The 2019 Evelyn Hayes Innovations in Healthcare Symposium continued an important discussion started last fall on the challenges facing Delaware in fighting and preventing substance use and mental health disorders.

Delaware is among the states feeling the biggest impact of this public health crisis. More than 30,000 adults, 9,000 adolescents and 82 percent of the prison population in Delaware are estimated to suffer with mental illness or drug addiction. Last year there were more than 400 overdose deaths in Delaware, up 45 percent from 2017, according to state statistics.

“Every 22 hours someone is dying from an opioid death overdose,” Lt. Gov. Bethany Hall-Long recently told the audience gathered in the Tower at STAR Audion for the afternoon symposium, entitled, “Substance Abuse and Addiction: Looking at the Current Landscape and Envisioning the Future Through Different Lenses.”

Hall-Long moderated the first panel discussion, which included Dr. Sandy Gibney, an emergency doctor at St. Francis Hospital in Wilmington; Joshua Thomas, executive director of NAMI Delaware; Tamera Fair, executive director of the Wilmington HOPE Commission; Michele Marinucci, senior director of pupil services for the Christina School District; and Carolyn Petrak, associate executive director of the Ability Network of Delaware. The second panel was moderated by Rita Landgraf, director of the Partnership for Health Communities and former secretary of the Delaware Department of Health and Social Services. It featured Don Keister, founder of AtTAcK Addiction; Stephanie King, a certified peer recovery specialist; Domenica Personti CEO of Recovery Centers of America at Bracebridge Hall; and Dave Humes, a father who lost his son, Greg, to an accidental overdose and has advocated for public policy changes to help people battling addiction.

The event was a follow-up to the Hayes Symposium held last fall featuring Dr. Karyl Rattay, director of the Delaware Division of Public Health, and Matt Denn, then attorney general of the state. The pair discussed addiction through a public health and legal perspective.

This time, panelists discussed some of the challenges facing those in recovery from substance use disorder, including a lack of available treatment beds in the state, barriers to employment and the need for additional funding for prevention, intervention and post-treatment.

One of the biggest hurdles, panelists agreed, is the stigma, which affects not just the person with addiction, but their loved ones as well.

“Stigma keeps people from getting treatment. You need to provide opportunities for those who need it,” said Keister, whose son, Tyler, died from an accidental overdose. “It has to be immediate and have a number of levels. It needs a continuum of care. I think people are trying to work toward that. But we’re still not getting the word out to the people who need the word.”

There also is a greater need for mental health services, especially since 45 percent of people with addiction also have a co-occurring mental health health disorder, according to the 2017 National Survey on Drug Use and Health by the federal Substance Abuse and Mental Health Services Administration. In Delaware, students are struggling with mental health and behavioral health issues at earlier ages, said Marinucci, senior director of pupil services for the Christina School District.

Gibney, the ER doc, said there has been a change in culture within her emergency department in recent years. Along with prescribing fewer opioid medications, there’s a focus on being less punitive and providing more medical help to those in active addiction – just like they treat patients with a chronic disease like diabetes. At the same time, additional resources, including the state’s use of the OpenBeds platform, which makes available the number and location of available treatment beds in the state, has helped emergency providers get more people into addiction treatment.

“Once they get to the ER, we should work to get folks into treatment, make them feel welcome, make them feel like there’s help,” said Gibney, a UD alum who also goes out in a mobile health van to bring needed medical care to the community. “Moving forward, we have so many opportunities outside the ED in the hospital environment. It they have abscesses, bacterial infections, we want them to be treated appropriately while they are hospital patients.”

There still are challenges even when people are in recovery, including finding employment that will allow them to be stable members of the community, said Thomas, the NAMI Delaware director. There has been talk of creating a resource fair to help connect people in recovery with employers who are willing to hire them.

“People in recovery need to be able to get back to work. They need some help how to have a conversation with a potential employer. Maybe they have an employment gap,” Thomas said. “We need to talk about building relationships with potential employers.”

It’s also important for providers, legislators and others to understand addiction issues at ground level. Breaking down barriers for data sharing would lead to informed and meaningful policy making, said Petrak of the Ability Network of Delaware.

“You really need good data,” Petrak said. “That moves the needle and makes substantial changes.”

Stephanie King, who is now in long-term recovery, said she was a student at the University of Delaware when she was prescribed opiates while recovering from a stomach ailment. That started an addiction that eventually led her to heroin. She now works as a peer-recovery counselor and has seen just how devastating this epidemic has become.

“We are human beings. We’re not just homeless people in the streets. We need help,” King said. “People out here my age are suffering. We are forgotten because we are dying.”

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