APU Receives Funding to Combat Opioid Addiction

by Irene Valdovinos

Angela, a young mother of three, suffered from chronic back pain. The drug her doctor prescribed relieved the pain (at least her brain’s pain messages) and allowed her to play with her kids, care for the household, and enjoy life again—until that drug took away more than her discomfort, and led to years of addiction. With slight variations, Angela’s tragic story plays out time and again in the country’s big cities and small towns, affecting countless souls without regard to economic status, race, religion, age, or gender.

Problematic use of opioids (opioid analgesics/heroin) ranks among the most pressing public health issues in the United States: 2.1 million Americans suffer from an opioid substance-use disorder, especially youth populations (under the age of 24). The rate of fatal opioid-related overdoses from prescription drugs and heroin more than doubled from 2000 to 2013; 2014 alone saw close to 30,000 opioid-related overdose deaths. In addition to the cost in human lives, a recent article published in the Journal of Medical Care estimated the economic burden of prescription opioid overdose, abuse, and dependence in the U.S. at $78.5 billion.

Combating this heartrending human crisis calls for compassionate and immediate action from stakeholders in multiple fields— including health departments, community health clinics, hospitals, pharmacies, substance-use disorder treatment programs, school systems, and law enforcement—that focuses on three main areas: prevention, intervention, and treatment.

An innovative prevention approach employed throughout the country includes monitoring opioid prescribing practices within state health departments’ Prescription Drug Monitoring Programs (PDMPs). Specifically, in 2017, California’s policy bill (SB 482) required licensed prescribers to check California’s PDMP Controlled Substance Utilization Review and Evaluation System (CURES) prior to making a prescription, in order prevent abuse of opioids and patient “doctor shopping” (i.e., obtaining overlapping opioid prescriptions from different providers), as well as recheck the database every four months. In addition to monitoring, the Centers for Disease Control and Prevention began employing other prevention strategies to address opioid abuse in local communities, including insurance regulations such as prior authorization, quantity limits, drug-use review, and patient education on the safe storage and disposal of prescription opioids.

In addition to prevention strategies, efforts must focus on educating and training the workforce on how to identify and address opioid risk issues among patient populations. Under the leadership of Rachel Castañeda, Ph.D., associate professor in the Department of Psychology, and other faculty from a variety of disciplines (including nursing, social work, psychology, athletic training, and pastoral care), APU received federal funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) to engage in a large, multisite education initiative to train students on the practices of screening, brief intervention, and referral to treatment (SBIRT) to better equip and prepare future healthcare providers with skills to address substance-use problems among patient populations they may encounter in their practice settings. “Given the growing issues with opioid use, there is a critical need to ensure that communities are prepared with evidence-based practices, like SBIRT, to address the significant public health issues associated with use, including overdose, injury, accidents, and addiction,” said Castañeda. Faith integration, unique to APU’s SBIRT training, encourages students to leverage faith and spirituality within the SBIRT practice encounter to prompt behavioral change. Students learn that from a Christian theological framework, substance use intersects with human thriving, a movement toward wholeness, and becoming what God intended us to be.

In addition to prevention and intervention efforts, new approaches to treatment have become a national focus. Federal, state, and local governments now aggressively extend access to Medication for Addiction Treatment (MAT) programs to treat opioid substance-use disorders. Current evidence-based MAT medications available for use include methadone, buprenorphine, naloxone, and naltrexone. For example, methadone, an opioid agonist, works to lessen the effects of opioids and prevent withdrawal. Naloxone, in comparison, quickly responds to an opioid overdose and reverses its effects. Medications for addiction treatment should be dispensed by qualified practitioners and monitored in office-based healthcare and treatment settings. Castañeda received a significant evaluation contract with UCLA Integrated Substance Abuse Programs and the Los Angeles County Department of Public Health, Substance Abuse Prevention and Control (SAPC) to monitor and improve the youth system of care for treatment. According to SAPC’s medical director, Gary Tsai, MD, “Expanding access to MAT within the substance-use disorder system of care is very important given that for most chronic conditions, such as addiction, we need to address both the psychosocial and biomedical aspects of the condition in order to get the best outcomes. Despite significant evidence supporting its effectiveness, medications for addiction treatment are, unfortunately, severely underutilized, and for that reason the greatest untapped resource in addiction treatment.”

As the country grapples with this crisis, the Church stands at the forefront of the fight, shoulder to shoulder with the agents and agencies trained to battle the problem from a medical and social perspective. Christ followers in research, education, health care, and social work know that this problem requires more than federal funds and state-run programs—it requires the Gospel message of hope that heals the heart and soul alongside the body and brain. In tandem with prevention, intervention, and treatment efforts, believers must care for the spiritual lives of those who have been ravaged by opioid addiction and help them find the true Source that satisfies every hunger, thirst, and need.

Irene Valdovinos, LCSW, MPH, is an evaluation coordinator in the Department of Psychology.

Originally published in the Summer '18 issue of APU Life. Download the PDF or view all issues.