The United States has been facing an opioid addiction epidemic for several years, and Texas has not been exempt. In 2018, Texas saw 1,402 opioid-involved overdose deaths, and according to the American Enterprise Institute, the epidemic cost Texas about $20,875,563.
Besides addiction treatment, costs account for resulting burdens to the criminal justice system and health care from attendant complications.
As part of the effort to fight the opioid crisis, the Texas Health and Human Services Commission (HHSC) recently received a two-year, $104 million grant from the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration.
“We’re working closely with agencies throughout Texas to increase prevention awareness and help people all over the state who have opioid use disorder or know someone with opioid use disorder,” commented Sonja Gaines, HHS deputy executive commissioner for Intellectual and Developmental Disability and Behavioral Health Services.
In 2018, HHSC received $46.2 million in funds and an additional $24.1 million in 2019. The money has been used as part of the Texas Targeted Opioid Response (TTOR) Program established by the state to implement prevention, treatment, and recovery programs around the state.
According to HHSC, “more than 600,000 people have received prevention, treatment, or recovery support services through the TTOR program, including treatment, peer coaching services, disposal of prescription drugs, and overdose-related emergency response services.”
When asked how HHSC evaluates the effectiveness of programs using grant funds, a spokesperson for HHSC said they must provide invoices and performance data related to their program goals.
For example, a project focused on helping opioid overdose survivors quickly get treatment and services to support long-term recovery provides HHSC with information including total numbers of overdose prevention kits distributed, how many people were connected to medical care, intensive case management, and peer recovery services; and total numbers of follow-up visits.
Dr. Jennifer Potter, who leads the Texas Medication for Opioid Use Disorder (TxMOUD) Initiative in San Antonio, has received about $12 million per year in grant funds to treat opioid addiction around the state.
“We want people to know that there is medication for opioid use disorder; this is a treatable disease,” Potter told The Texan, adding that medications like naltrexone and buprenorphine have a 50 percent response rate and help stabilize OUD patients rapidly.
“Taking these medications help you return to functioning,” Potter said, mentioning the story of a parent who was able to get medicine to help with opioid use disorder and whose family was reunited.
TxMOUD works with outpatient programs around the state to develop treatment programs. “All of the grant money goes to treatment,” Potter pointed out.
In the upcoming fiscal year, Potter said their focus will move away from the I-35 and I-10 corridors and into smaller cities.
“I am proud that HHSC is working with the UT Health Sciences Center because it helps show the public that we can help Texans. Opioid addiction is a public health issue and the university has a responsibility to help the public,” Potter said.
In 2018 and 2019, Potter said they had seen a tapering off of opioid use and overdoses, but she added that trends in 2020 suggest an increase in overdose deaths by 20 percent.
“One of the factors is [COVID-19] because access to treatment is reduced, and the social isolation that has resulted contributes to a relapse in those who suffer from opioid use disorder,” she explained.
In Houston, there is an opioid-related death every 32 hours, which prompted Dr. James Langabeer, PhD, MBA, a professor with McGovern Medical School and the School of Biomedical Informatics at UTHealth, to begin HEROES (Houston Emergency Opioid Engagement System) in 2017 with funding from the HHSC grant program.
As a professor of emergency medicine, Langabeer saw the need to train doctors in the emergency departments of hospitals how to better deal with the addiction side of opioid-related situations. This includes recognizing the signs of addiction, medications that help them overcome the addiction, and the need to treat as soon as the patient is ready.
Additionally, Langabeer started an assertive outreach program in 2018. Working closely with Houston Police and Fire Departments, HEROES reaches out confidentially to people who have called 9-1-1 for help with opioid addictions.
This program has reached out to over 5,000 people and has successfully treated over 650, Langabeer said.
“Now we are offering a program for family members who are impacted. We just heard from a mom whose son just overdosed on fentanyl, and she needs to know what to do,” Langabeer told The Texan.
Langabeer also confirmed that the number of overdose calls has increased during the pandemic. “Isolation is really bad for people with addictions and mental health issues,” he said.
The latest HEROES effort is to work with first responders who have addictions. This effort, started about six months ago, is aimed at helping first responders.
“This money is really needed to help people get back on their feet and contributing to society,” Langabeer said about the grant money from HHSC.
As part of the prevention prong of the program, Texas made the Prescription Monitoring Program (PMP) mandatory on March 1 of this year. Pharmacists and prescribers are required to check the patient’s PMP history before dispensing or prescribing opioids in an effort to help eliminate the duplication and overprescribing of controlled substances, as well as to obtain critical controlled substance history information.
Dr. Michael Mackert, director for the Center for Health Communications at the University of Texas, helps promote the Texas PMP with the $3.2 million in grant money he has received since 2017.
He told The Texan that the goal of his efforts is to help health care providers decide which is the appropriate prescription for a patient.
Mackert’s group used the HHSC grant money it received to research why providers weren’t using the PMP and how to make the tool more efficient. His team has also developed a communication toolkit to help providers have sometimes difficult conversations with their patients about whether a prescription opioid is a safe and effective way to alleviate pain.
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Kim Roberts is a reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.