by Caroline Griswold, NCAPA Program Coordinator
On Friday, December 13, 2019, NCAPA staff attended the quarterly North Carolina Department of Health and Human Services NC Opioid and Prescription Drug Abuse Advisory Committee (OPDAAC) summit at NC State University. The theme of the winter summit was Medication Assisted Treatment (MAT) and Harm Reduction in Jails. The OPDAAC hosted a number of speakers and panelists from across North Carolina.
The first speaker, Joe Prater with the Division of Public Health, spoke on developments in the field of harm reduction for incarcerated populations. Mr. Prater noted that in order to gain support for harm reduction, NCDHHS must emphasize the numerous levels at which drug use affects the community:
- Public health risks such as HIV/Hepatitis C, chronic and persistent medical and mental health issues, and overdose deaths;
- Public safety risks including an increase in crime and recidivism;
- Risks to families including the emotional toll on children.
His overarching message was that with substance abuse you can either pay now (invest in treatment and harm reduction) or pay more later (incarceration, crime, and overdose).
The second speaker was Dr. Shuchin Shukla with the Mountain Area Health Education Center. Dr. Shukla discussed the various options for Medication Assisted Treatment and the research behind each medication. The most widely used medications are Methadone (inpatient only), Naltrexone, Buprenorphine, and Suboxone. Each of these affects the opiate receptors in different ways. There are some prejudices against MAT in the substance abuse treatment community, though MAT has been found to be an effective way to prevent overdoses and improve treatment outcomes.
The third speaker was Anna Stein, also with the Division of Public Health. Ms. Stein discussed the various legal precedents that determined the legal responsibility that detention centers have of providing MAT to inmates. The 8th Amendment prohibition against cruel and unusual punishment requires detention center personnel to address inmates’ “serious medical needs.” North Carolina General Statute 153A-225(a) establishes that “each governmental unit that operates as a jail must develop a plan for providing medical care for inmates.” Finally, the 2018 ruling in Pesce v. Coppinger (US District Court, Massachusetts) found that persons suffering from substance use disorder are protected by the Americans with Disabilities Act, and that denying MAT is in violation of this act.
The final speaker was Elyse Powell from the NC DHHS. Dr. Powell presented on the Opioid Action Plan 2.0 which establishes best practices for combatting the North Carolina opioid epidemic. Dr. Powell stressed the importance of large-scale efforts to divert people with substance addiction from incarceration and into treatment. She recommended that police be trained in crisis de-escalation in order to help people seek treatment for mental health disorders instead of sending them to jail.
The summit ended with a panel on MAT made up of experts from detention centers across the state. The panelists described the importance of MAT use in detention settings and also encouraged participants to help reduce the stigma surrounding substance abuse and MAT. The general consensus was that any effort to reduce drug dependency is a step in the right direction.
For more information and to learn about the More Powerful NC campaign please visit our Opioid Resources for PAs page.