A four-year, $2 million grant from the Merck Foundation, will assist Marshall Health and its public health partners in launching the Great Rivers Regional System for Addiction Care, a collaborative opioid intervention system for Cabell, Jackson, Kanawha and Putnam counties.
The West Virginia region has the highest number of opioid-related deaths in the state, according to the announcement.
Programs like this are of critical importance to improving and maintaining public health,” said Dr. Michael E. Kilkenny, physician director of the Cabell-Huntington Health Department.
Collaboration is Key for Effective Opioid Intervention
The Great Rivers Regional System for Addiction Care is a public health approach to reducing opioid overdoses and deaths, improving and increasing access to substance abuse services and stemming rising rates of HIV and hepatitis C.
Robert Hansen, director of addiction services for Marshall Health, explained that the focus is on community-level interventions through partnerships with healthcare providers, public health experts, first responders and other community-based organizations.
The collaboration transcends what each agency can do alone, he told Gov1. Key components of the opioid intervention system will include:
- Comprehensive public health harm-reduction programs like risk reduction services, prevention education and counseling and referral services
- Integrated, community quick response teams
- Hospital implementation of clinical pathways to treatment and recovery services
- Specialized treatment centers to serve as central hubs for connecting individuals with addiction to recovery resources and treatment services
- Opioid overdose reversal treatment education and distributionby local health departments
- Community engagement and educationto raise awareness and prevention of substance use and addiction
“It is only through a coordinated approach working with local communities that we can begin to make headway against the multi-faceted issues the opioid crisis raises,” said Lori Tremmel Freeman, MBA, chief executive officer of the National Association of County and City Health Officials in its prepared announcement about the funding.
Regional Opioid Intervention System to Address Access Barriers to Treatment
According to Pew Trusts, the Cabell-Huntington Harm Reduction and Needle Exchange Program, launched in 2016 to curtail the spread of new cases of hepatitis B and C and reduce overdose deaths through naloxone distribution and training, was innovative at the time in providing users access to a recovery coach. The Cabell-Huntington Health Department was charged by the local governments to build trust within the drug-using community and in the first nine months, the program averaged 150 visits per week -- about 4,000 visits.
“People are begging for treatment and can’t get it,” Kilkenny had said, noting that a shortage of medication-assisted treatment (MAT) with methadone, buprenorphine or naltrexone in the county of about 96,000 people, was helping to propel the popularity of the clean needle program.
This new grant will provide funds to establish a new outpatient immediate action program to expand access to MAT services, said Hansen. The four partners -- Cabell Huntington Hospital, St. Mary’s Hospital, Marshall Health and Valley Health Systems -- are working together to enhance entrance into treatment programs with a goal to increase treatment services to another 800-1,000 people.
In the last 18 months, access to MAT has already increased dramatically, Kilkenny told Gov1.
Estimates of injection drug use is about 2.5-3 percent in the county, with total substance abuse disorder requiring treatment at about 10 percent -- based on triangulated data from needle exchange programs, neonatal opioid withdrawal syndrome case data and overdose death numbers. Johns Hopkins University has recently performed a study of the region, he said, but the numbers are not available yet. However, Kilkenny said that based on available expert data, there are about 3,000 Cabell County residents currently in treatment.
Immediate Access to Treatment is Critical
Ease of access is critical to increasing the numbers being treated, Hansen explained.
The window to help people is slim,” he said.
To increase access to treatment, quick response teams called Pro/Act follow up with every person that overdoses. It’s a “warm hand-off” that includes immediate entrance into a program and a ride there, said Hansen.
“Three minutes before you’re dead is not the best time to prevent death,” said Kilkenny. “It is really clear that it is important to treat people and [MAT] is probably the best accepted and most effective known way to reduce peoples’ risk of overdose and the other harms of injections drug use.”
The Pro/Act team in Huntington is composed of three peer coaches, and a new team is forming at Charleston in Putnam County.
Hansen said there will be a six-month report on the regional collaboration, along with annual reports throughout the grant period.
