1. Curbing the Impacts: How Opioids are Impacting Local Government
Gaston Controlled Substances Coalition Team Members
October 10, 2018

2. Panelists Velma V. Taormina, MD Todd Davis, MD Sheriff Alan Cloninger
Tammy and Nazrul Chowdhury

3. Objectives Overview of the NC Opioid Action Plan (2017-2021)
Overview of the Gaston Controlled Substances Coalition
Tell our story…

4. NC Opioid Action Plan (2017-2021)
11/29/2018
NC Opioid Action Plan ( )
Create a coordinated infrastructure
Reduce oversupply of prescription opioids
Reduce diversion and flow of illicit drugs
Increase community awareness and prevention
Make naloxone widely available
Expand treatment and recovery oriented systems of care
Measure our impact
The NC Opioid Action Plan was released in June It is a 42 page document outlining different focus areas.

5. NC Opioid Action Plan Goal?
Reduce the number of unintentional opioid-related deaths by 20% by 2021.

6. What is our story? What do the numbers tell us?
Who is impacted by this?
Who is paying for this?
Who do we need at the table?
How are we going to sustain the work?

7. Gaston County Facts
Ranks 74th of 100 NC counties in geographical size, but 7th in population
About 217,000 residents, 13 municipalities, home to more than 700 churches
Once a leading textile manufacturer, Gaston County’s mill system largely disappeared by 1990, but the influences of this culture remain a powerful force
Looking at the issue within the context of Gaston County
We are worse off health wise than our neighbors
Goal to work in mill….then the mills leave
Low literacy
Mill work physically tough = chronic pain = self medication
Helps to explain how we got to where we are.
Engaging the churches is so important (ex. Teen pregnancy, diabetes)

8. Gaston County North Carolina
Measure for the period
Gaston County
North Carolina
High school graduate or higher, persons 25 years +
82.9%
88.5%
Bachelor’s degree or higher, persons age 25+
19.0%
28.4%
Median household income, 2015 dollars
$42,429
$46,868
Per capita income in past 12 months, 2015 dollars
$22,828
$25,290
With a disability, under age 65 years
12.1%
9.6%
Because a good paying, lifelong job was immediately available in the textile mills, our educational levels lagged behind state norms.

9. History of Gaston County
Tough manual labor, higher rates of injury and disability, higher unemployment & poverty, lower rates of education
Gaston gained national attention in the 1980s as the Dilaudid capital of the US (most per capita prescriptions)
Multigenerational use of pain killers and benzodiazepines
Di-law-did: is an opioid pain med…used to treat moderate to sever pain
Therefore Gaston County has a “history” of opioid abuse…this is not a new issue. However the overdosing is a new issue based on these drugs being used in combination with other things

10. County Medication & Drug Overdose Deaths by Intent
County-level data: *USE CAUTION WITH LOW NUMBERS OF DEATHS*
Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths,
Medication and drug overdose: X40-X44, X60-X64, Y10-Y14, X85.
Analysis by Injury Epidemiology and Surveillance Unit

13. Gaston County’s Opioid Crisis
Something changed in 2016: the number of deaths grew, opioid misuse and abuse moved from the shadows to a visible communitywide health problem
Gaston County’s opioid problem arises from multiple needs and pathways. It is complex.
For years, it was seen as the local management entity/managed care organization’s (LME-MCO) problem to deal with or fix

14. How will Gaston County respond?
Gastonia Town hall Meeting – March 2016
Over 100 citizens attended
Senior staff from our local hospital and the Gaston Community Healthcare Commission
Healthcare Commission decided to focus on the opioid epidemic
The complexity of this question was articulated at a town hall meeting organized by Gastonia City Councilman, Robert Kellogg, in March 2016
Over 100 persons attended, heard presentations, and asked questions of the panelists; this conversation clearly articulated great community pain and need
Attendees included senior staff from our local hospital and the Gaston Community Healthcare Commission
As a result, the Healthcare Commission decided to focus on the opioid epidemic

15. Community support Four key stakeholders: one hospital system
11/29/2018
Community support
Four key stakeholders:
one hospital system
one LME-MCO
one FQHC
one Health Department
Stakeholders have a history of collaboration that continues to grow
Stakeholders agreed to provide resources to the Coalition
CaroMont was the original funder of the Healthcare Commission, it is now funded by the four key stakeholders
The Gaston County Health Department and Gaston Memorial Hospital – predecessor agencies to DHHS and CaroMont – established Gaston Family Health Services. GFHS has offices in two health department facilities and the two organizations share another facility. GFHS provides MAT to STAR patients.
PHBM collaborates with CaroMont on funding psychiatric care for indigent residents and ensuring linkage to community-based aftercare. Has shared KB Reynolds grant with GFHS and continues to collaborate on integrated care initiatives. Works with DHHS and the Health Dept on STAR and other Medicaid initiatives. Engaged partners in development of daylong Opioid Summit in March 2016, for which Dr. McClellan was the keynote speaker.
CaroMont helped fund our first CME event, dedicated a large portion of a speed-dating program to opioids, and hosts many of our meetings.
GFHS staff organized and marketed the CME event.
Partners Behavioral Health Management paid for Dr. McLellan to facilitate our Behavioral Health Summit and is testing and producing our brochure.
Gaston-DHHS hosts the coalition website and provides it with a grant writer.

17. Opioid Epidemic
Prescribers
Affected families
Social Services
Law Enforcement
Court System
Syringe Exchange Program
Behavioral Health
Hospital
Medication Assisted Treatment
Faith-based Groups
As you can, there are many entities that are tackling/affected by this problem.

18. Gaston Community Healthcare Commission
Gaston Controlled Substances Coalition
Steering Committee
Controlled Substances Policy Adoption Committee
Prescribers
Measurements
Community Education & Prevention Committee
Clergy Opioid Outreach Subcommittee
Medication Take-back Subcommittee
Treatment Linkages Committee
Opioid Overdose Response Team
The Coalition has over 145 members representing more than 30 organizations

19. Todd Davis, MD What causes someone to become addicted to opioids?
What is going on in their body and how does this impact their behavior?
How is this impacting your hospital?

20. Sheriff Alan Cloninger
How is the opioid crisis impacting first responders?
What training are first responders receiving to deal with overdoses or with someone who has an addiction?
What impact is this having on the justice and penitentiary system?

21. The Chowdhury Family Austin’s Story
What should parents be looking for?
What can the average person do to help address the issue of opioid abuse?

22. Gaston Controlled Substances Coalition’s Strategic Plan
11/29/2018
Gaston Controlled Substances Coalition’s Strategic Plan
Created a coordinated infrastructure
Reduce oversupply of prescription opioids
Reduce diversion and flow of illicit drugs
Increasing community awareness and prevention
Make naloxone widely available
Expand treatment and recovery oriented systems of care
Measuring our impact

23. What is Next for You?
Educate yourself on the signs and symptoms of drug use.
Talk to your family members.
Empty out your drug cabinets.
Review the NC Opioid Action Plan
Get involved.
Support a cause.
Not for us but for you.

24. Questions?
Not for us but for you.