Scott Ball / Rivard Report
For the first time, deaths linked to opioids have surpassed gun homicides, according to data from the Centers for Disease Control and Prevention (CDC). To address this public health emergency in Bexar County, organizations have joined together to launch a Joint Opioid Task Force to find solutions to this complex problem.
The inaugural meeting will take place Tuesday at 9:30 a.m. at the University Health System’s Robert B. Greene Pavilion, with the mission of decreasing opioid overdose deaths in Bexar County.
“This is a growing crisis in cities across the country,” Mayor Ron Nirenberg told the Rivard Report in a phone interview Thursday. “[Opioids] kill more Americans than car accidents. [The] issue has reached crisis levels and we want to stay ahead of it and address it before it gets to that point.”
Opioids are a family of drugs including prescription painkillers such as hydrocodone, as well as illicit drugs like heroin. Often people resort to heroin after becoming addicted to opioids because it is more affordable.
In a letter to the Opioid Task Force, Nirenberg, along with Bexar County Judge Nelson Wolff, cited data indicating that Bexar County leads the state in infant opioid withdrawal and has the third highest per capita rate of overdose deaths in Texas. County commissioners unanimously approved a resolution to form the opioid task force in June.
The task force brings together public health experts, medical and pharmaceutical professionals, first responders, policymakers, public school district representatives, and social services agencies to collaborate in creating effective strategies to address goals.
“[We are] trying not to make it like a typical task force where you just meet and talk,” Colleen Bridger, director of the San Antonio Metro Health Department and task force co-chair, told the Rivard Report. Instead, the opioid task force has outlined five measurable goals for its subcommittees to address, with progress to be reported on at the end of the year.
The task force seeks to increase the use of naloxone and several other overdose drugs by first responders, and will work to determine which other organizations might benefit from learning how to administer the drug on-site without a medical professional present. Naloxone blocks the effects of opioids, reverses an overdose, and gives the addicted individual the opportunity to participate in clear decision-making.
The percentage of deaths from heroin overdose in the U.S. has tripled since 2010, according to the CDC; further reports indicate that more widespread access to naloxone could help prevent the rise of opioid-related deaths.
Texas is one of 33 states that allows people to buy naloxone over the counter without a prescription. Researchers found that the adoption of a naloxone access law was associated with a 9% decrease in opioid deaths in those states.
The task force is seeking to increase the use of the Physician Drug Monitoring Program (PDMP), a state-run electronic database used to track the prescribing and dispensing of controlled prescription drugs to patients in an effort to monitor suspected abuse or misuse. This information can help prescribers and pharmacists identify patients at high risk who would benefit from early interventions.
Bridger told the Rivard Report that because the tracking system is voluntary for the prescriber, there has been low utilization. The task force will look into determining how to get more providers to use the system.
“If enough people [use the system] we can understand if a drug-seeking patient is going to physician after physician,” and the patient can then be flagged for drug abuse education and treatment, Bridger said.
In addition to increased education for those using opioids, the task force will focus on increased provider training on evidence-based practices regarding the prescribing and dispensing of opiate-related pharmaceutical products.
Regarding the reeducation of medical professionals, Bridger points to research indicating that opioids are not the best treatment for someone with long-term, chronic pain, which is what opioids are often prescribed for. There is plenty of evidence that prolonged use can result in complications, including a higher risk of addiction, overdose, and death.
“There are physicians who have been trained that opioids are the treatment of choice because there is little risk and high reward,” Bridger said. “We now know better. We have to retrain people to make sure that they are getting the appropriate information.”
Bridger went further to say that education includes working with providers to understand that opioids are a short-term solution, so prescribing a 30-day dosage is excessive and potentially dangerous for the patient.
University Health System, San Antonio Metro Health, the Bexar County Medical Society, Alpha Home, The Center for Health Care Services, UT Health San Antonio, and the Bexar County Health Collaborative are some of the participating organizations who may be working to ensure that the appropriate information regarding opioids is getting to both medical providers and the general public.
The task force will also work to provide community education on the safe storage and disposal of prescribed opioids, which Bridger explained includes making sure adults keep medication out of the reach of others, especially curious teens.
“Most folks know that its bad to dump [medication] down the toilet, but they don’t know what to do with it,” Bridger said. “They end up keeping it in the medicine cabinet and that leads to others using it.”
The task force will be looking into drug drop boxes as a means to provide a safe space for people to properly dispose of drugs so that they don’t end up in a public landfill, being abused, or enter into the water supply. Bridger told the Rivard Report that in addition to education efforts, improving data collection measures and accuracy in death reports coming from medical examiner offices will be crucial.
The Department of Health and Human Services also granted millions of dollars to fight opioid abuse in May. It is spending $480 million nationwide, including more than $27 million in Texas alone.
The task force also plans to look into increased availability of treatment options for opioid addiction, despite not having the funding to make that happen this fiscal year. But Bridger is optimistic about what the task force can achieve, stating that if it accomplishes its goals it may receive funding to continue its efforts.
Nirenberg told the Rivard Report that Bexar County doesn’t need more evidence by way of lives lost to understand that opioids are a growing concern in the community. “It has been in the Top 5 municipal concerns on the agenda for the last few years. We are actively studying and addressing the issue, and it has become the No. 1 concern.”