Opioid Crisis

Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. However, they are extremely dangerous when used incorrectly. Many Georgians have lost their lives caused by opioid overdose. In Georgia, within the last year, hospital emergency rooms have been inundated patients who have overdosed.

This crisis is constantly a reoccurring subject in the news. GHA is working with hospitals and state and federal agencies to develop strategies on saving lives. 

The Facts

According to the Centers for Disease of Control:

* 48.5 million Americans have used illicit drugs or misused Rx drugs

* Almost 218,000 Americans died from overdoses related to Rx opioids from 1999 to 2017

Newest Opioid Training for Providers

CDC released the final three modules in the Applying CDC’s Guideline for Prescribing Opioids interactive online training series for healthcare providers. The latest modules focus on, Opioid Use and Pregnancy, Motivational Interviewing, and Collaborative Patient-Provider Relationship in Opioid Clinical Decision Making. In these self-paced modules, providers will learn about opioid considerations in pregnancy, patient-centered communication practices, and approaches to shared, opioid decision-making. Each module includes clinical scenarios, knowledge feedback prompts, and a resource library to help enhance learning.

  • Module 9: Opioid Use and Pregnancy
  • Module 10: Motivational Interviewing
  • Module 11: Collaborative Patient-Provider Relationship in Opioid Clinical Decision Making

Rx Drug & Abuse Heroin Summit

The Rx Drug Abuse & Heroin Summit convenes a national collaboration of stakeholders from Federal to family to discuss what’s working in opioid overdose prevention and treatment. Be part of the international discussion on addressing the opioid crisis at the 2019 Rx Drug Abuse & Heroin Summit April 22-25, 2019 in Atlanta. 

Rural Patients Reportedly More Likely to Receive Opioid Prescription

According to a report released Jan. 17, the Centers for Disease Control and Prevention indicates patients in rural counties had an 87 percent greater chance of receiving an opioid prescription from their primary care provider between January 2014 and March 2017 than patients in large metropolitan areas, Prescribing rates were higher in rural than urban counties throughout the study period, but decreased across all rural and urban categories after the CDC released its guidelines for prescribing opioids for chronic pain in March 2016.

CDC Reports Synthetic Deaths on the Rise

Jan. 8, 2019 - According to the CDC, overdose deaths related to synthetic opioids increased more than 45 percent in 2017, likely driven by illicitly manufactured fentanyl. Deaths from heroin and prescription opioids remained stable. "The drug overdose epidemic continues to evolve, with the involvement of many types of drugs including opioids, cocaine and psychostimulants," said Debra Houry, M.D., director of CDC's National Center for Injury Prevention and Control. "This underscores the urgency for more timely and localized data to inform public health and public safety action." 

Article: How Hospital Leaders are Responding to the Opioid Crisis

Health systems are diverting resources from other areas of their operations to deal with the opioid epidemic, investing in new prescriber education, new technologies to monitor prescribing, and new alternatives for pain management. Research indicates that the most effective strategy has been offering dosage guidelines for acute care patients on discharge.

Read the full article in Fierce Healthcare.

GHA President Editorial

The abuse of opioids has tormented families and friends nationwide, claiming thousands of lives. Amid all the heartache, one thing is constant: Everyone recognizes that immediate attention is needed.

The Georgia Hospital Association (GHA) has supported solutions at both the federal and state level to address this epidemic. Our hospitals and partners have developed resources and tools and conducted seminars and meetings to educate the public. 

Now, in addition to the tremendous work that Georgia Attorney General Chris Carr is currently doing, some much-needed help at the federal level may be on the way. Our elected officials on both sides of the aisle have come together to support legislation that, hopefully, will provide answers and resources for so many families in need. On Oct. 3, the House and Senate overwhelmingly approved House Resolution 1099, the “SUPPORT for Patients and Communities Act.”

Our main mission is to give patients the best care possible. When it comes to opioid treatment, this piece of legislation is a step in the right direction. The extensive bill, if approved by President Trump, would allow states like Georgia to receive federal Medicaid matching funds for up to 30 days per year for services provided to adults aged 21-64 for substance abuse disorders (SUD) in institutions for mental diseases. Additionally, the bill will address several other provisions related to opioids and pain management, including the promotion of opioid alternatives in emergency departments; care coordination for drug overdose patients; and improvements to prescription drug monitoring programs.

I applaud the work of legislators to address opioid abuse. The creation of this bill goes hand-in-hand with the efforts of our hospitals, physicians, and other healthcare providers who are working around the clock to eliminate the abuse and misuse of opioids.

By itself, this legislation will not fix the crisis entirely. But it is another important step in our nation’s recovery from this epidemic.

Earl Rogers
GHA President

Resources Available for Rural Communities Combating the Opioid Epidemic

The US Department of Agriculture Rural Development agency has resources that can assist rural communities combating the opioid epidemic.  The USDA Rural Development are thankful to be able to team up with Georgia’s statewide opioid task force.  
 
These funds can be used through public bodies or non-profit corporations to build, renovate, equip or rehabilitate essential community facilities such as hospitals, mental health clinics, withdrawal centers, educational facilities and more. Eligible uses also includes upgrading E-9-1-1 systems and equipment and purchasing police, fire and ambulance vehicles.
 
In general, a city, town or unincorporated area with a population of less than 20,000 and unable to secure funding elsewhere can be eligible. Direct loans, loan guarantees and grants are available. Grants are capped at $25,000 per eligible project.
 
Contact USDA Rural Development to get started. Rural Development Georgia Opioid Response Coordinator:
Deborah Callahan706-552-2595, Deborah.Callahan@ga.usda.gov

Cartersville 678-719-3508
Monroe 770-267-1413, Ext. 4
Fort Valley 478-827-0016, Ext. 4
Sandersville 478-552-6073, Ext. 4
Tifton 229-382-0273, Ext. 4
Douglas 912-384-4811, Ext. 4

Statewide Opioid and Substance Use Response Plan Released

GHA joined the Department of Public Health for the roll out of the statewide Opioid and Substance Use Response Plan. This Plan, which includes input from various stakeholders around the state, including GHA, compiles goals and objectives for six work groups:  Prevention and Education, Maternal Substance Use, Data and Surveillance, Prescription Drug Monitoring Program, Treatment and Recovery, and Control and Enforcement. The Department of Public Health brought together many other state agencies, including the Department of Community Health, the Department of Behavioral Health and Developmental Disabilities, the Attorney General’s Office, the Department of Education, the Department of Human Services, and various law enforcement agencies to ensure a well-coordinated, statewide response. As we move on to the implementation phase of the Plan, GHA will continue to support our members in this important work.  

Surgeon General Releases Spotlight on Opioids

Facing Addiction in America: The Surgeon General’s Spotlight on Opioids calls for a cultural shift in the way Americans talk about the opioid crisis and recommends actions that can prevent and treat opioid misuse and promote recovery.

The Spotlight – the Surgeon General’s newest update on opioid addiction – also provides the latest data on prevalence of substance misuse, opioid misuse, opioid use disorder and overdoses.

The Surgeon General today also released a digital postcard, highlighting tangible actions that all Americans can take to raise awareness, prevent opioid misuse and reduce overdose deaths.

“Addiction is a brain disease that touches families across America – even my own,” said U.S. Surgeon General Jerome M. Adams. “We need to work together to put an end to stigma.”

According to preliminary data from the Centers for Disease Control and Prevention, overdose deaths in 2017 increased by almost 10 percent – claiming the lives of more than 70,000 Americans.. Nearly 48,000 of those were opioid overdose deaths, with the sharpest increase occurring among deaths related to illicitly made fentanyl and fentanyl analogs (synthetic opioids).

Despite the fact that effective treatment for opioid use disorder exists, only about one in four people with this disorder receive any type of specialty treatment. Yet for a variety of reasons, including stigma, inability to access or afford care, or refusal to stop misusing opioids, a treatment gap remains.

In addition, the existing healthcare workforce is understaffed, often lacks the necessary training, and has been slow to implement Medicated-Assisted Treatment, as well as prevention, early identification, and other evidenced-based recommendations.

“Now is the time to work together and apply what we know to end the opioid crisis,” said Dr. Elinore McCance-Katz, Assistant Secretary for Mental Health and Substance Use. “Medication-assisted treatment combined with psychosocial therapies and community-based recovery supports is the gold standard for treating opioid addiction.”

The federal government has been working with key stakeholders to address this problem and is seeing real progress. This week, HHS disbursed more than $1 billion in opioid-specific funding for states, which includes State Opioid Response grant programs administered by SAMHSA to support a comprehensive array of prevention, treatment, and recovery services. Additional funding from the Health Resources and Services Administration (HRSA) went to community health centers to increase access to substance abuse disorder and mental health services, to increase the number of professionals and paraprofessionals who are trained to deliver integrated behavioral health and primary care services as part of health care teams in HRSA-supported health centers as well as to rural grantees to increase services and develop plans to implement evidence-based opioid use disorder prevention, treatment and recovery interventions. There are signs that efforts to stem the opioid crisis are having success, with the use of medication-assisted treatment growing significantly and the number of Americans initiating heroin use dropping significantly from 2016 to 2017.

“Addressing the opioid crisis with all the resources possible and the best science we have is a top priority for President Trump and for everyone at HHS,” said HHS Secretary Alex Azar. “Surgeon General Adams has been a leader in raising awareness about the nature of addiction and the effectiveness of medication-assisted treatment, complementing the support HHS provides for access to treatment and recovery services.”

“Today’s announcement is another step forward in our efforts to educate the American public about steps they can take to prevent addiction,” said Assistant Secretary for Health Brett P. Giroir, M.D, who also serves as the HHS Senior Advisor for Opioid Policy. “We are making progress. Just last week we released the 2017 National Survey on Drug Use and Health (NSDUH) data, which showed significantly more people received treatment for their substance use disorder in 2017 than in 2016. This was especially true for those with heroin-related opioid use disorders.”

The science shows us that no area of the United States is exempt from the opioid crisis. Yet, only 53 percent of the public consider opioid addiction a major concern. As a result, the Surgeon General is calling on all individuals to do the following:

  • Talk about opioid misuse. Have a conversation about preventing drug misuse and overdose.

  • Be safe. Only take opioid medications as prescribed, make sure to store medication in a secure place, and dispose of unused medication properly.

  • Understand pain and talk with your healthcare provider. Treatments other than opioids can be effective in managing pain.

  • Understand that addiction is a chronic disease. With the right treatment and supports, people do recover.

  • Be prepared. Get and learn how to use naloxone, an opioid overdose reversing drug.

For the full document and to view the digital postcard, visit http://addiction.surgeongeneral.gov.

If you or someone you know is struggling with a substance use disorder, call 1-800-662-HELP or visit http://www.samhsa.gov/find-help.