Co-Author: Mary Parry
An early analysis of the local opioid crisis identified stigma reduction as an obvious need when the Healthy Wilkes: Community Opioid Prevention & Education Team first began working with the Opioid Response Project coordinated by the ncIMPACT Initiative at the UNC School of Government. “There is stigma around seeking treatment. There is stigma related to attitudes about joblessness,” said Heather Murphy, Executive Director of The Health Foundation in Wilkesboro. “Stigma is a major roadblock to connecting people who are struggling with the help they desperately need.”
Murphy leads a team of community advocates, first responders, and other professionals whose work is impacted by the opioid crisis. Together, with the help of UNC School of Government leaders, they are setting goals and adapting their own work to improve the community’s overall response to the epidemic. The team points to helpful trainings led by School of Government faculty as a primary reason for their early success working as a team to tackle local issues. “In the system of care, we have people with different roles trying to communicate and improve the system, like law enforcement, judicial, medical, and social workers,” said Murphy. “Collective impact is designed to change relationships among people and we’re benefitting from the expertise of the UNC School of Government, guiding us through our collective impact work.”
The ability to bring different community leaders together to discuss problems and solutions is invaluable, according to Murphy. Through their collaboration, the Wilkes team is helping staff at the local department of social services understand that medication assisted treatment shouldn’t necessarily be a barrier between parents and their children. They’re helping health care providers change the way they see the opioid crisis, through suggested readings, like “Dope Sick” by Beth Macy.
Another area of focus for the Wilkes team is adverse childhood experiences. According to a Stanford study on the impact of childhood trauma on life expectancy and overall health in adulthood, childhood trauma can shorten life expectancy by up to 20 years. Within the Wilkes team, a group of trained individuals help victims cope with childhood trauma. The “Reconnect for Resilience” group helps victims learn to regulate their own nervous systems. “It’s kind of like a ‘keep calm and carry on’ approach to dealing with stress,” said Murphy. “We need more professionals in the community to become trauma informed and trauma sensitive.”
The Wilkes team is also expanding the work of its harm reduction group, developing strategies to minimize impacts on people in the community while work to address the opioid crisis is underway. The team would like to see more businesses distribute Naloxone and hopes attorneys will soon be done parsing through language in North Carolina’s Good Samaritan Laws which sometimes prevents people from administering Naloxone. The Wilkes team also supports increased availability of syringe exchange programs. “When we started, Wilkes didn’t have a needle exchange program yet,” said Murphy. “We do now, and our hospital is expanding one at its Care Connection Pharmacy, too.”
Medication Assisted Treatment (MAT) is another option for addressing the opioid crisis, helping addicted patients with medication that blocks brain receptors expecting continued opioid use, paired with behavior therapy to help patients adapt. Doctors cannot prescribe MAT without special certification, which limits options for patients seeking care. While current medical school graduates from UNC-Chapel Hill are now certified, there are many physicians practicing across the state who are not yet certified. Murphy says some physicians worry that being certified to treat substance use disorder will impact how their general patient population views their practice, pointing back to the challenge of stigma reduction as a focus of the group’s work.
Leaders in Wilkes County attribute their work with the UNC Opioid Response Project to opening up new avenues of opportunity in their ongoing efforts to tackle the opioid crisis. “Because of this work, we’re more prepared to take advantage of a growing number of other offerings, said Murphy. “We have received a federal grant to help provide more treatment services for pregnant women. And we were in a position to participate in the Appalachian Regional Commission Listening Tour, which covers Work to Recovery programs in the vast Appalachian region, including Ohio and Kentucky.”
The Wilkes team is proud to have been selected for the UNC Opioid Response Project. While the long-term struggles of a community experiencing such a high incidence of opioid addiction is indeed challenging, Murphy says it’s an honor to have been chosen, knowing that UNC School of Government leaders see value in the county’s existing leadership and capacity to affect change. “Yes, our work is difficult,” said Murphy. “But, if you’re going to do the work and do it well, you can’t shy away from the difficult problems. Our team is excited by the progress we have already made, and about our ability make a difference.”
To learn more about the Opioid Response Project coordinated by the ncIMPACT Initiative, please visit: https://www.sog.unc.edu/opioidresponseproject