January 22, 2018
Holly Ireland, LCSW-C
Central East ATTC
In the spirit of collaboration and given our proximity, the Central East ATTC has offered to attend relevant national policy activities in Washington, D.C. to represent the ATTC Network and to support us all in staying abreast of what's happening and assess any potential future impact on our work or potential collaborations for the Network.
The Opioid Crisis: An Examination of How We Got Here and How We Move Forward
Senate Health, Education, Labor and Pensions (HELP) Committee Hearing, January 9, 2018
The Network Coordinating Office asked the Central East ATTC to attend this particular hearing, given the topic. This was an unexpected and welcome benefit of my new role as the Central East ATTC Co-Director, having joined the team in November 2017. I was excited and honored to go, given my increasing interest in public welfare policy, especially as it relates to the behavioral health of our communities, our states, and our nation. Until now, I have mainly been directly involved in policy action at local and state levels of government. I have always followed national policy action, and have inspired others to do so as a Social Work educator, most recently teaching social welfare policy practice for Salisbury University’s Social Work Department in the semester just ending in December 2017.
The morning of the hearing, my four-block walk from the metro station to the Dirksen Senate Building took me past the Capitol, the Library of Congress, and the Supreme Court. Walking along, I recalled the last time I had been in view of the Capitol: almost a year ago, participating in the Women's March with my then 11-year old daughter. Once I arrived at the Senate Building, I proceeded through security and navigated the halls filled with citizens, media, staffers, and elected officials. I shared an elevator with several others, including a senator, and found my way to the hearing room, where an audience of about 70 journalists, staffers, and citizens awaited the hearing.
Sam Quinones, featured witness and author of Dreamland, The True Tale of America's Opiate Epidemic, was already at the witness table, with his wife and daughter in the first row to his right. Several of the senators greeted him personally, expressing their appreciation for his journalistic insights and willingness to testify. All took their seats and the hearing began on schedule.
The HELP Committee
All Committee Members are listed and those present for the hearing are in bold:
Democrats: Patty Murray (WA) (ranking)
, Bernie Sanders (VT), Robert P. Casey, Jr. (PA)
, Al Franken (MN), Michael F. Bennet (CO)
, Sheldon Whitehouse (RI), Tammy Baldwin (WI)
, Christopher S. Murphy (CT), Elizabeth Warren (MA), Tim Kaine, (VA), Maggie Hassan (NH)
Republicans: Lamar Alexander (TN), Chair; Michael B. Enzi (WY), Richard Burr (NC), Johnny Isakson (GA), Rand Paul (KY), Susan Collins (ME), Bill Cassidy, M.D., (LA), Todd Young (IN), Orrin Hatch (UT), Pat Roberts (KS), Lisa Murkowski (AK), Tim Scott (SC) (Scott attended briefly, but did not speak.)
During opening remarks, Senator Alexander stated that the opioid epidemic is the number one public health problem in America, with overdose deaths now exceeding the number of motor vehicle accident deaths per day. Alexander emphasized that this was a bipartisan hearing with full support of all committee members, and remarked on the CARA and CURES Acts to address the effort. Senator Murray specifically addressed the committee’s commitment to move supplemental funding state’s need for implementing evidence-based practices (EBPs) to address the epidemic. This was the most direct reference to the work of the ATTCs.
Mr. Quinones testified for about 10 minutes, and then each of the Senators asked at least one question. Several of the Senators had in front of them a copy of Mr. Quinones book, referring to it directly.
There was no remarkably new information regarding the causes of the epidemic or strategies to address it. Mr. Quinones emphasized several times that this crisis has been in the making for more than two decades and that addressing it will take sustained efforts, resources, and funding. The CARA
Acts are solid beginnings but only that, beginnings.
Major themes of Quinones' testimony
Community is key
- Prevention, emphasizing community building, investing in recovery, increasing education about the addictive qualities of prescription medications, and decreasing the number and amount of prescriptions provided by health care professionals to the public. Senator Warren specifically spoke to the need for DEA and states to comply with the "Partial Fill" provision in CARA.
- Criminal Justice intersection: Retooling law enforcement agency and detention center responses to treatment needs.
- Public/Private Sector Partnerships: Increase accountability of the private sector that is profiting from this crisis to support and align with the public sector that is bearing the costs.
- Intervention: Expand access to care, specifically MAT, in detention centers, and also in the community. Increase access to alternative pain management—teach both health care professionals and the public about these alternatives—and make them reimbursable).
- Funding: Sustain the CDC’s role in funding Prescription Drug Monitoring Program (PDMPs), public awareness campaigns, and national surveillance data for both fatal and non-fatal overdose deaths.
- Research: Increase funding for research for addiction treatment and pain management and local community partnerships with law enforcement agencies, coroners, public health, health care, courts, detention centers, social services, and community members (persons in recovery, family members and advocacy groups - my editorial definition).
- Overcome access barriers: Develop resources in in rural areas and services to families (parents with addictions, parents with addicted children of all ages, grandparents as parents). Fund infrastructure: current CARA and CURES allocation fund interventions (e.g., Naloxone) but not the infrastructure to support it (e.g., personnel to educate and distribute to the public).
- Stigma: Address and defeat stigma by mainstreaming storytelling of addiction and recovery to create a social movement of recovery.
- Build a global partnership to address supply of heroin, fentanyl, and carfentanyl. Build partnership and community with Mexico and other source countries to stem the supply flow.
The hearing was scheduled to end at noon, but continued beyond. When finally adjourned, it was with many questions remaining unasked and unanswered, and several senators requesting follow up discussion with Mr. Quinones. It was clear the senators were cognizant of the impact of the opioid epidemic on citizens, families, communities, states and the nation. It was also evident how thoughtful and contemplative the committee members were about the responsibility in addressing this epidemic. However, it was also clearly recognized by all that to bring the opioid epidemic to an end, effort and engagement is needed from all, from everyone throughout the country, from every state, and from every strong and ever-strengthening community.
About our blogger:
Holly Ireland, LCSW-C, joined The Danya Institute/Central East ATTC
team as Co-Project Director in November 2017.
Holly has 27 years’ experience working in the behavioral health field, beginning her career as a Residential Rehabilitation Counselor while working on her undergraduate degree in psychology at Towson University. She graduated from University of Maryland, Baltimore with a master’s in Social Work with a primary concentration of Clinical and a secondary concentration of Management and Community Organization. During her career, she has provided direct service in outpatient behavioral health and recovery support settings, including individual, group and family therapy for co-occurring disorders, crisis intervention, trauma treatment, Assertive Community Treatment, and advocacy. Holly currently serves as adjunct faculty for Salisbury University’s Social Work Department, teaching social welfare policy and advanced practice courses.
Most recently she provided leadership and administration of Mid Shore Behavioral Health, Inc., a non-profit organization responsible for planning and management of the continuum of services in Public Behavioral Health System in Caroline, Dorchester, Kent, Queen Anne’s and Talbot Counties on the Eastern Shore of Maryland. Holly joined the MSBH team in 2006, serving as executive director since 2010.
A native of Easton, Holly loves the Eastern Shore of Maryland, its culture, its people, and its ecology. When not serving as a clinician, administrator or advocate, Holly enjoys spending time with her family and friends, traveling, being an active member of the community, and being outdoors – basically doing anything that advances health and wellbeing.