By Sally McMahon

The University of Kentucky’s (UK) Center on Drug and Alcohol Research (known as CDAR) conducts research on numerous aspects of substance abuse and related behavior, including intimate violence, criminal justice settings and characteristics of rural substance use. CDAR has a history of providing training on evidence-based treatment, intervention and prevention approaches, as well as providing service to the community.

Sharon Walsh, PhD is the director of CDAR and principal investigator on UK’s $87 million HEALing Communities study. Walsh leads a team of 20 investigators from not only CDAR, but across UK’s campus –including Dr. Patricia Freeman and UK’s College of Pharmacy – on this massive project. Freeman is director of the Center for the Advancement of Pharmacy Practice (CAPP) at the UK College of Pharmacy. We recently spoke to Freeman about her work with highlights below.

Medical News: Last year UK was awarded an $87 million grant to tackle the opioid crisis through the NIH HEAL Initiative. What is the goal of the grant?

Patricia Freeman: The goal of UK’s HEALing Communities study is an ambitious one – to reduce opioid-related deaths in 16 Kentucky counties by 40 percent over the next three years. We’ll be using these evidence-based practices in these communities to achieve that goal:

• Opioid overdose prevention education and naloxone distribution in high-risk populations.
• Effective delivery of medication for opioid use disorder maintenance treatment, including agonist/partial agonist medication, and including outreach and delivery to high-risk populations.
• Safer opioid prescribing and dispensing.

MN: What progress have you made since then? 

PF: We’ve spent much of the past year in our planning phase and are now beginning the work out in communities. The 16 counties participating in the study have been randomized into two waves, with Wave 1 receiving the Communities that Heal intervention to facilitate the implementation of evidence-based practices first, and Wave 2 beginning in 2021.

We have conducted a landscape analysis and collected baseline data to identify current community resources and services to treat opioid use disorder, reduce opioid overdose and mitigate other opioid-related harms.

From this data, we are creating community profiles that our community coalition partners will use to identify gaps in services and inform effective strategies to promote uptake of the evidence-based practices.

MN: What are the goals for 2020?

PF: The goals for 2020 are to work with the Wave 1 communities to develop and implement a community action plan.  Using a data-driven approach, the community coalitions will assess potential strategies for implementing the evidence-based practices and prioritize them, considering both feasibility and potential impact. Ultimately, the action plan will:

• Guide the community coalitions and partner organizations in implementing strategies to increase overdose prevention education and naloxone distribution to those at-risk for overdose.
• Expand capacity for treating people with opioid use disorder with the medications that are known to be effective and with a specific focus on linking people to treatment and retaining in them in treatment to promote remission and sustained recovery.
• Improve prescription opioid safety by promoting safer opioid prescribing, dispensing and disposal practices.

MN: How are you working with the healthcare community (providers, hospitals, other pharmacists, etc) to help reduce overdose deaths?

PF: Increasing access to naloxone has been much of the focus of my work over the years. In 2015, the Kentucky General Assembly passed legislation that allows certified pharmacists, acting under a physician-approved protocol, to dispense naloxone (an antidote that reverses opioid overdose) in their communities without an individual physician’s prescription.

As the director of UK’s Center for the Advancement of Pharmacy Practice, I worked with pharmacists from around the state to develop training protocols around naloxone usage. I also helped lead a major outreach initiative that has resulted in over 2500 naloxone-certified pharmacists in Kentucky.

Pharmacists are key partners in the community for overdose education and naloxone distribution and prescription opioid safety.  In developing their community action plans, community coalitions may prioritize strategies that include working with their community pharmacists/pharmacies as partners.

MN: What would you like the healthcare community to know about the work you are doing?

PF: The work we are doing to reduce deaths from opioid overdose is of utmost importance.  In the U.S. last year, over 45,000 people died from opioid overdoses.  Working with communities to facilitate the uptake and implementation of evidence-based practices that we know can significantly decrease an individual’s risk of dying from opioid overdose can have great impact in reducing the rate of opioid overdose deaths community-wide. 

We are excited about the role that pharmacists can play as partners in opioid-related harm reduction through increasing access to naloxone and ensuring patients have access to the medications they need to treat opioid use disorder.  Pharmacists are underutilized healthcare providers with great opportunity to improve patient and public health.

MN: How will you reach the public in order to increase awareness of — and access to — the interventions available through the program?

PF: A communication campaign is one of the three main components of the HEALing Communities study. The communication campaigns are being developed in partnership with our communities and will focus on raising awareness about naloxone and where naloxone is available, reducing stigma associated with opioid use disorder and the effectiveness of medications, such as buprenorphine and methadone, in the treatment of opioid use disorder and their impact on reducing opioid overdose deaths.  

As the communities hear and see the messages across multiple communication channels, we hope that more people will seek needed treatment and more community members will carry naloxone and be ready to save a life if someone has overdosed.