Massachusetts’ Community-Centered Approach Finds Success Against Opioids

In 2007, the Substance Abuse and Mental Health Services Administration (SAMHSA) granted Massachusetts federal funding to address opioid overdoses. The state’s Bureau of Substance Abuse Services (BSAS) then divided up the funds among fifteen communities to develop innovative programs to fight the opioid crisis. This strategy was dubbed the Massachusetts Collaborative for Action, Leadership, and Learning (MassCALL II).

In Quincy, Massachusetts, the police department began their efforts by adjusting their policy. Instead of arresting those in overdose situations for drug possession, they now allow for them to call for help without being charged. In addition, officers have been trained in identifying and dealing with opioid overdose, and all police vehicles have been equipped with nasal Narcan. The city’s opioid overdose deaths dropped by 66% in a matter of months.

Similarly, in Revere, Massachusetts, the fire department has received training regarding the application of nasal Narcan, and they carry nasal Narcan on all their vehicles as well. Since this implementation, they have saved more than 90 lives.

Bedford, Massachusetts has taken a more faith-related plan of attack. They have utilized their religious leaders to educate their community about opioid addiction and treatment options while also reducing some surrounding stigma.

Closely akin to Bedford’s efforts, the South Bay House of Corrections is focused on teaching as well. The Roxbury-Jamaica Plain Substance Abuse Coalition provides the inmates with intervention in the form of five classes and a graduation ceremony. The classes focus on inmate experiences with opioids and the police as the inmates help teach each other. As of now, there have been hundreds of graduates from this program.

Slightly differing, the Saint Anne’s Hospital has taken a consultation plan of attack. They named their model the Screening Brief Intervention Referral to Treatment (SBIRT). Within this system, they gauge a patient’s involvement in dangerous actions, explain the good and bad aspects of it, and then help set up a plan to change their risky behavior.

Lastly, a group called Learn to Cope works across the state providing counseling. This program assists in supporting, guiding, and educating those with children o siblings suffering from addiction. Several parents within the organization are certified to train others on the application of Narcan, and 16 parents have saved their children from overdose using Narcan as of 2011.

With a rather community-oriented approach to tackling the opioid epidemic, Massachusetts has clearly already made groundbreaking progress. With evidence to support their method, perhaps other places across the world should look to Massachusetts to model their own plans.

http://masstapp.edc.org/opioid-overdose-prevention

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Ohio’s Prevention and Education Strategies

The state of Ohio has recently put forth a considerable amount of effort in recent years. Governor’s Cabinet Opiate Action Team has prompted critical actions in attempt to prevent overdose deaths in Ohio. This includes the adopting laws that expand the access of naloxone (an opioid overdose reversal drug), strengthening the oversight of prescription drugs, requiring youth drug prevention curriculum in schools, developing guidelines for prescribing, closing pill mills, provisioning grant support and implementing tool-kits to local communities, investing for the integration of Ohio’s prescription drug monitoring program with electronic medical records and pharmacy systems across the state, and a focusing on public health and youth prevention campaigns.

Three departments within Ohio have been working together to address this issue. The Department of Public Safety of Ohio is the forefront of the 5 Minutes for Life educational campaign. Within this, ‘Ohio State Troopers, Ohio National Guard, or local law enforcement speak with student leaders about responsible decision-making and encouraging their peers to live a drug-free lifestyle.” The Department of Education has passed legislation which requires local school districts to cover the dangers of prescription opioid abuse within their health curriculum. This plays a fundamental role in Ohio’s Start Talking! Initiative, which gives parents and educators tips for talking to the youth about drugs. Lastly, Ohio’s Department of Mental Health and Addiction Services “leads the state’s Strategic Prevention Framework to guide communities in developing initiatives to reduce alcohol and drug abuse among teens and young adults.”

In addition to these action by the state government, there are many cases where young people directed prevention and education strategies throughout Ohio. Groups such as Prevention Action Alliance and Ohio Youth-Led Prevention Network are youth-led groups that took initiative amidst the opioid crisis. Additionally, young leaders from the Ohio 4-H Healthy Living Program created the display, “What’s in your medicine cabinet?” to raise awareness about the misuse of opioids and prescription drugs.

http://www.amchp.org/AboutAMCHP/Newsletters/Pulse/NovDec17/Pages/In-the-Fight-Against-Opioids,-Don’t-Forget-Our-Youth.aspx

The Opioid Crisis Seems to be Getting Better, but the Death Rate Still Continues to Rise

The opioid crisis and the misuse of prescription drugs are prevalent throughout adolescents. According to the Health and Human Services, 3.6 percent of adolescents ages 12-17 reported misusing opioids in 2016 and the percentage for older young adults were twice as high.

This percentage has decrease over the last couple of years. According to the Monitoring the Future National Survey Results, 1975-2018, the misuse of pain medication, excluding heroin, decreased from a peak of 9.5 in 2004 to 3.4 percent in 2018 among grade 12 respondents. More specifically, the “past-year misuse of Vicodin decreased from a peak of 10.5 percent in 2003 to 1.7 percent in 2018 and Oxycontin misuse has decreased from the peak rate of 5.5 percent in 2005 to 2.3 percent in 2018.”

Additionally, this national survey showed that students in the 12th grade believe that opioids are harder to obtain than in the past. In 2010, 54 percent of 12th grade respondents believed that these drugs were easily attainable, as compared to only 32.5 percent in 2018.

It may seem that the situation in the opioid crisis is becoming under control. However, the student death rates from overdose are increasing. In 2015, 4,235 adolescents between the ages 15 to 24 died from a drug-related overdose and over half of these were derivable to opioids. In addition, a larger population face health consequences from the misuse of opioids. The Centers for Disease Control and Prevention (CDC) estimates that for every young adult overdose death, “there are 119 emergency room visits and 22 treatment admissions.”

https://www.hhs.gov/ash/oah/adolescent-development/substance-use/drugs/opioids/index.html#ftn5

http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2018.pdf

Adolescents are Neurologically More Vulnerable to Opioids than Adults

According to studies in 2019, adolescents are developmentally wired to pursue highly stimulating behaviors to garner a large neurologic reward”. Unlike natural rewards such as eating food, opioids prompt a direct receptor binding of the signaling in the reward center. This is a psychoactive and forceful type of stimulation. As a result, the initiation of substance use peak during adolescence and early adulthood.

This type of risky behavior is more likely to be deterred in adults because of their development of the prefrontal cortex. This part of the brain is responsible for functions such as impulse control, self monitoring, and error correction. However, seeing that the prefrontal cortex does not mature fully until the age of 25 (approximately), the risky behaviors are less likely to be discouraged because of their insufficient development. This ultimately leaves the brain’s reward center vulnerable to changes that result in addiction.

Along with neurological vulnerabilities, physiologic vulnerabilities for opioids are intensified by environmental factors, such as availability, promotion, and cultural messaging.

https://pediatrics.aappublications.org/content/pediatrics/early/2019/01/02/peds.2018-2752.full.pdf

Where are the Dentists in Oakcliff, TX ?

 

The map today shows the geographic location of dentists currently practicing in the Dallas, TX area. In the process of conducting our GIS research, we noticed some areas that were heavily populated with oral health services as well as areas that are likely experiencing disparities in oral health care.

To bring awareness to the current health conditions in low-income areas in South-Dallas such as Oakcliff and other communities, the Oral Health Needs Index (OHNI) made an easy-to-access, oral health focused, Geographic Information System (GIS) based tool that allows people to find services based on their environment and resources.

Identifying dental providers who accept Medicaid/Medicare and forms of dental insurance in areas of low socioeconomic status can be difficult but it also essential in tackling disparities. With OHNI, users get a clear visualization of communities with lack of services. Lack of transportation and finding participating providers is a major barrier for low-income and rural populations. Identifying these barriers and how they contribute to health disparities experienced by under-served communities is important. It allows for a better understanding of ways to combat the health disparities in disadvantaged communities.

I Need a Ride to the Dentist!!!

 

The maps listed shows the location of practicing dentists in the Miami,Fl area. Areas that are highlighted in orange/red are areas that experienced a high number of residents reporting not having a working vehicle at their home. Based on our research and maps created, you can see a huge shortage in availability of practicing dentists in areas that are lacking transportation. What you will also notice is a huge difference in the amount of practicing dentists in South Miami compared to North Miami. Being able to bring a clear visualization of health disparities such as oral care is important in decreasing healthcare costs in the US.

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With the use of these maps, we get clear visualizations of health disparities experienced by under-served communities and it allows for a better understanding of ways to combat these disparities.

http://oralhealthindex.org/

https://www.pewtrusts.org/~/media/assets/2012/01/16/a-costly-dental-destination.pdf

#oralhealthcare #oralhealth #oralhealtheducation #oral #oralbgenius #dentist #dentistry #publichealth #healthcare #healthcaremanagement #oralcare #oralgenius #oralhygiene #oralmedicine #oralsurgery

What you didn’t know about Tooth Decay or Gum Disease!!

IMG_4047This is an example of a choropleth map. From the map we can see the percent of teeth that have been extracted due to tooth decay or gum disease for 2006, 2008 and 2010.  A large percent of teeth extractions occurred in southern states indicated by the counties in red compared to Western states indicated by the counties in yellow.

Interestingly, the South is known for having poorer health outcomes and higher rates of chronic disease. Maps like this allow for this information to be displayed in a picture.