost, Naloxone, also known by its brand name Narcan. We have a partnership with Overdose Lifeline and through a distribution network of 200 grassroot distributors across the state, we have distributed over 174,000 doses of Naloxone since March of 2020. That’s about 14,000 doses a month that we’re putting out into the community,” Huntsinger said.
Access is being provided through 430 Nalox Boxes that go on the exterior of a building. Nineteen vending machines also have been placed in high-need high-traffic areas like hospitals, jails and even libraries.
“We’re also pairing fentanyl test strips with all of these so that individuals are able to test the substances that they are using and know that if fentanyl is present they should take it slower or possibly use with someone there and with Naloxone so that they can administer that,” Huntsinger stated.
He continued that they also have 10 harm-reduction street outreach teams that are in high-need areas in which the teams are meeting people where they’re at, providing them with the tools they need to stay alive and access to various resources. Many of the teams are going into homeless camps and other places where there’s a concentration of individuals who need additional services.
“We have mobile response teams. We have 11 teams covering 30 counties. Last year, they served over 7,000 individuals. The goal here is, a lot of these teams are following up on overdoses from emergency departments. They are getting referrals through the justice system. There’s a lot of detective work in finding where people are living, but offering them a number to call when they’re ready for help, providing them with Naloxone and any other resources that are available within that community,” he said.
The teams usually follow up within 72 hours and look a little different in every community, Huntsinger said.
Twenty-one counties have been provided with $100,000 to improve and enhance their collaboration and coordination of mental health- and substance use-related efforts in their communities, “especially at the intersection of treatment and the justice system to ensure that we’re integrating evidence-based treatment into our justice system and having appropriate off-ramps for individuals so that they’re receiving treatment in the community.”
The state has expanded its opioid treatment programs. In 2015, Indiana had 13 opioid treatment programs. The legislature authorized additional licenses so they could be expanded to 26. “Come this spring, we’ll have 26 programs across the state and we’ll meet the governor’s goal of having an opioid treatment program within an hour’s drive of every Hoosier. Most Hoosiers are within about 25 to 30 minutes of an OTP. These are the only facilities that can dispense methadone for opioid use disorder,” he explained.
This past summer, he said the state announced its Community Catalyst Grants, which is a $54.8 million opportunity that includes $22.3 million of local and grantee match dollars, as well as $32 million in federal funding. They are one-time dollars that provide communities with the opportunity to build out infrastructure “and the critical parts and the pieces necessary to respond to individuals with substance use and mental health issues,” he said. The funding was intended to build out care continuum, but also to improve outcomes for individuals.
“So we’ve also worked to expand access to transportation through our partnership with Lyft and 211. We provided 34,000 rides across the state. Of course, we understand that in many areas, Lyft is not an option. So, this spring we awarded $2 million to 10 providers across the state for justice-involved individuals to have access to transportation to work, work release, probation, individuals who are awaiting sentencing, where the formerly incarcerated can travel to their employment, treatment appointments and court and other appointments related to their re-entry as well,” he said.
He also talked about the opioid settlements and directed everyone to a website at in.gov/recovery/settlement.
