University of Pittsburgh Institute of Politics Issues Western Pennsylvania Opioid Response Report and Recommendations
PITTSBURGH – The University of Pittsburgh’s Institute of Politics today released a 64-page report of the work undertaken by a regional working group convened and led by David J. Hickton, United States Attorney for the Western District of Pennsylvania. The report sets forth a community-based continuum of care model that demonstrates how Western Pennsylvania has implemented the recommendations of the National Heroin Task Force Report on a regional level and describes a framework for moving forward.
A Continuum of Care Approach: Western Pennsylvania’s Response to the Opioid Epidemic was released by United States Attorney Hickton, Mark Nordenberg, Chancellor Emeritus of the University of Pittsburgh and Chair of the University’s Institute of Politics, and Terry Miller, Director of the University of Pittsburgh Institute of Politics, at a news conference at the Joseph F. Weis Jr. United States Courthouse in Pittsburgh, Pennsylvania.
U.S. Attorney Hickton stated, “As of 2016, we have established a fusion center to receive reports of heroin overdoses and drug seizures from first responders, enhanced coordination with county District Attorneys on prosecution, continuing education for prescribers, pharmacists, medical students, first responders and the public, prevention efforts aimed at middle and high school students, increased access to naloxone, and additional take-back programs and drop box locations. The next frontier in successfully addressing the opioid crisis is to integrate public health and public safety responses. In this report, we show all that is being accomplished in our region; yet, we are transparent about what still needs to be done. The Institute of Politics has provided an effective and sustainable model that can be replicated across the country – in both urban and rural settings.”
In commenting on this initiative, Chancellor Emeritus Nordenberg said, “Partnering with U.S. Attorney Hickton to help advance the important work that he initiated has provided a special opportunity for the Institute of Politics to help this region meet the challenges of an epidemic that is taking lives, destroying families and damaging communities. More than sixty years ago, a team led by Pitt Professor Jonas Salk developed the vaccine that brought an end to this country’s polio epidemic. The opioid epidemic is the critical public health challenge of our time, and it will take a broad-based, well-organized and committed effort to meet that challenge.”
Institute of Politics Director Miller, who founded and was the first executive director of POWER (Pennsylvania Organization for Women in Early Recovery), stated, “Western Pennsylvania has been extremely hard-hit by this epidemic, but we also have the resources to effectively address the problem. Those resources include engaged and enlightened law enforcement officers, some of the world’s most accomplished scientists and public health professionals and a regional culture that is committed to cooperating to advance the public good.”
The plan underscores the importance of integrating public health and public safety to reduce overdoses; catalogs regional efforts, highlights existing best practices so that they can be deployed in other settings; exposes gaps; identifies next steps; and creates a continuum of care model to maximize interventions.
The report is organized into three sections:
- A Prevention section, which describes initiatives directed toward three groups with different vulnerabilities: the general public; those with a higher than average risk of developing a Substance Use Disorder (SUD) and their families; and individuals with an SUD at critical intercept points, including interactions with the health care system and law enforcement;
- A Treatment section, which identifies two stages of treatment strategies – case identification, which focuses on the screening process for identifying individuals suffering from an SUD, and Standard Treatment for Known Disorders, which uses SUD professionals to evaluate and determine where a person suffering from an SUD should be placed; and
- A Maintenance/Recovery section, which details strategies that are designed to help SUD patients manage the symptoms of their disease over the long term following treatment. This may include Medication Assisted Treatment (MAT) at least at the start of maintenance/recovery.
The Institute’s report contains targeted recommendations including:
- Improved access to overdose survivor data (data from EMS and hospital emergency services providers on overdoses that do not result in death);
- A uniform tracking system for open beds and outpatient slots that operates in real time, eventually showing availability throughout the state;
- The establishment of rapid response teams of first responders, law enforcement, public health professionals, health care professionals, forensic laboratory analysts and coroners, to respond to overdose spikes;
- Improved “warm handoff” processes for transitioning an SUD patient from an intercept point, such as an interaction with a physician or law enforcement officer, directly to a treatment provider through an immediate in-person transition;
- Implementation of “hard handoffs,” which are court-ordered commitments to treatment that are only used when the substance user appears to be putting his or her own life in imminent danger or is posing a risk to others;
- Establishing family support centers to provide social, emotional and financial support to families of substance users;
- Ensuring that prescribers are adopting the best practices in order to reduce the number of people who develop SUD as a result of prescription opioids; and
- Increased access to naloxone and take-back boxes.
The report reiterates the National Heroin Task Force report’s three main findings: that public safety and public health strategies for opioids must be integrated and complementary; that policies regarding opioid and heroin use must be grounded in the scientific understanding that substance use disorders are a chronic brain disease that can be prevented and treated leading; and that visible community-based recovery supports must be available, affordable and accessible.
Pennsylvania has been particularly hard hit by the opioid epidemic. In 2015, the number of drug-related overdose deaths reported in Pennsylvania increased 23.4 percent to 3,383. In the most recent data for 2015, more than 81 percent of those who died from drug-related overdoses were found to have either heroin or other opioids in their system. Several counties in southwestern Pennsylvania outpaced the state average in the number of deaths per 100,000 people. The problem affects rural, urban and suburban jurisdictions.
Pitt’s Institute of Politics serves as a neutral, non-partisan convener that facilitates the consideration of policy issues of particular importance to Western Pennsylvania. It regularly brings together federal, state, county, and municipal government officials, in association with academics and foundation, civic, and business leaders and is committed to processes that are characterized by civil discussion and evidence-based decision-making.
A Continuum of Care Approach: Western Pennsylvania’s Response to the Opioid Epidemic is available for download at http://iop.pitt.edu/sites/default/files/Reports/Status_Reports/A Continuum of Care Approach - Western Pennsylvania%27s Response to the Opioid Epidemic.pdf.