To fight Connecticut’s opioid epidemic, Gov. Dannel Malloy has adopted a three-year plan created by Yale researchers.
The strategy, commissioned for the University-based Connecticut Opioid Response (CORE) team, aims to reduce opioid usage and prevent addiction and overdoses. National and state agencies should expand access to naloxone, the treatment for an overdose, and educate youth on substance abuse, according to the report.
The plan, which Malloy accepted last week, ends with six strategies, including increasing access to treatment, more data sharing among state agencies and greater community understanding of opioid use disorder. Each strategy is also supplemented with specific tactics and methods for its implementation.
“The plan has discrete steps to be implemented and to reduce opioid deaths significantly, but the question might be whether we have the political will to implement some parts of the plan,” said Yale School of Public Health professor Robert Heimer, a member of the CORE team. “The important thing to be noted is that we cannot treat chronic disease with methods that are short-term.”
In formulating the plan, the team was asked to be cognizant of Connecticut’s budget shortages, and to be aware that the plan could not provide a broader solution to the complexity of the opioid crisis and addiction in general. Instead, the plan focuses on the immediacy of the problem and the need to reduce it in the short-term.
In the long-term, the CORE team will continue to work with the Alcohol and Drug Policy Council, a state stakeholder group, to comprehensively address the opioid crisis.
However, the report does not address funding for certain components of the plan, including access to naloxone and longer-term treatment with methadone and buprenorphine, Heimer said.
Heimer offered the plan proposed by Rhode Island, the solutions on which Connecticut’s plan was modeled, as a method for gauging effectiveness. In 2013, Rhode Island had the highest rate of illicit drug use in the nation, so the state’s action plan hopes to reduce the number of overdose deaths and the number of emergency room visits due to overdose. The plan is still being implemented, with the aim to reach Rhode Island’s goals in 2018.
The reason that plans like those being implemented in Rhode Island and Connecticut take time is because of the complexity of opioid use, said Dr. William Becker, another member of the CORE team.
“It’s a fairly multifaceted problem that stems from the U.S.’s reliance on opioids for treatment of chronic pain,” Becker said. “It’s estimated that there has been anywhere from four to sixfold increase in opioid prescription from 1990 to 2012.”
The problem is also widespread, affecting many medical professionals and rehabilitation facilities.
Dr. Kathryn Hawk, an emergency medical doctor at the Yale School of Medicine, noted that treatment has changed over the years to incorporate the increased number of patients suffering from disorders related to opioid use. As a result, her hospital has implemented Project ASSERT, which links patients to same-day treatment and a program with local centers that provide treatment for those addicted to the drug.
Along with affecting treatments in emergency medicine, the opioid epidemic has impacted local rehab centers such as the MCCA in New Haven. Victor Pittman, program director of the MCCA, said the demand of patients with opioid use disorder is greater than the resources available. In August of this year, 27 percent of those admitted to the New Haven outpatient clinic were diagnosed with opioid use disorder.
Though the plan’s focus is on immediate problems, preventing opioid use in the long-term requires more time, as seen in the five-year length of Rhode Island’s plan, Heimer said.
“The problem is so acute that we have to respond to the quantity of the disorder,” Heimer said. “This is a goal-oriented plan to reverse the epidemic with effective treatment. Once the situation is stabilized, we can help prevent the next generation with addiction.”
Still, the plan’s effectiveness will depend on resources and funding.
Roughly 23 percent of Americans who use heroin develop an opioid addiction, according to the American Society of Addiction Medicine.