ANA Maine Journal - August 2018

Page 10 ANA Maine Journal August, September, October 2018
Opioid Misuse in Maine – Partnerships in Action
Juliana L’Heureux, BS, RN, MHSA
BANGOR, ME – Drug overdoses are a leading cause of injury caused deaths in
the United States. Understanding the differences in illicit drug use disorders, and
overdose deaths in metropolitan and nonmetropolitan (rural) areas are important for
informing public health programs, interventions, and policies. Addiction treatments
in rural communities are often not providing equal access to care.
A crucial need for the prevention, treatment, and recovery to curb the opioid,
and substance use disorders in rural communities were the subjects of a panel
discussion held on July 9, at Husson University’s Gracie Hall.
Drug overdose deaths in rural areas are rising. Reported by the Center for Disease
Control and prevention (CDC), the causes for the rising rates of deaths from all
causes in rural America are related to the misuse of addictive substances.
A discussion panel was led by Anne C. Hazelett from the United States
Department of Agriculture (USDA). She convened members from Maine’s
community leaders, providers, clinicians, and advocates who are knowledgeable
in the prevention and care for people who are victims of opioid misuse. Panelists
also included Maine Senator Angus King and Second District Congressman Bruce
Poliquin. A total of 15 people were moderated by Hazelett, the Assistant to the
Secretary for Rural Development with the United States Department of Agriculture.
Access to treatment and recovery in rural communities was the focus of the
discussions. Compelling testimony about the importance of providing access to
recovery care was presented by Courtney Allen, who is the co-founder of James’
Place, providing recovery care in Augusta, ME, for men and women.
Hazlett described how the USDA intends to be a rural partner with leaders in
local communities to help prevent, treat and provide recovery support for victims of
opioid misuse.
Other panelists were Christine Theriault, LMSW, CPS, program Manager,
Maine Center for Disease Control. Also, Lenard Kay, Director of the University of
Maine Center on Aging; John Gale, Senior Research Associate, Maine Rural Health
Research Center, Muskie School of Public Service; Ric Tyler, “The Voice of Maine”
radio host and Damien Pickel, the Town Manager of Milo, Maine.
Community treatment was discussed by Trip Gardner, M.D., from Penobscot
Community Health Care.
Law enforcement was represented by Penobscot County Sherriff Troy Morton.
Stephanie Nichols, PharmD, BCPS, BCPP, Associate Professor at Husson University
School of Pharmacy, spoke about the pharmacists’ response to the opioid addiction
crises and the passage of LD 1594 “An Act Regarding the Dispensing of Naloxone
Hydrochloride by Pharmacists.”
Other panelists were public health clinician Captain Chrisopher Bersani, Deputy
Regional Administrator, Health Resources Service Administration (HRSA) and
Sheldon Wheeler, Director, Office of Substance Abuse and Mental Health Services,
Maine Department of Health and Human Services.
OMNE/ANA-Maine
Annual Meeting
“Cultivating the Future of Nursing in Turbulent
Times: Resilience, Civility, Empowerment”
September 27 – 28, 2018
The Hilton Garden Inn, Freeport, ME
Featuring Keynote Speaker
A. Lynne Wagner, EdD, MSN, RN, FACCE, CHMT,
Facility Associate, Watson Caring Science Institute
speaking on
“Renewing the Heart of Nursing for Self and Others:
Sustaining Resiliency Through Caring Practices”
Register online at www.omne.org
OMNE Nursing Leaders of Maine
PMB 342126, Western Avenue, Augusta, ME 04330
Leading the judiciary response was Leigh Saufley, Chief Justice, Maine Supreme
Judicial Court.
Clinicians on the panel were Bruce Campbell, Clinical Director, Wellspring/BARN
and Barbara Ford, Director, Shepherd’s Godparent Home
Husson University President Robert Clark welcomed the panel and the audience
who met in the Gracie Auditorium. Clark described how Hussen University is
concerned about how to provide quality services in response to the need for
educational and support services for students who live in an increasingly stressful
environment.
Senator Angus King welcomed the expert panel and Anne Hazlett to Maine.
He acknowledged the urgency of the opioid addiction crises. At least one person
dies every day from the misuse of addictive substances. The disease of addiction is
impacting rural communities and impacting all sectors of the community, from law
enforcement to families.
Cost of treatment is not only measured in the coverage for treatment, but also
impacting economics by not having enough young people in the workforce. For
every person who is not treated for addiction, means is there is one less person who
would otherwise be a support to Maine’s local and the state economy. Senator King
called for funding addiction prevention, treatment and recovery. “Treating addition
without funding is like sending a fire truck to the scene of a fire without water,” said
Senator King. Support for mental health care is also essential, because addiction and
mental illnesses are often co-dependent.
Congressman Bruce Poliquin recognized the importance for responding to the
opioid and addiction crises. Poliquin acknowledged his brother’s death as a result of
substance abuse. “I’m involved in this, in part, because my brother is no longer with
us,” he said. “He was a great guy with a big heart, who died too young because
of his drug addiction.” Poliquin called for support for H.R.5109: “Federal Opioid
Response Fairness Act of 2018.”
Access to prevention and treatment can be negatively impacted in rural areas
because people are more likely to hide their need to seek help caused by fear of
stigma due to their familiarity with others in the community. On the other hand,
urban areas may provide more anonymity for people who need access to care.
Rural hospitals are often the least well equipped to treat opioid addiction. Veterans
must also have access to care, where it must be made available close to home.
Access to broad band internet will help to provide access to people in rural
communities.
USDA is involved in prevention, treatment and recovery, includes Broadband
access in rural communities. Investment is focused on equipping local leaders with
tools where local leaders can access information about other agencies or nonprofit
agencies. An interactive map is now available to spread information between
community programs currently in operation. USDA Resources are focused on
leveraging available resources for prevention, treatment and recovery.
Courtney Allen is an advocate for recovery. She grew up in a family with
challenges and eventually she was in a situation where she needed recovery
care. She recognized the power she had to change her life. An opportunity for
recovery came from the family treatment court. In a court room she was told, “I
was a person.” Until then, she said, “I had no idea that recovery was possible. My
life dramatically changed.” Moreover the moral of Allen’s personal story was that
everyone must have the benefit of receiving treatment at the time when it’s needed.
Let’s build our communities to be “recovery ready.” Today, she is dedicated to
recovery advocacy. “People can and do recover,” she said.
Moderator Hazlett asked Allen what would have made a difference in her journey
toward recovery. “Was there a place where prevention would have helped,” she
asked? Indeed, childhood trauma prevention or “trauma treatment” for children
would have helped to prevent her need to access recovery, said Allen.
Prevention and root causes of addiction were discussed by panelist Theriault.
Youth and young adults must be educated before they are exposed to addictive
substances. Most youth do not begin their addictions with heroin or opioids.
Instead, they begin with alcohol, prescription drugs and marijuana. Individuals,
families, communities and schools must be included in prevention activities targeted
to their particular areas where intervention can be effective. For example, targeted
education is provided to prescribers of opioids who receive information about where
to obtain safe needle exchanges.
Lenard Kay spoke about the risk to older adults who are the most vulnerable to
receive prescriptions with opioids. Barriers to prevention and treatment for older
adults are miscommunications about prescription use. Often, older adults do not
follow the prescription regimens and they do not discuss this with their providers.
Effects of long term care opioid use are complicated by lack of “episodic foresight,”
the term used to describe the inability to address the potential outcomes of long
term effects of addictive substances.
Troy Morton spoke about the impact of addiction on law enforcement. Medicaid
coverage stops when a victim of substance abuse enters the criminal justice system
and goes to jail.
Damien Pickel is the Milo Town Manager. He spoke about the rural impact of
addiction. He is concerned about how to maintain the well-being of children and
to prevent food insecurity stay in touch with children who have lost their parent to
substance abuse. Some older people are selling their prescriptions as a way to pay
for expenses like fuel or food. Prevention is hampered by the low number of law
enforcement presence, compared to urban areas.
Public Health officer Dr. Christopher Bersani discussed trauma informed care at
a younger age and at school based clinics. He agreed with Senator King about the
need to include mental health care in addiction treatment and called attention to
AIMHS: Actively Increases Mental Health Services.
Dr. Trip Gardner spoke about addiction treatment at Penobscot Community
Health Center: He described how addiction causes people to change behaviors.