University of Kentucky experts on the front lines of the national opioid and addiction crises will share their work in the area of opioid use disorder research, treatment and prevention this week at the Rx Drug Abuse & Heroin Summit 2022 in Atlanta from April 18-22.
The Rx Summit is the nation’s largest annual gathering focused on addressing the opioid epidemic and is returning to an in-person format this year after being held for virtually the past two years due to the COVID-19 pandemic. .
A UK delegation including President Eli Capilouto and experts from multiple disciplines will collaborate with a global community of stakeholders who come together each year at the event to share best practices and strategies for prevention, treatment and recovery.
The meeting comes at a critical time, with U.S. overdose rates at record highs and drug overdose deaths exceeding 1 million for the first time since the Centers for Disease Control and Prevention (CDC) began collecting data on the problem more than two decades ago.
With Kentucky among the states hardest hit by the nation’s opioid epidemic, British experts tackling the crisis in the Commonwealth are at the forefront of the national effort to cultivate change and develop sustainable solutions.
Study of HEALing communities
On Tuesday, April 19 at 2:15 p.m., UK experts will present “HEALing Communities Study: Deploying Evidence-Based Practices to Reduce Opioid Overdose Deaths Through Community Engagement and Partnerships”. Speakers are Sharon Walsh, Ph.D., Research Director of the UK Center on Drugs and Alcohol; UK College of Arts & Sciences Professor of Sociology Carrie Oser, Ph.D.; Amanda Fallin-Bennett, Ph.D., assistant professor at the UK’s College of Nursing and director of the Voices of Hope program; and Jennifer Gulley of the Clark County Health Department.
In 2019, UK researchers from seven universities, in partnership with heads of state, launched a project as part of the NIH HEALing (Helping End Addiction Long Term) Study aimed at reducing opioid overdose deaths .
The four-year, $87 million study is the largest research grant the UK has ever received and builds on existing resources and initiatives, in partnership with communities, to implement a variety of ground-based strategies. on evidence to reduce opioid-related deaths in Kentucky.
The randomized study includes 16 opioid-affected Kentucky counties and is divided into two waves of eight counties each. With project activities for the first wave from eight counties – Boyd, Boyle, Clark, Fayette, Floyd, Franklin, Kenton and Madison, collectively known as WAVE 1 – nearing completion, UK experts will highlight the roles of Community Engagement, Criminal Justice and Peer Support Study.
The UK’s HEALing Communities study has partnered with county health/behavioural care and criminal justice agencies to expand drug treatment capacity for opioid use disorder (MOUD), connecting and retaining customers on MOUD, providing overdose education, and distributing naloxone, a life-saving drug that can immediately reverse the effects of opioids.
The presentation will highlight strategies used for community-level decision-making regarding evidence-based practices for opioid use disorders, explore barriers and opportunities to expand care for sufferers of opioid use disorders in criminal justice settings and examine the important role of peer support. specialists and recovery coaches to connect people to care and help them stay in treatment.
The HEALing Communities Study Team, in partnership with numerous state and community partners, is implementing evidence-based practices and removing barriers to care and recovery to reverse the tide on the impact of opioid use in the Commonwealth. With WAVE 1 of the study nearing completion, the summit offers our team the opportunity to share best practices, successes, and challenges with other experts working to develop lasting solutions to the opioid epidemic. The hope is that what we have implemented can become a national model for reducing opioid overdose deaths..”
Sharon Walsh, PhD, Study Principal Investigator, University of Kentucky
Overview of state data on overdose deaths
On Wednesday, April 20 at 4:30 p.m., UK experts will present “Insights From State Data Into Deaths Related to Fentanyl, Fentanyl Analogs, Psychostimulants, and Novel Psychoactive Substances”. UK College of Pharmacy Professor Chris Delcher, Ph.D., and UK College of Public Health Assistant Professor Dana Quesinberry, JD, DPH, will be joined by Jessica Bitting with the Centers for Disease Control and Prevention (CDC)/National Network of Public Health Institutes (INSPHI); Bruce A. Goldberger, Ph.D., of the University of Florida College of Medicine; and Michael B. Meit of the Center for Rural Health Research at East Tennessee State University.
Quesinberry will share findings from Kentucky State data on overdose deaths related to fentanyl and other psychoactive substances, including methamphetamine, and discuss how this data is shared with the community to inform efforts prevention and intervention.
Delcher will also present data showing changes in the proportional impacts of these substances across geography, time, and time periods relative to other political and societal changes, including the COVID-19 pandemic.
The Kentucky Injury Prevention and Research Center (KIPRC), an agent of the Kentucky Department for Public Health located at the UK’s College of Public Health, publishes annual drug overdose reports based on data collected from the Kentucky Office of State Medical Examiner’s Office and county coroner’s offices and placed in the Kentucky Drug Overdose Fatality Surveillance System (DOFSS) along with other data.
DOFSS’s inclusion of multiple data sources provides additional case-level information about drug overdose deaths that can better inform state and local prevention and response efforts, Quesinberry said.
“The process of investigating overdose deaths is actually very complicated, with data coming from many sources including the coroner, medical examiner and toxicology labs. Consolidating all of this information into one database gives a more complete picture of what happened in an event that caused a fatality,” Quesinberry said.
DOFSS toxicology data is also helping experts understand how the opioid epidemic is changing. Once primarily caused by prescription opioids like oxycodone and later heroin, drug overdose deaths in Kentucky are now due to fentanyl, a synthetic opioid. From 2019 to 2020, overdose deaths in Kentucky that included fentanyl in toxicology reports nearly doubled, with most related to illegally manufactured fentanyl.
Although fentanyl is the most common drug found in toxicology reports, data is also beginning to show increasing co-involvement with methamphetamine and cocaine. Quesinberry says these new trends warrant further investigation to better understand why this is happening. Delcher and Quesinberry received a grant called STIMuLINK from the CDC to investigate stimulant-related overdoses in Kentucky.
Launched in 2017, the DOFSS is now being developed as part of KIPRC’s implementation of the CDC’s Overdose Data to Action surveillance strategies to reduce the burden of substance use disorders and drug overdoses in Kentucky .
Policy, Prescribing, and Clinical Practice: Lessons from Recent Kentucky Evaluations
On Thursday, April 21 at 11:15 a.m., experts from the UK will present “Policy, Prescribing, and Clinical Practice: Lessons from Recent Assessments in Kentucky.” Presenters are Professor Trish Freeman, Ph.D. of the UK College of Pharmacy; Michelle Lofwall, MD, professor at the UK College of Medicine; and Svetla Slavova, Ph.D., associate professor at the UK College of Public Health. They will be joined by Kristin Holland, Ph.D. of the CDC.
The presentation will highlight three recent UK-led studies on opioid policy prescribing and clinical practice:
- Kentucky’s All Schedule Prescription Electronic Reporting (KASPER) Prescription Drug Monitoring Program is designed to be a source of information to assist practitioners and pharmacists in providing patient care using controlled substance medications. In 2018, a new law in Kentucky required that patient drug conviction data be made available to prescribers and pharmacists on KASPER. A UK research team has developed a continuing education program to educate prescribers and dispensing pharmacists on how to interpret this newly available data in the context of patient care. Lofwall will share insights gained on the usefulness of criminal drug records for prescribing and dispensing decisions.
- Slavova will present a study examining the use of buprenorphine, a drug used for the treatment of opioid use disorder (MOUD), during the first weeks of the COVID-19 pandemic. The results show that buprenorphine treatment increased during the pandemic after the initial hiatus from March to April 2020. Slavova says future studies are needed to examine treatment retention for people initiated on buprenorphine via telemedicine, and there is also a need to assess the association between the decline in the number of people on MOUD and the increase in opioid overdose deaths in the early weeks of the COVID-19 pandemic.
- The “day supply” is a key number that allows pharmacists to calculate average daily doses for opioid prescriptions. Since days supply is not always included on a prescription, it is often up to pharmacists to do the math and interpret the doctor’s instructions. Freeman will share a study examining the overall accuracy of opioid day supply in Kentucky pharmacies. The results show that the calculation is influenced by a variety of factors such as special instructions to the pharmacy, “as needed” instructions and payer source and suggest that these factors should be considered in research studies that depend on days supply for data. .