ETSU and Virginia Tech kickstart coalition to fight the Appalachian opioid epidemic

Brandon Paykamian • Apr 22, 2019 at 1:23 PM

East Tennessee State University and Ballad Health are teaming up with universities and researchers across Appalachia to combine their expertise in battling the region’s opioid epidemic.

Last year, ETSU and Virginia Tech applied for a one-year Eugene Washington Engagement Award grant from the Patient-Centered Outcomes Research Institute totaling $265,000.

The grant was recently awarded to establish the Opioids Research Consortium of Central Appalachia, or ORCA, which includes Marshall University, University of Kentucky, Virginia Tech, West Virginia University, Ballad Health and Carilion Clinic in Roanoke.

The team approach began with a conversation.

Years ago, ETSU’s Robert Pack and Kimberly Horn, with Virginia Tech, talked about the need for a regional coalition to both fight and research the opioid epidemic.

“We started our careers together at West Virginia University. When she moved to Virginia Tech, we made a connection and thought, ‘Let’s see what we may be able to do in a collaborative way to really form some connections between our institutions,” Pack said.

Pack is executive director of ETSU’s Center for Prescription Drug Abuse and Treatment and associate dean in the ETSU College of Public Health; Horn is a professor at the Fralin Biomedical Research Institute at Virginia Tech Carilion and in the Department of Population Health Sciences in the Virginia-Maryland College of Veterinary Medicine at Virginia Tech.

And now, the colleagues are the consortium’s directors and co-principal investigators.

Pack said he hopes the consortium’s partnerships will help Central Appalachian communities become more proactive in the battle against the opioid crisis and connected public health concerns — neonatal abstinence syndrome, hepatitis C and HIV outbreaks, mental health issues and others.

When it comes to the opioid epidemic, in particular, Pack said the “immediacy of the crisis creates a reactionary climate for institutions and organizations in the throes of the crisis.”

He hopes partnerships like the Opioids Research Consortium of Central Appalachia will help change this by taking an interdisciplinary and interstate approach to the epidemic.

“This is not a state-based issue; it’s a region-wide issue,” he said. “It’s important to have interstate collaboration when we’re talking about strategies that we know work for Tennessee and strategies that work in Virginia that we may want to adopt,” Pack said. “That’s why we’re seeking to partner with the Central Appalachian region because, frankly, this is bigger than any state.”

To make a bigger impact, Pack said institutions across state lines need to work together and “erase boundaries” to leverage as many resources as possible.

“You have to think about different conditions, diseases, disorders in terms of an interprofessional framework because there is no simple answer to any of these problems,” he said. “We just start from an interprofessional, interdisciplinary perspective.

“We’re stronger when we have a diverse group of perspectives at the table, and it’s just imperative that if we’re going to address the issues effectively, were take advantages of their strengths,” he continued.

Trish Baise, vice president of behavioral health services for Ballad Health and president of Overmountain Recovery, said she is “looking forward to designing and implementing more best practices” to fight the opioid crisis in a Wednesday press release. Pack said that’s where the research element of the partnership also comes in.

“What we’re going to do with ORCA is settle on a blueprint for research on the topic of the epidemic in the region. The reason for that is not research in and of itself — it’s to be able to bring the best evidence for innovative new strategies for prevention, treatment and other risk-reduction measures in the community,” Pack said.

“This is for trying to figure out what the best solutions are and trying to figure out how to get them used widely in the region,” he continued. “That, I think, is a proactive stance. Trying to get in front of the epidemic rather than just trying to chase it.”

While a lot of media focus often goes to treatment access and overdose prevention medications like naloxone, Pack said research points to the need to take multiple approaches at once to tackle the crisis.

“Those actually need to work in concert in a number of other systems in order to be most effective,” he said, adding that primary care physicians and medication treatment need to be further used together in the region.

“I think it’s important to think of this as a larger issue in order to move further upstream to prevent the problem in the first place.”

Pack hopes to draw more institutions to further collaborate on research, prevention and treatment efforts in the region.

Rather than competing, Pack said institutions need to work together to fight public health crises such as the opioid epidemic.

“We hope to bring other institutions on board with this,” he said. “We’d like to include the University of Tennessee-Knoxville and other large research institutions and begin to really collaborate between institutions so we can have a greater impact for the citizens of our region.”

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