Commissioners Corner July 2018

Hello and happy summer! For many, July holds holiday and vacation fun amidst the heat of summer in the South. At DBHDD, July is a time of transition, with the closeout of one fiscal year (FY 2018) and the start of the next one (FY 2019), while planning for the following year (FY 2020). We kick off FY 2019 with grateful acknowledgment of Governor Deal’s Commission on Children’s Mental Health, and the support from the General Assembly, which invested more than $20 million dollars in priority services and supports to address the behavioral health needs of Georgia’s youth and families.

Our system-wide work continues with great momentum, but there is one area of concern that I would like to highlight: DBHDD’s role in Georgia’s response to the opioid epidemic. Recurring headlines and your own family and community experiences may have you wondering how our state is responding. First, the facts: In 2014, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that more than 2.5 million Americans struggled with addiction to prescription pain medication or heroin. The Centers for Disease Control and Prevention (CDC) cited a four-fold increase in opioid-related overdose deaths since 1999, and in Georgia, the rate more-than-tripled between 2006 and 2015.

I want to assure you that Georgia is tackling the epidemic head-on, and DBHDD is on the front line. As the state opioid authority, DBHDD is responsible for the prevention, treatment, and recovery elements of Georgia’s statewide response. In 2017, we received SAMHSA’s two-year State Targeted Response (STR) to the Opioid Crisis grant ($11.8 million per year). At the end of the first year, we have made important enhancements in each area of responsibility.

Prevention
DBHDD’s Office of Behavioral Health Prevention has focused on three initiatives:

• Training in naloxone administration and distribution of naloxone kits for 312 first responders and 3,255 citizens, which resulted in 435 self-reported overdose reversals;
• Two new public service announcements (PSA) about Georgia’s Good Samaritan law and naloxone availability, which have been played in more than 100 movie theatres statewide; and
• Engaging four providers to implement SAMHSA’s Strategic Prevention Framework (SPF) model in regions 2, 3, 5, and 6.

Treatment
The Office of Addictive Diseases contracted with nine providers for treatment – including Medication-Assisted Treatment (MAT) – of uninsured and underinsured Georgians who have opioid use disorders. Through this initiative, 450 individuals have received treatment.

Recovery
Three recovery initiatives have been added through the grant:

• A peer warm line to support people who have an opioid use disorder by connecting them with individuals in recovery who have been through similar experiences;
• Recovery coaching in two hospital emergency departments; and
• Education for recovery residences to align with the various pathways to recovery.

In the second year of the grant, which began May 1, 2018, the Prevention Office will double naloxone distribution to first responders and will release two additional PSAs that promote self-advocacy and safe storage and disposal of prescription drugs. It will also continue to fund SPF providers. The Office of Addictive Diseases will continue funding programs for MAT services and add new providers in regions 1, 3, and 6 to address the treatment need. Recovery initiatives will continue with the addition of recovery coaches in two additional hospital emergency departments and funding of three recovery community organizations in regions 2, 4, and 6 to provide support to those seeking recovery.

The opioid epidemic is multi-faceted and requires extensive collaboration. DBHDD has many great partners in this venture. We are working closely with the Georgia Department of Public Health to develop Georgia’s Opioid Response Strategic Plan.

We also participated in the launch of a Statewide Opioid Taskforce, convened by Attorney General Carr in October 2017 to bring together key stakeholders. Following the initial meeting, the Attorney General’s Office, DBHDD, the Georgia Department of Community Health (DCH), and DPH met to discuss strategies for addressing the growing opioid crisis. To date, over 200 people from more than 50 organizations have participated in a series of meetings to inform the strategic plan by identifying key goals, objectives, and outcomes in the following areas:

• Prevention Education
• Maternal Substance Use
• Data and Surveillance
• Prescription Drug Monitoring Program (PDMP)
• Treatment and Recovery
• Control and Enforcement

This work will result in the publication of a statewide plan that ensures accountability and transparency in the work ahead. As an essential enhancement to our efforts to address the opioid epidemic, DBHDD received $4 million in new state funding to support statewide implementation of Addiction Recovery Support Centers. Led by peers, the centers offer non-clinical activities that engage, educate, and support individuals and families to make the life changes necessary for to experience recovery. There is growing evidence of the need for a continuum of care that offers support and assistance well beyond the bounds of treatment.

There is hardly a family in Georgia that is not touched by addiction. Even as we battle at the cutting edge of treatment and services in the opioid crisis, we know that the bottom line is that addiction is the fundamental issue to be addressed. Abuse of alcohol, cocaine, and methamphetamines still represent significant challenges in our state. DBHDD – along with our providers and our state, federal, and community partners – is committed to education, prevention, early intervention, and evidence-based treatment. We engage in this work grounded in the belief that recovery is possible for each and every Georgian.