Alabama Forms a Council to Counter Their State’s Opioid Epidemic

During the later half of this decade, Alabama was deemed as having the highest rate of opioid prescribing. As a result, the governor Kay Ivey established the Alabama Opioid Overdose and Addiction Council to head the state’s efforts in reducing opioid abuse. The council is made up of six sub-committees: Data, Prescriber-Dispenser, Rescue (Naloxone), Treatment-Recovery, Prevention-Education, Law Enforcement.

On the last day of 2018, the Alabama Opioid Overdose and addiction council released their annual report, featuring their extensive recommended action plan. The plan has five overarching objectives: prevention, intervention, treatment, community response, and workforce. Out of these, they strongly suggested focusing on the prevention and community efforts initially.

Additionally, this report also identified some treatment and recovery support options. The council promoted the My Smart Dose and Courage for All media campaigns, which deal with misuse education and aid, respectively. The report also mentions a 24-hours-a-day helpline of which the council desires to increase statewide awareness.

https://mh.alabama.gov/wp-content/uploads/2019/02/FINAL-Alabama-Opioid-Overdose-and-Addiction-Council-Report-to-Governor-2018-Read-only.pdf

https://www.moveforwardpt.com/resources/detail/opioid-abuse-statistics-of-50-states-2

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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

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

A Solution to the Youth Opioid Epidemic is Urgent

At 2014, the prescription rate of opioids increased by threefold since 1999. This exponential growth means that there is an increasing number of substances available to the public.

According to a national survey, youth and young adults state that it is easy to obtain and share opioids. Specifically, 32.7% of the respondents say that prescription opioids are easy to acquire and 49.5% of them state that they could do so within 24 hours.

As the availability of opioids aggravate the psychological vulnerabilities of substance use, the youth become increasingly susceptible to using these substances. However, programs designed for adolescents are absent.

Amidst the growing availability of opioids, programs that helps specifically the youth is vital and urgent in effectively step toward to solving the adolescent opioid epidemic.

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

https://www.hazeldenbettyford.org/education/bcr/addiction-research/youth-opioid-attitudes-ns-0415

Teen Opioid Use Linked to Parental Use

Recent studies have shown that teens have a higher risk of addiction to opioids if their parents struggle with the problem. This study shows similarity to the use of alcohol, cigarettes, and marijuana among teens in relation to their parents’ use of those substances.

Further analysis shows that 8% of teens who did not have parent that abused opioids compared with 14% of teens with parents that abused opioids.

https://www.aappublications.org/news/2019/02/25/opioids022519