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Commentary: Leading Kentucky’s fight against drug addiction through research, public policy, health care


By Eli Capilouto
Special to KyForward

In 2014, more people died from drug overdoses than at any point in our history. Overdose deaths are up in every demographic category. Driving this public health epidemic is the availability and prevalence of opioids.

According to the Centers for Disease Control and Prevention, “overdose deaths from opioids, including prescription opioids and heroin have nearly quadrupled since 1999.”

Research by the National Institute on Drug Abuse (NIDA) and aggressive efforts by the CDC are making inroads to address this complex problem. Citizens have become more engaged in prevention and treatment, while science is offering promising new approaches to save lives and hopefully reverse the alarming statistics.

Kentucky is among the top five states with the highest death rates due to drug overdose. But through research, public policy, community intervention, and effective health care, we are working against the intransigence of this ugly scourge.

The General Assembly passed a comprehensive law in 2012 that expanded our prescription monitoring system. It required pain management clinics be licensed and staffed by a physician. And it mandated that pharmacists and physicians register their practices to avoid patients receiving prescriptions from multiple doctors.

As a result, Kentucky decreased the frequency of “doctor shopping.” We shut down pill mills. We provided better education and outreach to communities, patients, and health providers.

But public policy is only one leg of the stool. This effort — and our success — also requires research and effective health care solutions that blend many disciplines and attack this Kentucky question at the community level.

This week, I attended the 2016 National Rx Drug Abuse and Heroin Summit in Atlanta, Georgia, with a contingent of UK faculty, staff, and clinicians. They’re on the frontlines of our fight against addiction in Kentucky. Together, we’re deeply committed to these important questions. It is part of our DNA as the university for Kentucky.

We’re laying the groundwork for a more widespread and intensive approach to complex health care through research, translational care, and clinical delivery. By tapping into a robust network of clinical outreach programs that partner with UK HealthCare and our academic medical center, we’re able to connect clinicians to 180 practices across the region – some 10,000 beds.

What are our faculty doing?

Dr. Dan Wermeling – an expert presenting at the Summit is talking about how his research and related company – AntiOp – have developed a tool to combat overdose deaths.

A Pharmacy professor, he developed a nasal-delivery system for the opioid overdose medication, naloxone. Our Center for Clinical and Translational Science — or CCTS — helped support and facilitate clinical trials for this easy-to-use solution for first responders in the field.

The UK College of Pharmacy is training pharmacists across the state for the prescription use of naloxone. It’s a game-changing effort for public health in Kentucky.

The initiative is a prime example of UK’s “bench-to-bedside” research in action. Increasing access to naloxone, coupled with the ease of use in the nasal spray device, has the potential to make a difference in the overdose death rate.

Advancing discoveries for human health and improving public health outcomes requires not only bench-to-bedside efforts, but also engagement with community partners to disseminate knowledge and support locally-suitable interventions. The CCTS therefore launched the Community Leadership Institute of Kentucky, a three-week, intensive leadership development program that enhances research and capacity-building competencies in community leaders who play key roles in data-driven decision making related to health and health care. The program builds capacity and collaborations at the community level to improve health.

It’s one of many ways we’re deeply ingrained in the region – working in and with communities to solve complex problems.

Drug addiction isn’t the only health malady confronting those we serve. The Appalachian region suffers a range of health disparities – heart disease, cancer, stroke, and diabetes — all at higher rates than the national average. With the support of federal leaders; health agencies like the National Institutes of Health (NIH), CDC, and NIDA; and our state leadership, the Shaping Our Appalachian Region – what we call SOAR – is creating change. We’re proud to be a presenting partner and lead university for the SOAR initiative.

These investments and our intent focus on this issue have encouraged others to join in our effort. College of Public Health Dean Donna Arnett and College of Medicine Dean Robert DiPaola recently joined us as experts in their fields who compete and receive top extramural research funding. They understand what it means to address health questions from the cellular to the community level.

Less than a year ago, we partnered with the state to fund the construction of a new research facility in the heart of our campus. It is a building whose primary focus will be defying death and defeating disease in Kentucky. More than a building, it is the people within it – UK faculty, clinicians, researchers, statisticians, behaviorists, and public health experts from myriad backgrounds – who will come together to make death a beggar in Kentucky.

At the groundbreaking for that building just a few months ago, Kentucky House Budget Chairman Rick Rand said: “The simple fact is that we cannot afford to lead the country in these causes of death. Too many lives are being cut short. Too many dreams are being extinguished. Too much potential is lost.”

Kentucky Senate President Stivers added: “Naturally a legislator does things that have an impact in their districts. But for the state as a whole, I know of nothing in my 19 years that will have” as large of an impact as this facility.

What was true then is true today.

Our work in educating Kentucky’s next generation of leaders is critically important to the long-term health of the state we serve. It’s a moral responsibility to them and a central part of our mission. At the same time, the University of Kentucky’s multi-faceted mission calls us to do more and to be more for the Commonwealth.

Our faculty – researchers and clinicians – are engaged in meaningful work that will ensure a healthier and more prosperous future for people from Pikeville to Paducah. They create new knowledge, improve practice, and shed light on the unknown.

Whether we are fighting drug addiction, addressing chronic illness, or improving life-saving drug delivery, we are the University for Kentucky.

Eli-Capilouto

Eli Capilouto is president of the University of Kentucky


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