Addressing the Opioid Crisis: Five Questions for Eric McNair-Scott
SWACH’s opioid lead talks about regional efforts to address the opioid crisis.
Five questions is a new SWACH web series in which we chat with regional experts about key issues related to health and equity in Southwest Washington. We’re kicking off the series with an interview with SWACH’s own Eric-McNair Scott, who heads up a Medicaid Transformation Project focused on addressing the opioid crisis in Southwest Washington.
We’ve heard a lot of national news about the opioid crisis. How is the crisis being felt here in Clark, Klickitat and Skamania counties?
While national data shows the massive human and economic costs, we see the local impact through community members’ stories. They’ve lost family members. They have friends and loved ones struggling with homelessness, behavioral health challenges, and other issues stemming from opioid addiction.
For example, a member of our opioid collaborative recently shared a story of a child who was prescribed opioids for a sports injury. That individual ultimately became addicted and overdosed. It’s heartbreaking. And they aren’t alone in this experience.
In fact, that may explain the level of interest in regional efforts around this issue. We started our opioid workgroup in 2017 with about 20 participants. It’s grown to a collaborative of 120 participants and counting, many with their own stories. As this issue grows we’re seeing more and more people come to the table.
What are some of the barriers to overcoming this crisis here in our region?
One of the biggest barriers to addressing the opioid crisis is stigma. The science is clear. Opioid Use Disorder (OUD) is a chronic brain disease. Yet many still see addiction as a moral failing.
That’s why we’re working to build support for treating OUD as a chronic disease. When SWACH talks about “changing the conversation,” what we mean is that providers, criminal justice, local leaders and businesses need to be on the same page to effectively identify and treat those experiencing OUD. It’s a big culture shift.
Another issue is access. Many providers want to champion this issue. However, they face real challenges, like lack of training and resources. And access varies depending on location. There are several treatment facilities in Clark County. Whereas in Klickitat, there are fewer providers with less capacity. Fortunately, we’re seeing some great things happening in these communities, like the community prevention coalitions and the opioid taskforce created at Klickitat Valley Hospital.
It seems like there are various organizations already working on this issue. How would you describe SWACH’s role?
We’re a connector and a neutral convener. A lot of good work is happening. But what’s new is there are real resources — funding, tools, etc. — and organizations like SWACH working to connect the dots.
A great example comes from conversations between PeaceHealth, Lifeline and SWACH. Through a series of meetings, we learned PeaceHealth has streamlined the process of prescribing naloxone (the anti-overdose drug) at their pharmacies. We also learned it’s covered by Medicaid. This low barrier to access offers real potential to save lives. However, there wasn’t much awareness.
Around that time, I also met with public health officials in New York and was really impressed by their posters promoting naloxone as a means to save lives. We discussed the idea at our workgroup and quickly started working with PeaceHealth, Lifeline and the Syringe Exchange on a poster campaign. The posters are almost ready, and there’s an army of folks ready to take them out to the community.
What other initiatives have come out of regional collaboration?
Washington has nine Accountable Communities of Health like SWACH working together and with various partners on issues like the opioid crisis. We’re constantly looking at what’s working in other communities.
A great example comes from Bellingham, where PeaceHealth is working with a community partner to embed chemical dependency professionals in their hospitals. When a patient is identified with OUD someone is right there to connect with patient, offer support and connect them to continued treatment after they are discharged from the hospital. That led to discussions in Clark County about embedding a Lifeline chemical dependency professional at PeaceHealth. Now other local health systems are looking at similar arrangements.
But there was another barrier; access to evidence-based medication assisted treatments (MAT) like buprenorphine. In general, providers tend to feel more comfortable about starting patients on MAT treatment when there’s a clear and straightforward path for the patient to access that treatment after discharge. This led one of the champions from PeaceHealth, Dr. Hart, to work with Lifeline to set up a rapid response clinic, providing low-barrier access to MAT.
These are the sorts of changes coming out of this regional effort and the hard work of these partners. SWACH plays an important role in connecting some of those dots.
How can community members and organizations get involved?
Also, this month we’re hosting a no-cost Medication Assisted Treatment (MAT) training course on August 18, 2018 to help build capacity for treatment of opioid use disorder (OUD) in Southwest Washington. The training is part of a regional effort to address the opioid crisis by certifying providers to prescribe buprenorphine, an evidence-based treatment for OUD.