Grant to boost statewide treatment for drug, alcohol addictions

Published on Monday, October 31, 2022

By: Ruth Cummins

A $6 million federal grant awarded to the University of Mississippi Medical Center is making possible more drug and alcohol addiction services statewide to directly help those fighting increasingly deadly substance abuse.

The grant will fund the Mississippi Horizons Project within the Medical Center’s Center for Innovation and Discovery in Addictions, or CIDA. It comes as the nation and state grapple with an escalating opioid epidemic and upswing in alcoholism.

“Our model of substance abuse treatment is unique in the state. It’s individually tailored and focused,” said Dr. Jefferson Parker, professor and division director of psychology in UMMC’s Department of Psychiatry and Human Behavior, who co-directs CIDA with Dr. James Rowlett, professor of psychiatry.

“Our approach is to offer what the patient needs, within the bounds of evidence-based practice.”

“There’s no question that since the COVID pandemic began, substance use disorders and the impact they have had on society have gotten worse,” Rowlett said. “What’s super exciting is that this work is for the entire state. From a research perspective, we will have so much that we can build on so we can see what the real problems are.”

The award comes from the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration. An appropriation in the FY22 federal budget through the efforts of Mississippi’s congressional delegation, it makes possible new services ranging from expanded substance abuse telemedicine to real-time information on what residential treatment centers have available beds.

Statistics from the Centers for Disease Control and Prevention paint a picture of how deadly illicit drugs can be. For the 12-month period ending in January 2022, the country recorded 107,375 drug overdose deaths. Of that number, 67 percent were from synthetic opioids such as fentanyl, a substance that the U.S. Drug Enforcement Agency says is the nation’s deadliest drug threat ever.

Almost 15 million U.S. residents ages 12 and over had an alcohol use disorder in 2019, says most recent data from the National Institute on Alcohol Abuse and Alcoholism. Only about 7.2 percent received any form of treatment during that past year.

Highlights of the new CIDA services:

• Medication-assisted treatment (MAT) for adults with opioid disorders will be delivered through TeleMAT in addition to in-clinic care. The telehealth component of MAT is an expansion of the clinical arm of CIDA and Psychiatry’s Addiction Clinic at the University Physicians Riverchase Building in Flowood.

Previously restricted to collaborations with regional mental health centers, TeleMAT will be open to referrals statewide, including self-referrals. A psychologist will provide concurrent collaborative psychosocial relapse prevention therapy to TeleMAT patients.

The national gold standard for treating opioid addiction, MAT is the use of drugs that reduce cravings for opioids and prevent patients with addictions from getting high if they relapse. Dr. David Vearrier, professor of emergency medicine, and Dr. Laura Vearrier, associate professor of emergency medicine, will treat TeleMAT patients and are certified in addiction medicine.

Dr. Saurabh Bhardwaj, one of the few addiction psychiatrists in the state, sees MAT patients at the Addiction Clinic.

• UMMC’s addiction medicine team will give substance abuse consultations to providers in emergency rooms in rural hospitals. A limited amount of scholarship aid will be available to transition someone with no insurance or means to pay from an emergency room to an inpatient treatment bed.
• A limited amount of money will be available to help with MAT medications for those who don’t have insurance or another way to get it, and for transportation to pharmacies or treatment centers in the community.
• Web-based resources for treatment providers, families and individuals will “give real-time information on the availability of beds at treatment facilities,” Parker said. “That will help families proceed with making choices on where to apply for treatment.”
• A new Academy of Addiction Training will offer education to providers, patients and families.

Mississippi State University and the University of Mississippi, as sub-grantees, will play key roles in supporting the grant.

MSU’s Dr. Will Davis and Dr. Devon Meadowcroft will serve as health economists, evaluating the economic benefit of CIDA programs that aim to increase the accessibility of substance use treatment and working alongside the project team in assessing how the interventions improve patient well-being and access to care.

“The MSU research team is excited to work with UMMC on such an important project for the state,” Meadowcroft said. “We hope that these efforts will expand substance use disorder care across the state through removing some of the barriers that patients face when seeking treatment.”

UM’s CREW, short for Community First Research Center for Wellbeing and Creative Achievement, and its CERE, short for Center for Research Evaluation, will combine implementation science theory with on-the-ground data and feedback to guide thinking about program design and roll-out, while collecting data on outcomes to assist in decisions about continuous improvement and scaling up.

"This grant is a wonderful opportunity to help improve access to care and treatment for people who have addictions,” said Dr. Meagen Rosenthal, co-director of CREW. Dr. Sarah Mason directs CERE. “We know that implementation science and evaluation are critical tools for thinking about the design and roll-out of support programs, and we're delighted to be supporting these efforts."

The extra funding will allow UMMC addiction medicine providers to see more patients, give them a shorter wait, and provide expanded services. Bhardwaj is medical director for the CIDA Mississippi Horizons Project.

“We will be able to offer from the simpler level of care to intensive outpatient therapy. It opens up a lot of opportunity to expand,” Bhardwaj said. “We have patients waiting in line to see us.”

The grant will fund more therapists and mental health professionals to care for a population that has become more challenging to treat. “Fentanyl is causing more overdoses, and MAT for those patients must be closely monitored,” he said. “It’s much more resource-intensive to manage fentanyl disorders.”

The Mississippi Bureau of Narcotics reports that from Jan. 1 to Dec. 31, 2022, there were 496 overdoses reported in the state, 416 of them involving an opioid. From Jan. 1, 2022 to Sept. 28, 2022, there were 238 overdoses, 185 involving an opioid.

The grant’s research component will explore the effectiveness of treatments and training programs. “That’s critical, because there are so many things about substance abuse that we don’t know,” Rowlett said. “Mississippi is mostly rural, and reaching those who need help is a big challenge. Once we have more data on how well the programs work, we can try to fix things in a research-based way.”

“This is a perfect example of translational research,” said Dr. Joey Granger, associate vice chancellor for research and dean of the School of Graduate Studies in the Health Sciences.

“Translational research is what we do in the lab that reaches Mississippians, especially in rural areas. It goes from the lab to the bedside to the clinic to the population. This grant allows us to make that big step,” Granger said. “It will allow us to fill gaps in access to care and treatment. We will be educating not only patients, but our health care providers in the latest treatments.”

“We’re so thankful for the support of our congressional delegation in garnering this (Congressional Directive Spending project) funding,” said Kristy Simms, UMMC executive director for external affairs. “Through this program, we can increase access to services for more Mississippians who need counseling and treatment, no matter where they live.”

Although the one-year grant includes money for psychiatric nurse practitioners and peer support specialists, Parker said, the positions are only funded for that year. “We want to work for ways that the programs that are effective can become permanent,” he said.