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Symposium drives at efforts to treat, prevent opioid addiction


LEBANON, Ind. — About 400 rural Indiana residents gathered in Lebanon last week to discuss a state and national issue which has become deadly for Hoosiers everywhere: The opioid addiction crisis.

AgrIInstitute hosted the symposium, featuring a panel discussion and Lt. Gov. Suzanne Crouch, among other speakers. A recent poll conducted by the American Farm Bureau Federation and the National Farmers’ Union indicates that approximately 75 percent of those involved with farms and farm work have a direct tie to the opioid issue.

“One out of five Hoosiers are facing mental illness challenges or fighting drug and alcohol addiction,” Crouch explained. “We are facing an addiction crisis, which is taking hold particularly in our rural community.”

She said she and Gov. Eric Holcomb are committed to fighting the epidemic, pointing out that Holcomb signed an executive order on his first day in office to create the position of director of Drug Prevention, Treatment and Enforcement, currently held by Tim McClelland.

“With the General Assembly’s help, we have been taking this fight directly to this evil substance and the people who push it, and we have not a second to lose,” Crouch said. “We cannot simply arrest our way out of this problem. And we must address those dealing with addiction and not allow them to fall further into the clutches of despair.”

Overdoses are the leading cause of death for people under the age of 50, and affect every age and socioeconomic group. Babies addicted to opioids are born to addicted mothers in the state, and businesses are finding it difficult to hire employees who can pass a drug test.

Rural Indiana is particularly at risk, Crouch said, because people living there tend to have lower incomes, higher levels of pain prescriptions and a lack of treatment facilities. A five-person panel, all from different perspectives of the opioid issue, agreed on the fact that no one solution can fix the epidemic – and no one treatment can save someone dealing with addiction.

Some measures already taken by the Governor’s Office include limiting the amount of controlled substance prescriptions and refills physicians can prescribe; enhancing penalties for those who commit pharmacy robberies; launching a website at www.in.gov/recover to serve as a source of information on the issue; and working on an anti-stigma campaign through Indiana’s Family and Social Services Administration.

Crouch said more efforts are in the works. Kevin Moore, director of Indiana’s Division of Mental Health and Addiction (DMHA), also sat on the symposium’s panel.

“Opioid use disorder is a brain disease that really impacts how we approach access to treatment and recovery,” he explained. “Opiates affect the brain of individuals, whether they are prescription drugs, illegal drugs such as heroin or a mix.”

Most people believe prescription medications are safe, but Moore said they are not when misused – a fact overlooked by some who become addicted to them after being legally prescribed these for pain management. Awareness is, he said, a big part of what needs to be done to halt the progress of the epidemic, especially in terms of prevention.

‘Look hard enough’

Dan Krouse, another panelist, who is an employer at Midwest Poultry Services, suffered the consequences of not being aware of the epidemic before it affected his company.

“We went into this totally naïve,” he said. “I had no idea what was going on, or that Indiana’s ranked 16 (nationally) in opioid-related mortality. We’ve seen several employees go down that road.”

Krouse worked with a young employee in 2014 who came to management for help when he could not properly perform his job because of opioid addiction. “He was coming in late for work or not coming in at all, and we were making accommodations for him that we probably wouldn’t normally make, because he was communicating with us and trying to do the right thing,” he said.

“He was going in for methadone every morning, talking to a counselor and we tried to make that work for him, and ultimately it didn’t – he passed away. That’s when it really hit me that something was going on.”

Later, Krouse had another employee struggle particularly hard with addiction. This person had been training for a supervisor position, when his performance began to slip. he had to let the man go.

“He was hard-working, trustworthy, he was best friends with a supervisor – he was in the supervisor’s wedding,” Krouse noted. “He came back and worked for us after he got clean, but then relapsed and completely vanished.

“If an employer thinks it’s not happening, they haven’t looked hard enough. Even if they haven’t got an addicted person working for them, they’ve probably got someone who has a nephew or someone else in their family that they’re worried about.”

Moore said community-level efforts are essential to tackling the crisis. “We have to work at the state and community level on this issue,” he added. “If not, we will continue to chase the next crisis, and the next crisis related to drugs. That’s all a part of prevention efforts.”

Moore admitted that in Indiana, treatment can be difficult to access, especially in rural areas. “The farther you get from Indianapolis, Lafayette, Fort Wayne or Evansville, the harder it gets,” he said.

“We have over 350 outpatient providers in Indiana. By June 30, we will have 18 medication-assisted treatment centers and opiate treatment centers that we will certify. Soon, we will have access to a platform through Open Beds and 211 that will allow providers and people to know where residential treatment beds are at any specific moment in time.”

Moore said other efforts include working to increase access to treatment by redirecting federal and state grant money, and the 21st Century Cures Act to increase access to medication-assisted treatment. With rural residents in mind, he said his department is enlisting and supporting mobile addiction treatment teams that will travel to parts of the state where there are no treatment providers.

To access these services and learn more about the epidemic, Moore suggests visiting the DMHA website, where access to contact information of treatment providers can also be found. It is at www.in.gov/fssa/dmha

Doug Payne, a farmer from Brown County, also participated in the panel. His perspective on the issue is personal: He struggled with drug addiction for 10 years before becoming clean in 2007. He said growing up with good parents and the best life he could ask for didn’t stop him from falling into addiction.

“It’s easier for me to walk out right now and get high than it is to sit here to talk to you guys,” Payne admitted. “This is deadly, and it is taking kids out. These are good kids. Any addiction like this holds no prisoners. It’s unforgiving.”

Despite living through some bleak years with the affliction, he did find hope through his support system and Narcotics Anonymous meetings. Crouch said hope is something Indiana retains through a collaboration with all residents.

“To truly achieve excellence in this state, we must dedicate our lives to elevating all Hoosiers,” she said, “including those with disabilities, mental health issues and those fighting drug and alcohol addiction. We are attacking this problem on all levels: Prevention, treatment and enforcement.”

1/9/2018