Experts Discuss Opioid Crisis at UM STEM Fest Panel

The University of Mississippi hosted a panel of experts to discuss the opioid crisis in Mississippi in partnership with the university’s STEM Festival last week.

Bobby Pepper, Lee County Neighbors editor at Northeast Mississippi Daily Journal, moderated the panel discussion. Panel members included Dr. Ben Banahan, Dr. Randy Wadkins, Clint Crawford and Chad Clardy.
Crawford, who is the director of addiction services at Lifecore Health Group in Tupelo, said the number of patients seeking rehabilitation for opioid addiction has increased from 2017 to 2018. 
“About 29 percent of our patients in January of last year [had] opioid-related addictions,” Crawford said. “ January of this year, we are up to 48 percent, and in fact, from January to February – just from the short amount of time in the month – it jumped to 55 percent.”
According to the Mississippi State Department of Health (MSDH), Mississippi’s per-capita rate of painkiller prescriptions is one of the highest in the nation.
Crawford said the opioid crisis is not a issue that’s been only in recent spotlight, but an ongoing problem within the United States that’s been going on for decades. The government first intervened with opioid abuse in 1914 with the 1914 Harrison Narcotic Act. The act, which was adopted into legislation by President Woodrow Wilson in 1915, forced a regulation on opium and coca leaves.
“It seems like a lot of the funding that we are seeing is going everywhere, but where it should be going is treatment,” Crawford said. “We’re spending a lot of time and a lot of money treating the symptoms of addiction, but we’re never treating addiction.”
According to Crawford, it takes six months to two years for patients to fully understand the recovery process. Crawford would rather see patients recover in a six-month to one-year span, but it’s difficult to keep patients in recovery when most of their insurance providers only cover the first 30 days. These cost limitations have caused 30 to be the “magic number” of days for the recovery process.
There has been an approach to combat opioid addiction with other pharmaceutical medication, such as Methadone and Suboxone, but the approach is viewed as a medication-assisted treatment (MAT) in order to treat opioid patients. According to drugabuse.com, the practice is viewed by some as the mere replacement of one drug dependency for another.
“The other issues that comes with [MAT] are you are only treating symptoms but you are not treating addiction,” Crawford said.
Dr. Banahan, director of the UM Center for Pharmaceutical Marketing and Management as well as project director of the Mississippi Medicaid Evidence-Based Drug Utilization Review Program, has been working with the Pharmacy Quality Alliance to better monitor the number of opioid medications prescribed to patients with Medicaid.
The Centers for Disease Control (CDC), published guidelines on how to appropriately disrupt opioid medication to patients.
“We have been spending about two years trying to put in place prescription edits, things to help get rid of the problem in terms of how we prescribe opioids and also at the same time, how to extend coverage [on treatment],” Banahan said.
Prior to 2016, patients were subjected to the “happy face,” Banahan said. It was a chart of smiley faces that doctors would ask to see what level of pain a patient was experiencing immediately after surgery.
“[Doctors’] accreditation groups’ judgment [is based] on how many smiley faces [doctors] got [from patients],” Banahan said.
Banahan argued that once time elapsed on a dosage of pain medication, doctors would check again to keep the patient’s pain at “happy face” level because accreditation groups are judging the doctor’s credibility by this scale.
“The healthcare system spent a good 15 years promoting the idea that nobody is supposed to hurt,” Banahan said.
Chad Clardy, business director of Mid-South for Addiction Campuses in Tupelo, experienced his own opioid addiction in high school after being prescribed for knee pain due to severe cuts. 
Clardy has been clean since he was 23. Now at 37, Clardy works to improve opioid addiction treatment in Mississippi.
“We have work to do,” Clardy said. “Want to know why there was a successful HIV/AIDS [movement]? Because [activists] raised an ever-loving hell.”
That is what opioid activists must do, Clardy said. He added that the HIV/AIDS movement was successful because it made the federal government listen to them.
Dr. Randy Wadkins, professor of chemistry and biochemistry at the university, also worked in the office of Rep. Steve Cohen (TN-9; Memphis) where he handled healthcare policy. He said there is money in healthcare to help combat opioid addiction.
Wadkins worked in Washington when the Obama Administration passed the Summary of the Comprehensive Addiction and Recovery Act (CARA) in 2016.
According to the American Society of Addiction Medicine,
“CARA is a sweeping bill that came together over the course of several years with input from hundreds of addiction advocates. Its provisions address the full continuum of care from primary prevention to recovery support, including significant changes to expand access to addiction treatment services and overdose reversal medications. It also includes criminal justice and law enforcement-related provisions.”
“When CARA was passed, it had enormous $4billion budget that was authorized,” Wadkins said. “There is a big difference between authorization and appropriation.”
Authorization is how much money the government allows to be spent while appropriation is how much money is actually spent.
“There is a growing awareness in Washington that [opioid addiction] is a problem that isn’t going to go away anytime soon,” Wadkins said. “The amount of funding is going up and up over the years.”
As of this past month, Mississippi was awarded a multi-million dollar grant to fight the opioid crisis for prevention and treatment, according to WXXV25 out of Gulfport, Mississippi.
For more information on how UMMC is combating opioid abuse, read UMMC Using Acupuncture, Other Alternative Therapies to Combat Opioid Abuse.

By Talbert Toole, associate editor of HottyToddy.com. He can be reached at talbert.toole@hottytoddy.com.