medical services for the Montgomery County Hos- pital District, said he believes recent crackdowns on unnecessary opioid prescriptions have attributed to the county’s falling opioid dispensing rates. “[Law enforcement] worked to arrest those doc- tors and get them out of practice, which has been a huge impact,” Campbell said. With opioid dispensing rates falling over the last decade, Brown said Harris County Public Health’s focus has since shifted to illegally obtained opioids. The use of fentanyl in Harris County has risen by more than 100% since 2019, she said. “Unfortunately, where we are is the rise in street drugs—specifically, the dispense of synthetic fentanyl
areas where patients could not access in-person care. Lori Fiester, clinical director at Houston-based nonprofit Council on Recovery, said telehealth gave patients who were without transportation or who were immunocompromised access to care. Government solutions Federal, state and local entities are working to address the opioid epidemic through funding, law enforcement resources and increased education surrounding opioid misuse. Campbell said law enforcement initiatives, including the use of naloxone—an overdose emer- gency treatment—were implemented in 2019 to prevent opioid overdoses in Montgomery County.
THE CRISIS
State funding was implemented and resources are available to curb opioid addiction and overdoses in Harris and Montgomery counties. SETTLEMENTS TO ROLL OUT Local cities and counties are expected to receive funds from settlements with opioid
manufacturers and distributors. Harris County: $14.97 million
is a huge issue,” Brown said. “Now, the [production] of … lookalikes of prescription medication, I think, is overtaking the prescription medi- cations themselves.” Telehealth affecting treatment At the beginning of the COVID- 19 pandemic in 2020, many health care centers were forced to shift to offering services remotely. Katy Franklin—a substance use counselor at Tri-County Behav- ioral Healthcare, which offers substance abuse programs in both Harris and Montgomery counties—said the transition was difficult for patients who were struggling with addiction. “It’s not the same level of care;
“WHENPEOPLE ARE ECONOMICALLY CHALLENGEDOR PSYCHOLOGICALLY CHALLENGED, … WE SEE INCREASED VULNERABILITY IN OUR COMMUNITIES TOOPIOIDUSE AND OTHER FORMS OF SUBSTANCEMISUSE.”
“We train and educate law enforcement on how to use Narcan [device that delivers naloxone],” Campbell said. “When they arrive to a patient who’s not breathing from an overdose, they’re able to give the Narcan before the ambu- lance even arrives.” In addition, Brown said HCPH’s Overdose Data to Action program collects over- dose data to inform local pre- vention and response efforts. HCPH also partners with the Harris County Sheriff’s Office to identify areas of high risk and provide resources to mit-
Montgomery County: $2.7 million
Tomball: $34,620 Magnolia: $26,031
The attorney general’s office said funds can be used for the following remediation efforts: SETTLEMENT FUNDING USES
Community drug disposal programs
Youth-focused education programs
TYLER VARISCO, HEALTH SERVICES RESEARCHER, UNIVERSITY OF HOUSTON
Expanded telehealth to increase access to treatment
Fellowships for addiction medicine specialists
you’re missing some things over Zoom that you wouldn’t in-person,” Franklin said. “Treatment was less effective for this particular population.” Varisco said he believes the drastic changes to health care for individuals experiencing addiction undid the positive work done for patients before the pandemic. According to the Treatment Episode Data Set, which compiles national patient discharges from treatment for the Substance Abuse and Mental Health Services Administration, detoxification treat- ment discharges became less common from 2016-19, when detoxification discharges decreased from 20% of all discharges to 16%. “When you have a destabilizing event like a global pandemic, [vulnerabilities in health structures] become more evident,” Varisco said. At the beginning of the pandemic, Varisco said there was “some confusion” about what treatments were acceptable to prescribe. A 2020 memo from Phil Wilson, the Texas Health and Human Services executive commissioner, said buprenorphine could be prescribed virtually, but methadone required a face-to-face evaluation before the first dose could be provided. According to the SAMHSA, buprenorphine and methadone are Food and Drug Administration- approved drugs used to treat opioid use disorders. “I don’t know if [the policy] was well understood by providers, and that led to lapses in our treat- ment,” Varisco said. Telehealth did, however, allow some smaller clin- ics and private practices to expand their coverage
igate crime and drug use in those areas in the Violence Prevention Program. These initiatives are funded by a Centers for Disease Control and Prevention grant and the federal American Rescue Plan Act, respectively. Statewide, Texas Attorney General Ken Pax- ton announced Feb. 16 that the state secured a nearly $1.17 billion settlement with three major pharmaceutical companies: AmerisourceBergen, McKesson and Cardinal. According to the attor- ney general’s announcement, Texas has secured $1.89 billion to date from opioid settlements. According to global settlement allocation figures from the Texas Attorney General’s Office, Tomball will receive $34,620; Magnolia will receive $26,031; Harris County will receive $14.97 million; and Montgomery County will receive $2.7 million from opioid settlements. A list of funding uses provided by the attorney general’s office includes community drug dis- posal programs, training for first responders, and youth-focused programs aimed at discouraging and preventing drug use. “Texans have been devastated by the opioid cri- sis, and it is important that this settlement is pro- portioned fairly among the communities that need it most,” Paxton said in the announcement. Ally Bolender and Danica Lloyd contributed to this report.
Expand first responder and law enforcement training
SOURCE: TEXAS ATTORNEY GENERAL/ COMMUNITY IMPACT NEWSPAPER
Harris County Public Health’s Opioid Overdose Prevention program analyzes overdose data, connects patients to treatment and works to prevent opioid overdoses. STAYING ONHIGHALERT OVERDOSE DATA TO ACTION Funded by a CDC grant, this program supports HCPH in collecting overdose data to inform local prevention and response efforts. INTEGRATED FAMILY PLANNING OPIOID RESPONSE Clinics in Humble and Pasadena provide medication-assisted treatment and counseling to help patients with opioid use disorder. VIOLENCE PREVENTION PROGRAM This county initiative works with local law enforcement agencies and other community partners to mitigate violence and its root causes—one of which is drug misuse. FIND HELP Call the Substance Abuse and Mental Health Services Administration National Helpline at 800-662-4357 or visit www.samhsa.gov for resources and treatment.
SOURCES: HARRIS COUNTY PUBLIC HEALTH, HARRIS COUNTY INSTITUTE OF FORENSIC SCIENCES/COMMUNITY IMPACT NEWSPAPER
For more information, visit communityimpact.com.
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TOMBALL - MAGNOLIA EDITION • MARCH 2022
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