By Mikenzie Frost
HELENA – One in ten Montanans deal with substance abuse in some way and a shift in the way the country thinks about addiction is changing the way people get treatment.
Millions of people across the country suffer from what is now known as substance abuse disorder.
Tuesday, the Montana Healthcare Foundation held a summit that brought state leaders, lawmaker tribal representatives and even the 19th U.S. Surgeon General to Helena; all with the same question in mind – How do we address the problem?
“What we’ve been doing, we know, is not enough,” said Montana Attorney General Tim Fox frankly.
The summit’s goal was to look at these changes and help bring resources to Montanans who need them. A national study from 2014 that was discussed during the summit shows more than 66,000 adults over the age of 18 are dependent on or abuse alcohol and 18,000 of the same age category use illicit drugs.
“Everybody’s feeling like look, it’s a chronic medical treatment, people need treatment,” explained Montana Healthcare Foundation’s CEO Aaron Wernham.
This summit highlighted the need for collaboration between state agencies, especially with budgets shirking across the board in Montana.
Director of Montana’s Department of Public Health and Human Services Sheila Hogan how explained that collaboration, “We’re working collectively with Department of Corrections and with Department of Justice. We all serve certain populations, but they’re all impacted by this disease.”
While the Department of Justice tends to handle interdiction and the prosecution side of this issue and the Department of Corrections handles the incarceration and possible rehabilitation, DPHHS said they see just how many other people substance use disorders can impact.
In 2016, DPHHS said 65 percent of kids placed with Child and Family Services had substance abuse indicators present in the home life situation.
One of the biggest changes in regards to treating those who suffer from substance use disorders is the shift in the way addiction is viewed.
“This is not a character flaw, or a moral failing. This is a chronic disease in the brain,” explained Dr. Vivek Murthy, 19th U.S. Surgeon General.
During Dr. Murthy’s tenure as surgeon general under President Barack Obama, he issued the first ever report on alcohol, drugs and health.
“But I know that a report is not the end of the journey, it’s the start,” he added.
To start that journey, Dr. Murthy believes more people need to get treatment. Right now, he said only ten percent of people seek help.
“If you can imagine for a moment, what it would be like if only one in ten people with diabetes or cancer were getting treatment, we would say ‘that’s absolutely unacceptable’.”
Dr. Murthy said 21 million people in the country suffer from substance use disorder. He added, “To put that in context, that’s more than one and a half times the number of people with all cancers combined.”
For Wernham, this is a complex issue that deserves attention.
“It’s not as maybe simple as perhaps having high blood pressure where you can take a pill.”
While the national trend continues to increase in opioid deaths, DPHHS shows Montana hit its peak for deaths in 2008 and 2009 and now begins a slow decline. However, in 2015, 138 people died from a drug overdose in the state and more than half of those were from opoid overdose.
The Centers for Disease Control 2016 study shows despite the downward trend in opioid overdose deaths, they are still the most deadly illicit drug used in Montana. For every 100 residents in the state, the CDC says there are 70 opioid prescriptions.
The DPHHS has been able to double the number of providers available to those with substance abuse problems in Montana but Hogan said that came to be through Medicaid expansion, which she believes is crucial.
“I think the evidence is there, just from listening to this group. We have to reauthorize Medicaid expansion,” she added.
The DOJ launched their ‘Aid Montana’ initiative in April to study substance abuse in the state and try to get a better understanding of what the justice piece of the puzzle needs to do.
Hogan also mentioned a new ‘hub and spoke’ approach to treatment.
“The specialist is in the hub and then the spokes would be primary care, peer support. It’s to get more people in the field,” she explained.
Plus, a large justice reinvestment has been made within the Department of Corrections, with the help of major criminal justice reform bills passed during the 2017 Legislative Session. These state agencies working together show commitment to change, but that won’t happen overnight.
“It has taken us time to get here, it’s going to take us some time to get out of it,” Fox said.