The Battle Has Begun, but Much More is Needed to Defeat the Opioid Crisis

I’ll start this ‘Yikes Summer is Almost Over’ blog with a bit of good news: While many of us were on vacation during the last month, the U.S. Department of Health and Human Services initiated the process of distributing $53 million to 44 states, four tribes and Washington, D.C., to combat the nation’s opioid-heroin epidemic. The funding is targeted toward improving data collection and analysis, particularly in order to enhance access to treatment, decrease mortality and improve prevention. 

While this is a step in the right direction, it’s important to point out that no money has yet been appropriated to carry out the Comprehensive Addiction and Recovery Act – which was signed into law in July – despite the $1.3 billion identified to address the opioid issue next year. I’ll still choose to see the glass as half full for now, since Congress approved CARA with overwhelming bipartisan support and since the states themselves are increasingly channeling resources in this direction. That is, they’re concentrating their efforts on learning more from physicians, pharmacies, hospitals and other sources of relevant medical information with which to shape effective responses to this coast-to-coast crisis. That’s obviously a vital thing to do because so many lives are at stake; an average of 78 people in our country die every day as a result of an opioid-related overdose.

From the perspective of the Stewards of Change Institute (SOCI), however, this is just a start rather than a comprehensive approach to dealing with a burgeoning health emergency. Here’s what I mean:

In order to showcase the importance of interoperability and information-sharing during our recent 11th Annual National Symposium, SOCI developed a case study in which we chronicled the journey of one family that fell apart because the mother became addicted to opioids after a car accident, then moved on to heroin. Everything in the case study happened in real life; we just changed the names and tinkered with some details to protect everyone’s privacy.

The bottom line for this blog’s purposes is that the four family members interacted with 14 separate agencies, departments or organizations during their downward spiral from a middle-class existence to homelessness. Some of these entities were not medical in nature (courts, schools, child welfare, etc.), but they all obtained critically important information. Unfortunately, there is currently no means for gathering all this information, much less utilizing it to help this family or the millions of others like them.

Identifying and sharing a diverse spectrum of data is exactly what we suggest is needed to fully address the opioid/heroin epidemic, as well as to improve practices and outcomes across a broad range of other issues that aren’t necessarily crises. Furthermore, it’s important for the governmental and nongovernmental entities involved not only to exchange data, but also to routinely communicate across their silos with each other – i.e., to interoperate – in order to optimize processes and outcomes.

To get that point across, SOCI recently hosted a webinar in which we continued the educational initiative we began at our June symposium, using the opioid crisis as a stark illustration of how and why information-sharing and interoperability can accelerate progress. You can listen to a recording of the webinar here. The presenters included Dr. Karen Smith, Director of California’s Department of Public Health; and Katja Fox, Director of the Division for Behavioral Health of New Hampshire’s Department of Health and Human Services. Those two states are among the most impacted by the opioid epidemic, and are among the most active in working to advance information-sharing and interoperability in response.

Dr. Smith, for example, outlined a highly collaborative statewide effort to connect systems, governments and programs in response to the crisis, linking people and data from criminal justice to public health to the Prescription Drug Monitoring Program – among many others – while also forming 17 community coalitions in various California counties and initiating an “active surveillance” system specifically to learn more about the epidemic and to improve responses to it.

Fox followed by explaining her state’s own ambitious initiative, which links personnel, departments and programs from all three branches of government and which has developed a governance structure to support its prospect for success. One big lesson they learned early in this process in New Hampshire was that professionals who could have used valuable data didn’t even know it existed “because of silos.”

As impressive as these still-in-progress efforts are in California and New Hampshire, Smith and Fox both readily acknowledged that much more needs to be done, and both agreed that many of the players who should be involved in exchanging information and shaping solution still aren’t in the game. It’s also worth pointing out that this webinar provided the first structured opportunity for officials from these two states to learn what each other is doing.

I think it’s safe to assume that all jurisdictions, as well as leaders in Washington, could benefit enormously from greater knowledge about what’s working, what’s not working, and what information and resources are available to most-effectively fight an epidemic that shows no signs of letting up anytime soon. So, as part of our educational initiative, SOCI is working with numerous federal and state partners – along with foundation and industry representatives to build an Interoperability Community of Practice specifically focused on identifying efforts that prevent and detect indicators earlier in the addiction process.  Please keep an eye on www.stewardsofchange.com for more details as we proceed.

While you’re on our site, I also invite you to take a look at our new InterOptimability Training and Certification Curriculum. This first-of-its kind programs is designed to provide organizations with the most-current knowledge and most-effective tools to succeed in the 21st Century. To learn more about how your organization can get in on the ground floor of ITCC’s development and use, please feel free to contact me at daniel@stewardsofchange.org.

 I hope you had a very good summer and, on behalf of all of us at the Stewards, I wish you a wonderful – but all too quickly approaching – Autumnal Equinox.

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