Worth County Grad Designs National Program to Combat Opioids

Worth County grad Tisha Wiley has designed a $155 million national initiative to address gaps in the opioid crisis. She currently lives in Washington, DC and works for the National Institute on Drug Abuse, which is part of the National Institute of Health.

Around 18 months ago, she was asked to come up with a big idea for an initiative to address the crisis, which has been in the news lately. She spent the last 18 months designing the program, and she will spend the next five years overseeing the program.

As a result of Wiley’s work, the NIH is awarding 12 grants totaling $155 million to 10 research institutions and two centers that will provide supportive infrastructure. A network will be formed, which will be known as the Justice Community Opioid Innovation Network, which will support further research on opioid use disorder in criminal justice settings nationwide.

The goal will be to bring together justice and behavioral health stakeholders to improve the capacity of the criminal justice system to respond to the opioid crisis. This will be part of the NIH’s efforts to end long-term opioid addiction.

Awarded research centers will study evidence-based medications, behavioral interventions, digital therapeutics and comprehensive patient-centered treatments in 15 states and Puerto Rico.

Specific research examples include:
–Conducting research on the effectiveness and adoption of new medications for OUD
–Evaluating new state mandates around medication services and drug courts
–Assessing effectiveness and implementation of processes to engage and retain individuals in OUD treatment (e.g., telehealth, patient navigation, and peer recovery support services)
–Determining how to implement opioid-related services at the community, state, and national levels

Each grantee will work with five or more communities, where they will engage with organizations in justice settings and service providers in the community. JCOIN will address gaps in OUD treatment and related services in a wide range of criminal justice settings, including jails, drug courts, problem-solving courts, policing and diversion, re-entry, and probation and parole.

The funded institutions and respective site locations include:
–New York State Psychiatric Institute – New York
–Baystate Medical Center – Massachusetts
–Friends Research Institute, Inc. – Maryland
–Texas Christian University – Illinois, New Mexico, Texas
–New York University School of Medicine – Connecticut, Delaware, New Hampshire, New York, Oregon
–Brown University – North Carolina, Pennsylvania, Rhode Island
–University of Chicago – Illinois
–Chestnut Health Systems, Inc. – Illinois
–University of Kentucky – Kentucky
–Yale University – Connecticut, Minnesota, New York, North Carolina, Puerto Rico

George Mason University, Fairfax, Virginia, will serve as the JCOIN coordination and translation center and will be responsible for the management of logistics, engagement with practitioners and other key stakeholders in the justice and behavioral health fields, and dissemination of products and key research findings. It will also conduct research to identify effective dissemination strategies for reaching criminal justice stakeholders and provide funding for rapid turnaround innovative pilot studies. An educational component will provide outreach and mentorship to researchers and practitioners working in justice settings.

The University of Chicago will serve as the methodology and advanced analytic resource center and will provide data infrastructure and statistical and analytic expertise to support individual JCOIN studies and cross-site data synchronization. In addition, the center will conduct novel empirical research to understand the changes in state policies and practices within the criminal justice system as they relate to the opioid crisis.

Opinion -- More than Ever, We Need Each Other

by Dr. Gary Welton

My heart aches over the stories I hear about heroin overdoses. Local fathers post stories about their sons and daughters, fatal victims of the heroin market. Police conduct raids. The illegal marketing demand continues to fund Afghanistan poppy farmers. Other illegal drug markets cause societal issues, as meth labs contaminate homes and acreage. A house in my neighborhood is selling for half its former market value because of meth lab damage. More than ever, we live in a drug culture.

When I google “heroin,” however, my top hit is an article by the National Institute of Drug Abuse indicating that nearly half of young people who inject heroin reported abusing prescription opioids before starting to use heroin. As bad as our illegal drug market has become, the potential for the abuse of prescription drugs is a much more pervasive problem throughout America today.
This conversation is frequently fueled by stories about yet another superstar and his/her battles with prescription drugs, the most recent being that of Prince. I am not sufficiently familiar with his pain and challenges to comment on his possible addictions, but I am saddened at his plight and that of millions of Americans who deal with chronic pain.

Whether the pain is associated with migraines, cancer, cancer treatment, performance anxiety, or one of a hundred other issues, I am certain that someone among your friends and family needs the treatment by and benefits from prescription pain medication, in spite of the risks of addiction.
Responsible physicians are careful and cautious about prescribing opiates; sometimes they are too cautious. Individuals suffering from terminal cancer need the assistance; their risk of addiction pales in comparison to their current need. Individuals in hospice care often need the assistance; the short-term benefit overwhelms the challenges of the pending passing. In many applications, however, it is essential for physicians and users to balance the risks and benefits. The opiates are needed, yet they provide challenges associated with possible abuse and addiction. What is the answer?

More than ever, we need each other. I need you to help me make wise choices about the use and possible abuse of the opiates. I need an accountability partner, who will help me monitor my potential for abuse and addiction. I need to draw on your strength and wisdom; we need to make this a team effort.

We need accountability partners in many areas of our lives. When yet additional stories broke this winter about Johnny Manziel and his immature and illegal antics, threatening his NFL career, one of the CBS sport commentators asked where his family and friends were. Where are the mature adults in his life telling him, “Johnny, you can’t act that way. Cut it out.” Johnny needed an accountability partner.

Although we often hear of the rich and famous and their immature self-destruction, all of us are at risk, and especially so when it comes to prescribed opiates. Recognize the risks and ask your family and friends for help and monitoring. The risks will be greatly reduced when we have an accountability partner. More than ever, we need each other.

-- Dr. Gary L. Welton is assistant dean for institutional assessment, professor of psychology at Grove City College, and a contributor to The Center for Vision & Values. He is a recipient of a major research grant from the Templeton Foundation to investigate positive youth development.

Missouri PDMP NOW Coalition Applauds Sen. Sater and Rep. Engler for Sponsoring Bills To Combat Prescription Drug Abuse

The Missouri PDMP NOW Coalition applauds Sen. David Sater and Rep. Kevin Engler for introducing legislation to establish a prescription drug monitoring program (PDMP). The coalition also encourages lawmakers to pass these critical bills during the 2013 session.

The Missouri PDMP NOW Coalition is a bipartisan, broad-based coalition comprised of 30 organizations that have come together to support passage of PDMP legislation. Forty-nine other states have passed PDMP legislation. Missouri is the only state in the country that has not passed a PDMP bill.

A PDMP is a secure electronic database that lets doctors and pharmacists track prescription drug data and helps prevent drug abusers and traffickers from accessing prescription medications. PDMP data are treated as private health information and only track certain types of controlled substances dispensed within a state. It can act as an early warning system for prescribers to avoid doctor shopping, prevent dangerous drug interactions and ensure quality patient care.

"We find that many of the youth who have had issues with opioid abuse started with prescription painkillers. It is time for Missouri to take action and address this critical issue facing our families and our communities," said Dan Duncan, executive director of National Council on Alcoholism and Drug Abuse-St. Louis Chapter, a coalition member.  "This legislation protects patient privacy and helps to ensure that only legitimate patients get the prescription drugs they need." The coalition strongly supports proposed legislation filed by Sen. Sater and Rep. Engler.  These bills address the concerns of healthcare providers, patients, law enforcement, abuse prevention/treatment community, businesses and citizens.  With 49 other states having already passed PDMP legislation, Missouri can use the best provisions of other states when implementing its PDMP.  Missouri's PDMP will be designed to ensure confidentiality of information, support best use of clinical practice guidelines and
 enable real-time reporting of prescription data.

"PDMPs are critical to patient safety," said Dr. Bob Twillman of the American Academy of Pain Management and a coalition member.  "Patients occasionally fail to disclose every medication they are taking, either because they can't remember or intentionally fail to disclose the information," said Twillman. "Sometimes, those medications, when combined with new prescriptions, can make a deadly combination. Having a PDMP allows healthcare providers to check for this and avoid unintentionally prescribing problematic combinations of medications."

"A PDMP helps to reduce abuse and saves lives," said Kent Oberkrom, president of the Missouri Sheriffs' Association and a coalition member. "It will help control the growth of prescription drug abuse  a problem that the Missouri law enforcement community deals with daily. A PDMP would also give us a tool to identify pill mills  facilities that illegally prescribe opioid pain medications."