When fighting opioid abuse, a one-size-fits-all approach doesn’t work.
That’s a message from the executive leading Indiana’s efforts in drug prevention, treatment and enforcement.
“Every community will do this somewhat differently,” said Jim McClelland, who visited Columbus April 25 to learn more about the Alliance for Substance Abuse Progress in Bartholomew County.
While many communities are bringing together people from enforcement and behavioral health, every community’s approach will differ because their resources are also different, he said during an interview with The Republic.
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“I’m incredibly impressed with the way you have taken this on. You’re doing it right,” McClelland said of efforts in Bartholomew County and Columbus to create a multi-faceted approach to opioid addiction prevention, treatment and the response by law enforcement and the courts.
Working on the state level, McClelland said Indiana officials quickly learned how complex the opioid problem is, and as a result have set broad priorities that focus on the most basic premise of keeping people alive.
Leaders from community efforts around the state are sharing some of their best-practice initiatives, which are being distributed wider in hopes that communities searching for strategies might build upon them, he said.
The challenge
McClelland, who was appointed by Gov. Eric Holcomb in January 2017 to the newly created drug prevention and treatment position, reports directly to the governor, while also chairing the Indiana Commission to Combat Drug Abuse.
When Holcomb took office just over a year ago, the governor pledged he would focus on curbing the drug addiction crisis in Indiana.
Holcomb cited the human crisis, with Hoosiers failing to live productive lives, and the challenge of employers that are unable to find enough workers who are sober and able to perform work.
“Indiana and the Midwest are Ground Zero when it comes to addiction, and its toll is apparent,” Holcomb said previously. “Addiction is keeping Indiana and its people from reaching their full potential.”
Indiana was ranked as having the 15th highest drug-addiction death rate in the United States in 2016, McClelland said.
Neighboring Ohio, one of the top three states in the U.S. for heroin-related deaths, has an even worse problem. And some of its issues — overdoses, children placed in foster care due to their parents’ drug addiction and babies being born addicted to opioids, are migrating to Indiana, McClelland said.
Drug overdoses killed 63,632 Americans in 2016, according to the federal Centers for Disease Control. About two-thirds of these deaths involved a prescription or illicit opioid.
“We have a significant lack of access — timely access — to medically assisted treatment,” McClelland said of Indiana’s current response to the opioid crisis.
Recent steps
The state added two dependency recovery initiatives from the Indiana Division of Mental Health and Addiction in February. Also, Indiana residents can now search for certified addiction treatment providers throughout the state on the Next Level Recovery website, at in.gov/recovery/, which offers options based on location, treatment and age and gender of patients served.
McClelland cited efforts around Indiana to help the state, including Indiana University’s $50 million challenge grant over five years to prevent, reduce and treat addiction in Indiana.
As part of IU’s commitment, initial pilot grants feature collaborative teams of faculty members, researchers, community organizations and cross-sector partners working on ground-level data collection and analysis; training and education; policy analysis and development; addictions science; and community and workforce development.
Those principals are outlined in Holcomb’s strategic approach to addressing substance abuse in Indiana.
The state is also working with the Indiana Chamber of Commerce on the Indiana Workforce Recovery Initiative, which is a toolkit for employers to help re-engage people in recovery from addiction back into the workforce, McClelland said.
He is also working to compile and share information about evidence-based prevention programs in Marion County schools and the formation of voluntary recovery support groups, primarily formed in the northeast part of Indiana, that McClelland hopes to expand to every county in the state.
Some encouraging signs indicate that the efforts throughout Indiana are starting to work, McClelland said.
The number of overdoses treated at emergency rooms are dropping statewide, as are the number of deaths, he said.
Some of the spikes that the state was seeing in overdose deaths leveled off at the end of 2017, he said.
The Center for Disease Control lists 1,600 fatal drug overdoses in Indiana in 2016, with nearly 800 of those being opioid-related. The CDC reports that from May 2016 to May 2017, Indiana saw a 29 percent rise in overdose deaths while the national overdose rate death increased about 17 percent.
Local trends
Calls for service for suicide-related or overdose calls are down so far this year, the Bartholomew County Emergency Operations 911 center reports.
The Columbus Police Department reported 127 calls through April this year, compared to 198 in 2017. The Barthlomew County Sheriff’s Department reported 53 calls through April this year, compared to 69 last year.
On the funding side, state officials are expecting triple the amount of federal funding the state has received each of the past two years, about $11 million, to fight the opioid crisis, McClelland said. Indiana could receive more federal funds based on the higher negative impact on the state from the crisis based on its population, he said.
McClelland, who in 2015 concluded a 45-year career with Goodwill Industries of Central Indiana, 41 of them as president and CEO, said he is glad to be working to create communities that Hoosiers want to live in and raise their families.
The state is focusing on prevention, to bring down opioid prescription rates, and also to prevent any use of addictive substances by young people by intervening in their lives as early as possible, McClelland said.
Part of the effort needs to be in strengthening families, which in turn helps prevent the use of addictive substances in the home, McClelland said.
Opportunities to provide after-school activities that focus on a child’s interests create opportunities to provide a feeling of accomplishment and progress to young people, something that can help prevent drug abuse, he said.
And the state needs to take a look at some of the greatest adverse childhood experiences Hoosier young people may experience. They include physical, emotional or sexual abuse, parental incarceration and other risk factors that lead to a greater risk for substance abuse, McClelland said.
“The very first step is an acknowledgement that there is a problem,” said Jeff Jones, ASAP executive lead, who brought McClelland to Columbus to speak to local residents about the opioid crisis.
Jones said the stigma of addiction is one of the largest hurdles in the way of an individual’s recovery.
“We all need to recognize that addiction is a very human unique disease and these people need to be respected and supported,” he said.
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The Hub
ASAP’s Hub is a proposed resource center connecting people throughout a Substance Abuse Support System, including service providers and recovery support programs. Although The Hub is a concept right now, ASAP hopes to have a small staff supported by an army of recovery-trained volunteers as part of its program. Since The Hub will be an actual location in the community, there will be access to recovery-oriented community partners either on a walk-in basis or online. A proposal is being prepared to submit to the Substance Abuse Public Funding Board to financially support The Hub.
Physician prescribing practices
ASAP physician lead Dr. Kevin Terrell is working with four groups representing the Columbus Regional Hospital emergency department, inpatient/hospital, outpatient/ambulatory and surgeons to identify pain management protocols for opioids which will be listed as best practices and placed in the medical records system where every doctor can access them. The effort is also reaching out to non-CRH physicians, dentists and oral surgeons to share the information.
Medical-assisted treatment
Columbus Regional Health is in the process of creating an addiction medical specialty clinic within the health system, a medical practice focused on helping patients in recovery. The practice would include a combination of medical-assisted treatment and behavioral therapy and area physicians could make referrals. The new practice could be available later this year.
Recovery coaches
Centerstone Recovery Coaches will be part of the Columbus Regional Hospital emergency department starting this spring. The coaches are available for patients who come to the emergency department and need to talk with a peer about entering the recovery process. Hospital officials hope to have recovery coaches in the department by mid-summer.
Nurse-family partnership
A local program called the Nurse-Family Partnership through Goodwill is beginning in Columbus to help low-income, first-time mothers. It was established to prevent drug addiction and promote health education and economic attainment. The first nurse who will be working in Columbus has been hired.
The court system
Two courts designed to help individuals and families in crisis as a result of opioid addiction are being developed. A Family Recovery Court under the administration of Magistrate Heather Mollo has been certified, and accepted its first family this month. Circuit Court Judge Kelly Benjamin and the ASAP intervention team are making site visits to determine best practices for a Problem Solving Bartholomew County Adult Drug Court, which could be in place in 2019.
Housing
Human Services Inc., Columbus Township and Centerstone have partnered and received a $300,000 grant to be used to help people re-enter society after completing Community Corrections programs by assisting with rent expenses. The grant will be used to help pay rent for women who are coming from the WRAP program, a jail-based addictions recovery program for females that began in 2011. The program has had 13 graduations with 91 participants in the program since 2011.
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Job: Executive director for Drug Prevention, Treatment and Enforcement for the state
Appointed: By Gov. Eric Holcomb in January 2017
What the job is about: Coordinating, aligning and focusing the work of a wide array of state agencies to work on substance abuse issues. Leveraging state resources with business, higher education, health care, philanthropic, faith-based and others to respond to the opioid crisis.
Work experience: Served as Goodwill Industries of Central Indiana CEO and President for 41 years, concluding a 45-year career there in 2015.
Philanthropic work: Serves on the Dean’s Council of the Indiana University Kelley School of Business, the advisory board of the School of Industrial and Systems Engineering at Georgia Tech and the board of directors of Building Tomorrow.
Honors: Inducted into the Central Indiana Business Hall of Fame in 2009, received the Distinguished Entrepreneur Award from the Kelley School of Business in 2011 and inducted into the Georgia Tech College of Engineering Hall of Fame this year.
Education: Earned a bachelor of industrial engineering degree from georgia Tech and a masters in business administration from the Kelley School of business.
Family: Married to Jane McClelland, and they have two children and two grandchildren.
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The United States is in the midst of the worst drug epidemic in history.
With alarming frequency, opioids — including prescription drugs, heroin and fentanyl — are killing Americans, including an increasing number in Bartholomew County.
The Republic is taking a yearlong look into the public health crisis that touches nearly every segment of our community and that crosses all socioeconomic lines.
Addicted & Dying will tell the harrowing stories of people with drug addictions and families who have lost loved ones.
We will talk to doctors, addiction specialists, law enforcement officers and others on the front lines battling a problem that is ruining lives and putting mounting pressures on social service agencies, hospitals, the judicial system and the economy.
Beyond that, Addicted & Dying will explore solutions and a path forward — what treatments and approaches work, what communities can do and how to help people in need.
The project began in January, with a three-day introduction, followed by a two-day report in March. This is the third installment.
SUNDAY: Today, people closest to Clayton Perry described how he lived — and how they have been shaken by the Columbus man’s death.
TODAY: Jim McClelland, Indiana’s executive director for drug prevention, discusses the state’s efforts to slow the opioid crisis. And researchers talk about results of a new study on the economic impact of opioid misuse in Indiana.
Got an idea for our project? Contact us at [email protected].
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