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Fighting Addiction

Commentary: Successful Rural Development Means Fighting Addiction



Hilda Legg (right), Kentucky State Director, USDA Rural Development, speaks with Director of National Drug Control Policy Jim Carroll and Volunteers of America Mid-States’ President and CEO Jennifer Hancock outside a newly opened Recovery Community Center in Manchester, Kentucky, Nov. 25, 2019. Photo: Greg Thomas /USDA Rural Development

I recently had the honor of attending the grand opening of the newest Volunteers of America Recovery Community Center in Manchester, Kentucky. This is only the fourth of its kind in Kentucky and offers a safe, welcoming place for those battling addiction. Kentucky has been hit hard by illicit drug abuse, especially opioids, with 54 of our 120 counties listed on the Centers for Disease Control and Prevention’s most vulnerable counties list.

Shortly after the Recovery Community Center’s grand opening, I joined the President’s Director of National Drug Control Policy, the U.S. Senate Majority Leader, and the Kentucky Senate President at an anti-drug roundtable discussion in London.

While you may be wondering why the state director for USDA Rural Development would be talking anti-drug efforts, President Trump’s administration has employed an all-of-government approach to fighting the epidemic of opioid addiction, and Rural Development Kentucky has played an integral role in that fight. Rural communities cannot thrive when addiction eats away at their foundations (families, workers and community leaders).

Thanks to the herculean efforts of non-profits and government initiatives at the local, state, and federal levels, we learned just a few months ago there was about a 15% reduction in the number of overdose deaths in Kentucky.

Recently, I was invited into the home of a young couple with five children. The couple was finishing up their Rural Development-funded self-help home build while she worked from home and he worked at an addiction recovery center, all while both fought the daily battle to overcome addiction. During the center’s grand opening, Volunteers of America Mid-States’ President and CEO Jennifer Hancock melted my heart when she talked about the 200 plus babies born healthy to women in their Freedom House treatment program.

These touching stories give me hope.

While it’s easy to see a slight reduction in overdose deaths and think we are winning the battle, deciding to focus attention (and funding) elsewhere would be a mistake. During the roundtable in London, the Director of National Drug Control Policy Jim Carroll said that he wasn’t sure if the country had seen rock bottom yet with methamphetamines, a topic often overshadowed by the opioid epidemic. Whether it’s opioids or methamphetamines, the bottom line is the same: We can’t afford to ease up in our efforts to rid our rural communities of the scourge of opioids and other illicit drugs.

We have made great strides in reducing the number of overdose deaths, and I’m proud of the various anti-opioid projects Rural Development Kentucky has been a partner in — from our landmark transitional housing agreement in 2018 to our recent Distance Learning and Telemedicine grants to the numerous smaller projects across the commonwealth like the mobile opioid unit in Magoffin County.

But that is not enough.

My team will continue looking for ways we can partner with our rural communities because together, America prospers.

Hilda Legg is Kentucky State Director of USDA Rural Development. Find your state’s USDA Rural Development Office here. 

This  article was originally published by The Daily Yonder. 

Fighting Addiction

Innovating Recovery: Group Highlights New Approaches To Addiction Crisis



PROACT Executive Director Micheal Haney (center right) with other recipients of the Innovation Now Awards in West Virginia. Photo: Courtesy Addiction Policy Forum
PROACT Executive Director Micheal Haney (center right) with other recipients of the Innovation Now Awards in West Virginia. Photo: Courtesy of Addiction Policy Forum

This article was originally published by Ohio Valley ReSource.

After years of leading the nation in overdose death rates, Ohio Valley communities are looking for new ways to deal with the addiction crisis. A national nonprofit organization promotes and partners with programs that do just that.

The Addiction Policy Forum celebrated new ideas at events in Kentucky, Ohio and West Virginia to honor programs selected in their Innovations to Address Addiction reports.

The 37 programs selected look beyond traditional methods of addressing addiction, which often rely on a person’s “force of will,” or expect a short period of treatment to end addiction.

“This is a disease that begins in adolescence and continues on into adulthood. To think it could be magically cured in four weeks is a mess,” Executive Vice President For Community Engagement Kimberly Clapp said.

Kimberly Clapp presents an Innovation Now Award to Amy Haskins from the Jackson County Anti-Drug Coalition in West Virginia. Photo: Courtesy Addiction Policy Forum
Kimberly Clapp presents an Innovation Now Award to Amy Haskins from the Jackson County Anti-Drug Coalition in West Virginia. Photo: Courtesy of Addiction Policy Forum

The Addiction Policy Forum is a national nonprofit organization focused on eliminating addiction as a major health problem.

The innovative programs also align with the Forum’s goals of helping patients, improving treatment and educating the public about addiction.

“Using the science that we know about the brain disease of addiction,” Clapp said. “And 50 percent of our country still doesn’t believe that addiction is a brain disease.”

Those working in the programs the Forum highlights say it’s time to focus on solutions that are forward-thinking, collaborative and that can be recreated in other communities in order to combat the crisis.

PROACTive Approach

One program in Huntington, West Virginia, applies that model to nearly every aspect of the treatment and recovery process.

Micheal Haney stands in a renovated building that used to be a CVS pharmacy. It’s now a one-stop shop for those needing help with addiction.

He is the executive director of PROACT, an outpatient treatment center that aims to guide patients from diagnosis all the way through recovery.

“We have one mission, addiction work,” Haney said. “But we focus on addiction work as the whole person.”

Executive Director Micheal Haney in his office at PROACT. Photo: Aaron Payne/Ohio Valley Resource
Executive Director Micheal Haney in his office at PROACT. Photo: Aaron Payne/Ohio Valley ReSource

PROACT is a collaborative effort. The main partnership links Valley Health, a Health Center Program that serves eastern Kentucky, southeast Ohio and southern West Virginia, and Marshall Health, which operates through Marshall University’s medical school.

“We wanted to set competition aside to actually do something meaningful together,” Haney said. “Some things Valley Health can do Marshall Health can’t, some things Marshall Health can do Valley Health can’t.”

The combined resources allow them to take walk-in clients for immediate addiction treatment — something that isn’t too common, but Haney believes is critical.

“The number one reason you lose patients is when you schedule an appointment, anything over 48 hours, your retention rate drops off by 50 percent,” he said. “So we tell people at the moment you want to come in, come in, walk in the door, you’ll see a therapist.”

That therapist guides the patient through an assessment, develops a diagnosis, and then recommends a personalized plan for treatment with the patient. That plan can take an abstinence-based approach, include medication-assisted treatment, and even incorporate a spiritual aspect.

With the help of other local partners like Marshall University and St. Mary’s and Cabell Huntington hospitals, a patient can also have housing, transportation and employment needs addressed.

The shared resources allow them to see nearly 500 patients a week, according to Haney’s estimates.

Stopping Stigma

PROACT also works to educate the community about the disease of addiction and to eliminate the stigma surrounding it.

Photo: Alexandra Kanik/Ohio Valley ReSource
Credit: Alexandra Kanik/Ohio Valley ReSource

One of the more recent education efforts involves a local African-American pastor who inquired about PROACT’s mission.

“There is a lack of treatment in the African-American community,” Haney said. “So even though we were here, and we’re open, not everybody avails themselves to that. And he felt that a lot of that was due to just a lack of understanding of what we do and the lack of understanding of addiction in general.”

As talks continue, Haney hopes they can include that congregation in PROACT’s efforts.

Stigma can also keep those who struggle with addiction from seeking out help. They may not want to associate themselves with the negative connotations surrounding the disease.

But Haney said breaking down the barrier of stigma through education equips patients with the knowledge they need to start their journey to recovery.

“Healthcare should always be about informed consent. And so if they’re informed they can then decide what they want to do,” he said.

Working Together

Haney said the Addiction Policy Forum’s recognition of PROACT as an innovative program is “gratifying.”

He thinks their model could help people in other communities struggling with the addiction crisis.

“We want to be the best,” he said.  “And we hope that through the example of collaboration, that others become even better than us.”

PROACT was one of five programs selected by the Forum that have a presence in Huntington, a city that had become notorious for high rates of addiction and overdose.

Haney credits the community with coming together with an open mind toward solutions after the city experienced 26 overdose calls in just four hours back in 2016.

“I think that was the moment when [Huntington] became sick and tired of being sick and tired,” he said. “Because of that, then everybody wants to do something, because it takes a community to come together to create something large enough to tackle a problem this big.”

Kimberly Clapp of the Forum said PROACT is a great example of the sort of innovation the region needs.

Regional Efforts

Other programs highlighted by the Addiction Policy Forum go far beyond treatment to address other aspects of the addiction crisis.

Young People in Recovery, formed in Louisville in 2012, now has 100 members and provides a wide variety of support services. Unlike traditional “anonymous” recovery programs, the group regularly hosts community events celebrating recovery. Participants often wear T-shirts with the slogan “This Is What Recovery Looks Like,” in an effort to break down the stigma barrier.

During the summer the group hosts ultimate Frisbee tournaments and in the winter, dodgeball. It also provides critical links to recovery resources and has successfully advocated for increased access to the overdose drug naloxone.

According to the Forum, the Louisville group is expanding its services to seven other Kentucky counties.

The Hocking County Vivitrol Drug Court in Logan, Ohio, partnered with a regional behavioral health provider to incorporate judicial reform into addiction recovery.

It was one of the first drug courts in the country certified to administer Vivitrol as part of its program. The drug nullifies the effects of opioids and helps those with substance use disorders manage their cravings. Hopewell Health Centers works with the court to provide the medication-assisted treatment.

The voluntary program allows participants to deal with their disease, and provides the tools to do so, rather than putting them in jail and delaying treatment.

Clapp says the Ohio Valley’s addiction crisis is complex and requires communities working together for more than one solution.

“We feel like it takes everybody to come together to solve the opioid and addiction crisis,” she said. “No crisis has ever been solved by just one sector.”

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Fighting Addiction

ARC Funds Addiction Treatment For Women In Rural Kentucky And Ohio



Key partners of the Appalachian Recovery Project meet at Ohio University Wednesday to provide updates on how the ARC Power grant will be utilized. Photo: Aaron Payne, Ohio Valley ReSource

This article was originally published by Ohio Valley ReSource.

The Appalachian Regional Commission has awarded more than two million dollars to expand addiction treatment and recovery resources for women in rural regions of the Ohio Valley hit hard by the opioid crisis.

Ohio University received $1,100,000 for the Appalachian Recovery Project in Athens County, Ohio. WestCare Kentucky, Inc., received $1,136,000 for the Judi Patton Center for Families project in Pikeville, Kentucky.

The funding comes from the ARC’s POWER Initiative, which was intended to boost economic development in regions affected by the decline of the coal industry.

The ARC found addiction recovery and economic recovery go hand-in-hand.

“There is clearly some correlation between economic distress and substance abuse,” ARC Federal Co-Chair Tim Thomas said. “So the commission though it appropriate that we use some of these resources from the POWER program to address this problem.”

Appalachian Recovery

Thomas was in Athens, Ohio, Wednesday to announces the grant as part of an update on the Appalachian Recovery Project.

The effort involves eight major collaborators working to turn the old Hocking Correctional

Facility in Nelsonville, Ohio, which closed last year, into a treatment facility able to help 300 women at a time.

Tracy Plouck, an executive in residence at Ohio University and lead for the grant proposal, said it will be a year before the renovations are complete.

The ARC grant funds will help jump-start the program and make services available to women in the community and in the justice system this fall.

“We’re bringing different kinds of resources from the community to bear into a single network so that we can more effectively assist women who are trying to connect with recovery,” Plouck said.

Those resources include residential addiction treatment, music and art therapy, job training, and health workers to help navigate the program.

Family Treatment

The ARC grant will fund the renovation of a building in Pikeville, Kentucky, to house the Judi Patton Center for Families project.

The project is named after former First Lady of Kentucky and Pike County native Judi Patton. She is known for her work advocating women’s safety and child abuse prevention issues.

The facility will provide services through WestCare Kentucky to women seeking addiction treatment and their children.

“Patients will live with their children at the site while receiving treatment through professional, licensed, evidence-based, gender-specific programming for women,” according to a description of the program from the ARC. “Onsite therapeutic child care will provide a safe environment for children while their mothers obtain needed recovery services.”

The center plans to serve 300 patients each year and provide them with resources to sustain recovery and reenter the workforce.

Thomas says the ARC invests in projects like these because they believe solutions to the addiction crisis will be found when communities work together.

“We have to build a recovery ecosystem within the Appalachian region to help bring these people through recovery.”

The ARC has awarded over $148 million in POWER Initiative grants since its inception. An estimated $45 million will be made available via the POWER 2019 funding cycle.

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Fighting Addiction

The Lonely Drop Box: How Government Drug Take-Back Efforts Can Improve in Appalachia



On the Lonely Drop Box’s website, eight red dots mark where Southwest Virginia residents can find pharmacies with permanent drug drop-off boxes.

Those dots — along with 17 blue dots representing law enforcement agencies with drop-off sites — are surrounded by gray markers showing pharmacies that don’t collect unwanted or expired prescription medication. Out of 217 pharmacies in a 26 county area, only eight offer a permanent box where customers can safely get rid of medicine, according to the project’s website.  

That’s a statistic the project is hoping to change. The Lonely Drop Box project is part of the Urgent Love Initiative, a strategy started by The Prevention Council of Roanoke County that aims to tackle the opioid epidemic and drug addiction more broadly.

In January, the Lonely Drop Box project started sending out postcards to the largest chain pharmacies in the area: Kroger, CVS, Walgreens and Walmart, urging them to install drop boxes. The idea was to flood CEO offices with 4,000 total postcards, each bearing the Lonely Drop Box — a cartoon mascot meant to remind executives of the only drug drop box provided through a chain store, which is at a Walgreens in Roanoke.

The group also began conducting research on which locations already provide drop boxes. Besides that Walgreens, they found one other drop box provided through a franchise pharmacy and six provided by independent pharmacies.

“We contacted every pharmacy in our area, which was not a small feat,” Urgent Love Initiative strategist Walt Boyle said.

The project’s goal is to give more residents the opportunity to drop off expired medication at the same place where they pick up new prescriptions. That gets unwanted medication out of people’s cabinets and out of reach of anyone who might want to use those drugs for recreational purposes, Boyle said.

“Holding on to them creates its own problems,” Boyle said. “Children, contractors, relatives, housekeepers get into these stashes and pick up a few pills and they can slowly drain away magically.”

Since 2010, the U.S. Drug Enforcement Administration has hosted national drug take back days in communities across the nation as a method of fighting prescription drug abuse. Every six months, residents can take their unused or unwanted medication to a designated location — usually a law enforcement agency — so it can be incinerated. On Oct. 14, 2017, the DEA collected 912,305 pounds of medication from 5,321 collection sites through the program, according to the department’s website. Nearly three tons of that were collected in the 26- county area that the Lonely Drop Box project is focusing on, Boyle said.

After the DEA’s program was introduced, some law enforcement agencies created permanent drop-off sites. In the Roanoke, Roanoke County and Salem area, there’s just two such sites: one at the Roanoke County Sheriff’s Office and one recently installed at the Vinton Police Department.

Roanoke County Sheriff’s Office Deputy Chad Beheler, who works as the department’s Community Outreach Coordinator, said a deputy empties 60-70 pounds out of the department’s drop box about every two weeks. Sometimes, if he sends a reminder about the drop box’s availability through social media, the box fills up in a single day.

But the presence of drop boxes in a few law enforcement agencies is not enough, Boyle said. With only 17 departments participating, residents in some counties like Craig, Amherst and Appomattox either have to wait for the next take-back day or just not donate the medication at all.

Boyle argues that the companies selling the drugs should do more to make sure they don’t fall into the wrong hands.

“Is it the responsibility of tax payers or law enforcement or the non-profit community to be working so hard to take these medications back?” he said.

The group’s idea has merit, according to Jeffrey Gray, an associate professor with East Tennessee State University’s Bill Gatton College of Pharmacy. He co-authored a 2015 study published in the American Journal of Public Health that analyzed eight permanent drug drop box locations in Northeast Tennessee over the course of two years. The results: 4,841 pounds of pharmaceutical waste, almost 240 pounds of which were controlled substances. While that accounts for less than 5 percent of the collected materials, it adds up to 106,464 dosages. Hydrocodone, tramadol and oxycodone were the top three controlled substances collected, according to the study.

Gray said there’s “no question” that drug drop boxes serve as a good method for removing medications that can be abused from communities.

I’m an advocate for patient options. The more options that patients have, the better, and the less likely that the medications will be used non-medically,” Gray said.

When Gray first began studying the drop off sites in 2009, collection of unwanted medication was limited to sporadically held law enforcement events. Now, Gray said, communities have more disposal options. Using a five-year National Institutes of Health grant, he and other researchers have continued their work. He said the group has discovered that the period between when a patient receives the medication and when they donate it has decreased during the time that the drop boxes have been in place. Researchers have also discovered that very few people are willing to go more than 10 miles to get to drop-off site.

“How far are you willing to travel to a pharmacy to pick up a medication?” Gray said. “It would make sense that they’re willing to donate it at an equal distance.”

Many people living in the Lonely Drop Box project’s 26-county focus area already have to travel a long distance before reaching a pharmacy, much less a drop off site, according to the data the group has collected. In Grayson County, two independent pharmacies are clustered near Independence, Virginia. The next closest pharmacy is near Galax, about 16 miles away. The group’s map also shows few pharmacies in Carroll, Floyd and Craig counties.

That lack of access is demonstrative of larger trends in Appalachia. According to a 2012 study prepared for the Appalachian Regional Commission, Appalachian counties have higher health care costs on average, as well as more coverage and access disparities, than other U.S. counties.

So far, Gray said the independent pharmacies in his research area seemed most receptive to the idea of installing drop boxes.

“They’re able to see the need in their community, and they don’t have to go through red tape and corporate policy to make those steps,” he said.

Boyle said the Lonely Drop Box project has also had more success engaging with independents. The group is currently working on ways to guide independents through the process of acquiring a drop off box.

But Boyle still hopes to convince chain pharmacies to “do the right thing” and join the fight as well.

“We’ve been in touch with some of the folks inside a couple of the companies, but it has turned out to be more of a PR conversation,” he said. “This is a marathon, not a sprint for them. For us, it needs to be a sprint. There needs to be a sense of urgency.”

Tiffany Stevens (@tiffanymstevens) is a print journalist living in Southwest Virginia. Their newsletter, “Happening at Home,” rounds up great reporting from two different cities each issue.

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