change the patient completion rate of detoxification treatment, which remained stable with fewer than half of patients completing treatment. “When you have a destabilizing event like a global pandemic, [vulnerabilities in health structures] become more evident,” Varisco said. With in-person treatment at risk due to the coro- navirus, health care centers went remote in 2020. Many centers were limited to offering substance use disorder care through telehealth services as opposed to in-person, personal programs, compli- cating opioid recovery for patients. Katy Franklin, a substance use counselor at Conroe-based Tri-County Behavioral Healthcare,
surrounding opioid misuse. Campbell said law enforcement initiatives, including the use of naloxone—an overdose emer- gency treatment—were implemented in 2019 to help curb an opioid overdose increase in Mont- gomery County. “We train and educate law enforcement on how to use Narcan [device that delivers naloxone],” Camp- bell said. “When they arrive to a patient who’s not breathing from an overdose, they’re able to give the Narcan before the ambulance even arrives.” According to Campbell, the MCHD administered naloxone 309 times in 2019, 304 times in 2020 and 375 times in 2021.
THE CRISIS
State funding and education resources were implemented to curb opioid addiction and overdoses in Montgomery County. Local cities are expected to receive funds from State settlements with opioid manufacturers and distributors. Montgomery County: $2.7 million SETTLEMENTS TO ROLL OUT
Statewide, Texas Attorney General Ken Paxton announced Feb. 16 that the state had secured a $1.17 billion settlement with three major pharmaceutical companies: AmerisourceBergen, McKesson, and Cardinal. Accord- ing to the attorney general, Texas has secured $1.89 billion to date from opioid settlements. “Texans have been devas- tated by the opioid crisis, and it is important that this settlement is proportioned fairly among the communities that need it most,” Paxton said. Paxton’s office has also reached out to local govern-
said the transition was difficult for patients. A federally quali- fied health care organization, Tri-County’s substance use pro- gramserves 13 counties, including Harris and Montgomery counties. “It’s not the same level of care; you’re missing some things over Zoom that you wouldn’t [miss] in-person,” Franklin said of tele- health treatments. “Treatment was less effective for this particu- lar population.” Despite being less effective, telehealth did allow some smaller clinics and private practices to expand their coverage areas. Lori Fiester, the clinical director at the
Shenandoah: $47,122 Oak Ridge North: $33,512
"WHENYOUHAVE ADESTABILIZING EVENT LIKE A GLOBAL PANDEMIC, VULNERABILITIES INHEALTH
The Woodlands Township did not qualify for settlement funds, but may be eligible for grant funding from The Texas Opioid Abatement Fund Council.
STRUCTURES BECOMEMORE EVIDENT." TYLER VARISCO, HEALTH SERVICES RESEARCHER, UNIVERSITY OF HOUSTON
The Texas attorney general’s office provides a list of opioid remediation uses. SETTLEMENT FUNDING USES
Community drug disposal programs
Youth-focused education programs
Houston-based nonprofit Council on Recovery, said telehealth allowed patients without transportation access or those who are immunocompromised to receive care. “We’ve had people across the state in our groups, including in the Austin area, which was really help- ful for our groups to stay vital,” Fiester said. At the beginning of the pandemic, Varisco said there was some confusion about what treatments were acceptable. A 2020 memo from Phil Wilson, the Texas Health and Human Services Commission executive commissioner, said buprenorphine could be prescribed virtually, but methadone required a face-to-face evaluation. According to SAMHSA, buprenorphine and meth- adone are Food and Drug Administration-approved drugs used in combination with counseling 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. Some barriers for treatment go beyond drug-re- lated issues. Varisco, Fiester and Franklin agreed the lack of accessible public transportation in Texas increased difficulty for lower-income patients. “If you’re prescribed for buprenorphine or metha- done or whatever, you have to take a bus across the city [of Houston] to get the prescription,” Varisco said. “Proximity to care is just not there.” Government solutions State and county entities are working to address the opioid epidemic and the effects the pan- demic had on recovery through local funding, law enforcement resources and increased education
ments, encouraging them to sign on to existing set- tlements to receive funds. According to the attorney general’s website, 482 Texas municipalities signed on to two settlements with Janssen—owned by Johnson & Johnson—and with AmerisourceBergen, Cardinal Health and McKesson. As of Feb. 24, OakRidgeNorthwas allocatedapprox- imately $33,512 from the settlements with opioid manufacturers and distributors, and Shenandoah was allocated $47,122, according to the attorney general’s website. The Woodlands Township joined the settle- ment as well, and while the township did not qual- ify for direct settlement payments, it could receive grant funding from the Texas Opioid Abatement Fund Council, according to township documents. A list of funding uses provided by the attorney general’s office includes community drug disposal programs, training for first responders, and youth-fo- cused programs that discourage or prevent misuse. Campbell said he believes early education is effec- tive to prevent addiction. State Senate Bill 435, which took effect in September 2019, directs local school health advisory councils to recommend appropriate opioid addiction and misuse curriculum for their dis- tricts. According to Conroe ISD officials, new health instructional materials are under review dealing with opioid use and addiction. “We’re fortunate in Montgomery County,” Camp- bell said. “We have good resources, good law enforce- ment, good first responders, fire partners, public health. Montgomery County is doing very well.”
Expanded telehealth to increase access to treatment
Fellowships for addiction medicine specialists
Expand first responder and law enforcement training SOURCE: TEXAS ATTORNEY GENERAL/COMMUNITY IMPACT NEWSPAPER A variety of programs are offered in Conroe ISD to educate students and prevent drug use. YOUTH EDUCATION EFFORTS HEALTH INSTRUCTIONAL MATERIALS Curriculum under review covers topics about opioid use, addiction and overdose. D.A.R.E. Ten Drug Abuse Resistance Education instructors teach a drug misuse curriculum. DRUG SAFETY CLASSES Conroe ISD Police Department offers drug safety classes to student and community groups. KIDCHAT An anonymous phone tip line at 888-543- 2428 allows anyone to report illegal drug use or possession via text or phone. Tips are investigated by campus administration and by Conroe ISD police. 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.
For more information, visit communityimpact.com.
SOURCE: CONROE ISD/COMMUNITY IMPACT NEWSPAPER
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THE WOODLANDS EDITION • MARCH 2022
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