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Louisiana efforts to fight opioid epidemic get boost -- thanks to nearly $30 million

The Advocate - 9/24/2018

Sept. 24--Louisiana's beefing up its efforts to combat the opioid epidemic, thanks to a nearly $30 million boost from the federal government.

The U.S. Department of Health and Human Services announced last week that Louisiana will get more than $20 million for efforts to create a model that will provide a more holistic approach to addiction treatment, and the Centers for Disease Control and Prevention announced an $8 million grant to the effort.

"This epidemic is the public health crisis of our time -- and we are losing far too many Americans each day from opioid overdoses," CDC director Dr. Robert Redfield said in a statement announcing the grant. "These funds will provide critically needed resources to those on the frontlines of the fight against the opioid overdose epidemic."

According to statistics tracked by the National Institute on Drug Abuse, Louisiana has seen a sharp increase in the number of opioid-related deaths in recent years. The state also has a high rate of opioid prescriptions.

Opioids are a commonly prescribed category of narcotic pain medication, which includes OxyContin, Percocet, Vicodin and codeine.

About 20 percent of patients who see doctors for noncancer pain symptoms or pain-related diagnoses receive an opioid prescription, according to a 2016 CDC report.

Janice Petersen, deputy assistant secretary for the Louisiana Department of Health's Office of Behavioral Health, said the grants will build upon the $8 million federal grant the state received last year to improve its response to the opioid crisis.

"We really were depending on this to help continue those efforts and start new efforts," Petersen said.

Louisiana is hoping to emulate Vermont's nationally recognized "hub-and-spoke" system for addressing the opioid crisis, which has been hailed as a successful model for other states to copy.

A study on the results published by the National Institutes of Health concluded that "development and implementation of a hub-and-spoke system of care has contributed substantially to improvements in 'opioid agonist treatment' capacity in Vermont. This system may serve as a model for other states grappling with the current opioid use epidemic."

In Vermont's model, the "hubs" are addiction treatment centers that provide intense medication-assisted treatment. "Spokes" are ongoing treatment in community-based settings, including primary-care doctors and nurses, counselors and social workers.

U.S. House Majority Whip Steve Scalise, R-Jefferson, said he credits President Donald Trump's administration's commitment to addressing the nation's opioid epidemic for the boost in resources to try to address the issue here.

"These funds will go a long way toward our goals of addressing opioid addiction at the local level and treating those already battling addiction," Scalise said. "I'm proud to have worked with President Trump and my colleagues in Congress to pass some of the most significant laws to confront this drug crisis, and I will continue fighting to make sure our law enforcement officers have the tools they need to keep these drugs off of our streets."

U.S. Health and Human Services Secretary Alex Azar said that Louisiana's grant, which is part of more than $1 billion awarded to states last week, will help build in progress that the nation is seeing in combating the epidemic. "Addressing the opioid crisis with all the resources possible and the best science we have is a top priority for President Trump and for everyone at HHS," Azar said.

One of the things that will benefit from the grants is improved "wrap-around services" -- social workers and nurses, job education and other programs that are meant to increase success of treatment.

"We're trying to provide comprehensive services," Petersen said. "Of course we are ecstatic (about the federal funds)."

Petersen said that state health officials have worked to identify "hot spots" where addiction and opioid-related deaths are high and treatment is limited.

The additional funds mean that the state will be able to expand its outreach efforts to places that it hasn't before -- including local libraries and homeless shelters.

"We really are reaching out to different types of settings," Petersen said.

Louisiana has the sixth-highest opioid pain-reliever prescribing rate in the country, according to IMS Institute for Healthcare Informatics' analysis of a yearlong period through June 30, 2016. It found that there were 102.3 opioid prescriptions for every 100 people, when counting new prescriptions and prescribed refills. The national average was 69.5 prescriptions for every 100 people during that period.

The state's drug overdose rate also outpaces the national average, fueled by the rise in prescription opioid abuse and the use of illicit opioids, like heroin, and synthetic black-market opioids, like fentanyl. The CDC said Louisiana had the 19th-highest age-adjusted opioid overdose rate in 2015.

The state Legislature, in recent years, has sought to address the crisis through legislation limiting prescriptions and making opioid treatment more available.

Vermont's system has been boosted by the federal Affordable Care Act, which allowed states to expand Medicaid to more low-income adults, with the federal government picking up most of the tab.

Shortly after taking office in 2016, Gov. John Bel Edwards, a Democrat, expanded Medicaid in Louisiana by executive order.

More than 480,000 people, mostly the working poor, have been added to the state's Medicaid rolls through expansion. Nearly 12,000 people have received substance abuse treatment through outpatient services and another 13,000 have received inpatient treatment through their Medicaid expansion benefits.

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