In the state of Indiana, there are now enough bottles of opioid painkillers in circulation for nearly every resident to have their own, according to the Centers for Disease Control and Prevention. Experts indicate if the opioid-related death toll continues to rise, it could exceed 15,000 in the next decade in Indiana alone.
Indiana Gov. Eric Holcomb appointed Executive Director for Drug Prevention, Treatment and Enforcement Jim McClelland as part of the new administration’s “NextLevel Recovery” initiative. McClelland states in 2016, Indiana had the fifteenth highest drug overdose death rate in the country.
While the statistics are staggering, he says, it’s forced businesses, organizations, agencies, universities, medical professionals, law enforcement and the judicial system to band together in new, unique ways.
“Many groups are working in cooperation with the state to attack this issue in a comprehensive way,” McClelland says. “We have a big problem in Indiana and we have a lot of work to do. Every day this crisis is destroying lives.”
The state has recently authorized the opening of five new opioid treatment facilities. Passage of legislation currently before the General Assembly will make possible up to an additional nine in the near future so no Hoosier is further than a one hour drive from treatment.
In the last two years, CleanSlate Addiction Treatment Centers has opened seven office-based, outpatient addiction medical centers in Indiana, two in Indianapolis in January. The company focuses on science and medicine-based addiction treatment plans.
“At the community, state and national levels, everyone needs to work together to remove barriers for treatment. Opioid addiction is still underground. We need to remove stigmas associated with this disease. Patients come in from all walks of life,” CleanSlate Centers Medical Director Dr. Claudie Jimenez says.
McClelland adds, “It’s been far easier to get high than to get help. That must change.”
In an effort to increase access, addiction residential treatment is now be covered by Medicaid and the state’s healthcare program, Healthy Indiana Plan or HIP. Recent approval by the Centers for Medicare and Medicaid Services in Washington D.C. could result in up to an additional $80 million per year in federal dollars for those services.
Indiana University committed $50 million over the next five years through its Grand Challenge Initiative, “Responding to the Addictions Crisis.” IU is homing in on five focus areas that include: ground-level data collection and analysis, training and education, policy analysis and development, addictions science, and community and workforce development. Their hallmarks are to concentrate resources, to work with others and focus on practical impacts.
“Everything we’re doing, we’re doing with someone else ... it is still rare to have people work together across boundaries; the willingness to say, ‘We don’t care who gets credit, we just want to reduce the risk of duplicating efforts.’ We want everyone to have a seat at the table. We don’t want to keep repeating mistakes of the past,” Indiana University Vice President for Research Fred Cate says.
The unique approaches to combating this issue run the gamut from companies creating or supporting drug rehabilitation programs for existing employees or future employees struggling to pass a drug-screening test to emergency rooms offering access to peer recovery coaches. Online webinars are in development to aid smaller communities and more rural areas. Mobile crisis teams are being implemented.
Courts join the battle
Indiana Chief Justice Loretta Rush and co-chair of the National Judicial Opioid Task Force says this all-hands-on-deck approach can be seen statewide and has become top of mind at a judicial level.
“This is a public health crisis that intersects with the judicial system. It is the No. 1 issue Indiana judges are facing,” Rush says.
Rush says the task force is defining best practices and setting goals that can be brought back to state and local courts. She says judges need to be equipped to handle this new type of caseload, while understanding the science of addiction to implement solutions such as requiring effective, evidence-based treatment.
“A punitive approach is not a long-term solution. It is not a good or right solution,” she says.
The National Center for State Courts released a new online resource this month that will be updated weekly in an effort to foster additional collaboration and resources, a tool Rush says is invaluable.
“To create long-term sustainable solutions, collaboration is key … All addiction is tragic, but this one has such a hold on people. In my 35 years of experience, I’ve never seen a manmade epidemic of this magnitude … there is no part of Indiana that isn’t touched by this.”