On September 23, 2016, the U.S. Attorney's Office of the Northern District of Alabama hosted the Pills to Needles Summit 2.0: Building Solutions. Its purpose was to engage participants in conversation and consideration of strategies to address the opioid and heroin problem in Birmingham and the surrounding communities. Approximately 140 individuals attended the summit, representing the public health, medical, law enforcement, prevention, education and treatment communities.
Participants were invited to identify challenges and propose solutions in two areas: Prevention, Education and a Message to Parents and the other Access and Resources to Treatment. Below are the results of those sessions.
PREVENTION, EDUCATION, A MESSAGE TO PARENTS
What else needs to be done to further youth-specific preventive measures for opioid and heroin abuse and addiction?
About 60% of the responses to this question focused on building awareness and offering education for youth and families. These included
- creating a targeted plan for outreach
- educating teachers
- developing age appropriate curricula about addiction
- hiring more prevention educators and counselors in schools
- using media to increase attention to the issue
Specific strategies for building awareness and educating youth included creation of youth advocacy groups within schools and across districts, increasing outreach to elementary school students, mandating drug awareness and education classes for students and parents in schools, promoting programs through the faith community, and leveraging social media and other technology resources.
Additional recommendations addressed prevention; these included
- focusing on those experiencing "adverse childhood events" (ACE)
- mandating drug prevention education for vulnerable populations, such as youth in foster care and the juvenile justice system
- creating tougher drug testing protocols for students and an anonymous reporting system
With regard to treatment, increased access to mental health care and third party coverage of substance abuse treatment was recommended as was street outreach for referral to treatment.
A number of comments referred to the need to reduce stigma about opioid and heroin use to encourage schools, churches, neighborhood associations and other groups to talk about this issue. Creating safe spaces for people to share their stories, leveraging social media, and promoting the face of recovery were strategies identified to address stigma.
Other suggestions included partnering with law enforcement agencies in rural areas to dispose of prescription drugs, pursuing grants through the Drug-Free Communities Support Program, providing free drug testing kits for parents and establishing a central individual and phone contact number for kids and adults to report drug issues and concerns so that they can be acted upon by school and law enforcement.
What metrics do we need to track the impact of these preventive measures?
- number of 30+ day prescriptions
- number of students requiring intervention
- crime statistics for minors
- age of onset of drug use
- number of overdoses and overdose deaths
- quantity of unused medication turned into drop boxes
RESOURCES AND ACCESS TO TREATMENT
What else do we need to be doing within our personal communities and the community-at-large to combat opioid and heroin addiction and abuse?
What are we missing?
Approximately 50% of responses to this question focused on educating youth and their families and teachers about opioid abuse and heroin addiction, recommending
- student awareness initiatives
- teacher training
- curriculum development
- increasing availability of social workers in schools
Responses also included recommendations about general community engagement and awareness, such as
- developing community coalitions
- holding public workshops and information sessions
- using PSA's and drug deactivation kit distribution to raise awareness
With regard to providers, recommendations included educating and empowering physicians and better equipping the non-medical provider community with evidence based resources such as naloxone. Additional suggestions included more stringent use of PDMP and opening additional county health departments to assist with treatment.
Additional comments included the suggestion to research best practices in other communities for addressing the opioid epidemic. Finally, with regard to law enforcement, it was recommended that law enforcement agencies be encouraged as appropriate to divert substance users to treatment instead of the legal system.