Communications Fuel Progress on Multiple Fronts

From interagency collaborations to opioid use disorder treatment through telemedicine, communications proved key in various projects discussed Tuesday at Rx Drug Abuse & Heroin Summit.

Federal agencies are coordinating their efforts to reduce the availability of illicit opioids in the U.S., and Kemp L. Chester, MA, associate director of the White House Office of National Drug Control Policy and chief of its National Opioids Coordination Group, said on Tuesday that he would like to see a similar kind of open dialogue between law enforcement and the public health sector moving forward.

“I would tell all of our public health professionals to speak to some law enforcement folks and talk about what they see every single day,” Chester said. “They do such hard work. I think it would be interesting to get their perspectives in terms of what they see as the social and human landscape in their particular communities. I think it would be incredibly valuable for them to understand. The more those two communities can talk to each other, the better off we are going to be as a whole in addressing this issue.”

Chester participated in a panel discussion along with Adam W. Cohen, JD, director of the Organized Crime Drug Enforcement Task Forces, and Patrick Shannon, JD, EdD, MPH, who has served as a judge for the Saginaw Chippewa Tribe of Michigan since 1999. Among the topics covered by Cohen were how law enforcement has helped by partnerships with the public health sector to more safely conduct testing of new psychoactive substances, cut down testing times and share new identifications with public health and public safety officials.

Chester later noted: “How we have changed the nature of the discussion about substance use disorder and how law enforcement has embraced their role in helping people are going to be two decisive elements as to what helped us turn the corner on this when we look back years from now.”

A twist on telemedicine

Factors ranging from geography and transportation to healthcare workforce shortages and the lack of anonymity often found in small towns can create barriers to patients with opioid use disorders accessing medication-assisted treatment, said Eric Weintraub, MD, faculty member at the University of Maryland School of Medicine. Moreover, he said, 60.1% of rural U.S. counties have no waivered buprenorphine providers.

To overcome this challenge, Weintraub launched a program to provide counseling and prescribe buprenorphine and naloxone through telemedicine. Through the initiative, the university has engaged in partnerships with rural health departments, rural outpatient, intensive outpatient and residential treatment programs, and a rural not-for-profit outpatient practice.

Of the first 177 patients treated in the program, 57% were retained in treatment onsite and 6% had opioid-positive toxicology results after three months.

“Telemedicine and video conferencing can be an instrumental way of expanding access to life-saving medication-assisted treatment,” Weintraub said. “At this point, we still need to be careful that you’re following all of the regulatory requirements that you need to. I’m just hopeful that DEA will put out regulations that will allow this to expand so we can get it out to individuals who really need it.”