Millions in federal funds flow toward opioid epidemic
Look for fairly consistent funding to flow into programs combating the opioid crisis over the next several years after Alaska was designated the recipient of three grants to pay for more treatment and more law enforcement.
Gov. Bill Walker declared an opioid crisis on Feb. 14, 2017, prior to the national public health emergency declaration that came from President Donald Trump last October. Since then, the state has secured more than $5 million in funding for key rehab and law enforcement work ahead.
A McDowell Group study estimated the costs of Alaska from the opioid epidemic to be more than $1 billion in 2015.
Funds were made available through the Substance Abuse and Mental Health Service Administration, or SAMHSA. Alaska is utilizing two SAMHSA grants to support treatment expansion.
One, under the 21st Century Cures Act, has provided the State of Alaska with $2 million annually for two years through a State Targeted Response grant.
It is focused on increasing access to treatment and addressing unmet treatment and recovery needs, said Andy Jones, the director of the Office of Substance Misuse and Addiction Prevention in the Department of Health and Social Services.
Another goal is reducing overdose related deaths through prevention, treatment and recovery activities for people suffering opioid use disorders.
Three facilities that provide treatment for high-risk populations were awarded these funds: Interior AIDS Association in Fairbanks is providing medication assisted treatment, counseling, and case management; Cook Inlet Council on Alcohol and Drug Abuse in Kenai is providing comprehensive addiction services, including medication assisted treatment in the Kenai area who are struggling with opioid use disorders; Fairbanks Native Association began an integrated opioid treatment project that provides outpatient opioid use disorder treatment integrated with medication assisted treatment.
A second grant came from the Medication-Assisted Treatment Prescription Drug and Opioid Addiction program sponsored by SMHSA. It provides the state with $3 million over three years to expand access to medication-assisted treatment services for those with opioid use disorder.
Two grantees were awarded these funds: the Narcotic Drug Treatment Center of Anchorage to double capacity to 200 people; and the Bartlett Rainforest Recovery Center in Juneau, to increase the number of people it can serve to 75 per year.
A third program, this one from the Department of Justice called the High Intensity Drug Trafficking Area, will go to law enforcement for increasing resources to fight against the illegal trafficking. The designation allows Alaska to share in a $275 million federal program that coordinates law enforcement efforts targeting the distribution and sale of illegal drugs.
Alaska hasn’t yet officially received the final award amount, Jones said.
“This gives us quite a few dollars to expand treatment,” Jones said.
Work so far
Jones said a coordinated effort began to build momentum after the 2017 declaration by the governor.
The glue that held it together was weekly meetings of the Alaska Opioid Policy Task Force that included Walker and heads of state agencies, Jones said.
“We didn’t talk about what we want to do,” he said. “We talk about what we are doing.”
When Walker issued an administrative order that said the Department of Health and Social Services should look for federal grants and address the crisis head on, “he held our feet to the fire,” Jones said.
“We met every week, and now we meet monthly. We are continually briefing the governor. He has been very involved in this,” he said.
Dr. Jay Butler, chief medical officer at the Division of Public Health, said getting a handle on this kind of epidemic is different from other health emergencies.
“It’s a complex disaster. Different from say, a response to an influenza pandemic. We have multiple levels of response that’s needed and it’s a very fluid situation,” Butler said.
The practice of over-prescribing opioids by physicians was a relatively easier side to tackle than the demand and supply side of illegal drug use.
“It means increasing access to treatment. Increase the providers who can treat addiction, and remove the stigma,” he said. “We’re working on it as a health condition, not just a bad habit but it actually is a condition that affects the brain so the behavior is different.”
Butler said he draws on a comparison to get the public to understand addiction. Campaigns that teach people that “learning to just say ‘no’ would be just like saying a person with Alzheimer’s has to take a Dale Carnegie course and they’ll remember things. It’s not addressing the problem.”
A disaster declaration means public resources are strained or insufficient to handle a particular problem. Police departments and emergency responders in Alaska describe their systems as overloaded during an opioid epidemic and the community can only react as opposed to planning safeguards.
“Project Hope” was launched statewide as one of the first steps, Jones said. The Naloxone nasal spray that can save a person in the midst of an overdose was included in kits and distributed as part of the campaign.
To date, the life saving doses have been administered to 644 people throughout the state, according to data collected between May 1, 2017, and April 30.
In the same time period, about 100 people died of overdoses.
“Instead of these kits going to a select group, anyone could get training and administer emergency treatment as a citizens,” Jones said. About 10,000 kits were handed out for police cars, clinics, parents and concerned citizens.
“Many of the doses were done by citizens,” Jones said. “A woman in a grocery store bathroom saved a person’s life. The person was overdosing and the woman administered the dose in time to save her life.”
Knowing CPR and first aid basics, along with the easy-to-administer Naloxone — it goes directly into the nostrils for quick absorption into the blood — can be all it takes to save a life, Butler said.
One valuable grant came from the Centers for Disease Control. It made $750,000 available annually for three years, with a $600,000 supplemental grant, for data collection and strategic planning based on data collected.
That allowed the Division of Public Health to create the Alaska Opioid Data Dashboard.
Information collected over the past year shows 459 overdose patients were treated at Alaska emergency rooms. It also shows the number of prescriptions written by doctors that involved opioids: 504,616 from May 2017 to the end of April this year. The average number of prescriptions per month is listed as 42,051.
The numbers should prove a valuable snapshot for gaging the epidemic, Butler said, and any progress that makes a dent in it. It lists how many 2,086 drug seizures by law enforcement took place in that year, for example.
And as required by House Bill 159, which was signed into law by the governor in July 2017, it records the number of medical professionals registered with the Prescription Drug Monitoring Program, or PDMP.
Small measures help
Because most of the deaths are now resulting from fentanyl-laced heroin, the Division of Public Health will soon be making strips available that allow heroin users to test a drug for fentanyl.
“We’re waiting for the strips to come in,” Jones said. “This will help in overdose prevention because they will be better informed. And we have to be knowledgeable about what is coming in.”
Another new tool soon to be available to the public is called a “shark shaft” that encases spent needles when they are picked up off the ground so that they don’t infect members of the public that come into contact with them. The division wants to make these available for volunteers and others who help clean up homeless camps.
Lack of treatment options is often cited as the biggest problem in the state.
But programs are expanding based on public need and the urging of legislators and public health officials. A key program was instituted in Alaska’s prisons late last year.
In a contract with the Salvation Army’s Clitheroe program, the Alaska Department of Corrections has expanded its prison treatment program to serve 1,400 inmates. The new program addresses opioid as well as other drug and alcohol addictions.
Clitheroe also is expanding with the addition of new beds. A women’s treatment program will be relocated in late June to the Salvation Army Annex at 1700 C Street.
“In October and November, we are moving the men from the current Clitheroe operations to our building which used to be the Adult Rehab Center,” said Salvation Army Communications Manager Robert DeBerry. The men’s facility will then be at 660 E. 48th Ave.
“We will be going from 42 beds currently to 60 beds and we have opened a 15-bed women’s facility. So we have expanded that program to 75 beds total.”
Another facility that recently added capacity at is at Set Free Alaska in Palmer. Joy Stein, interim executive director of Set Free Alaska said “the need for space is so great that we have even converted a closet under the stairs into an office.”
A newly announced $350,000 grant from the Murdock Trust will help Set Free Alaska remodel and expand into a new building with a capacity to serve more than 1,000 outpatient clients annually that includes substance abuse treatment.
At a total cost of $2.6 million, the building will also provide much needed space for counselors and administrative services.
Added to the increased capacity at the facilities named as grant recipients by the Division of Public Health, Alaska is increasing its bed footprint, Jones said.
“We have more grants coming out,” to serve more facilities.
“The big question now is what are we missing?”
Naomi Klouda can be reached at [email protected].