Helping Appalachians trapped by opioid epidemic



Go to Google and type: “leading cause of accidental death in …” Then type in a state — any state in central Appalachia — and hit search.

The answer is the same: opioid overdoses and drug poisoning lead the way in fatalities in these states, far above former front-runners, such as car accidents and gun violence.

Now, with a new grant from the Patient-Centered Outcomes Research Institute (PCORI), universities led by Virginia Tech will unite scientists, a range of health-care and service providers, and communities, including individuals in recovery, to confront the opioid problem, directly in the epicenter of the epidemic.

“Everyone responds to the crisis according to their expertise, from first responders to treatment specialists to researchers, and there is so much we can learn from each other if we have better ways to share,” said Kimberly Horn, a professor at the Fralin Biomedical Research Institute at VTC and in the department of population health sciences in the Virginia-Maryland College of Veterinary Medicine at Virginia Tech. “Research is key to unlocking new and better solutions. For instance, when we bring together research universities with emergency service providers, law enforcement, and major health care systems, such as Ballad Health in Tennessee and Virginia and Carilion Clinic in Virginia, to set research priorities and share best practices, we can reverse the tide.”

The effort, called the Opioid Research Consortium of Central Appalachia (ORCA), is led by Horn and co-principal investigator Robert Pack, the associate dean for academic affairs and a professor of community and behavioral health in the College of Public Health at East Tennessee State University (ETSU).

“Central Appalachia is at the epicenter of the opioid crisis,” said Pack, who is also the executive director of East Tennessee State University’s Center for Prescription Drug Abuse and Treatment. “The purpose of the grant is to facilitate planning for a research blueprint on opioids for the central Appalachian region.”

The consortium also includes faculty from Marshall University, the University of Kentucky, and West Virginia University.

In central Appalachia, West Virginia, Southwest Virginia, eastern Kentucky, southeast Ohio, eastern Tennessee, and western North Carolina have the nation’s highest opioid death rates, and people have limited access to treatment. In addressing the addiction problem, regional groups have acquired a lot of knowhow.

“It is this type of community-centered knowledge that leads us to do research that has high impact,” Horn said. “These experiences help us conduct research that generates answers that are more meaningful for the people of central Appalachia — in part because they help form the research questions.”

For example, experts from Marshall University and their communities around Huntington, West Virginia, have invaluable knowledge from nearly two decades of responding to the opioid problem.

The Roanoke Valley Collective Response to the Opioid and Addiction Crisis, a new group that comprises more than 70 organizations and nearly 200 members representing professionals and community members from all aspects of the crisis, will serve as ORCA’s initial community advisory group.

“This is the kind of work that brings academics, communities and health care providers together to solve big problems,” said Michael Friedlander, Virginia Tech’s vice president for health sciences and technology and the executive director of the Fralin Biomedical Research Institute. “It is only through the lenses, expertise and experiences of those groups’ collaborations that we are likely to solve problems such as the opioid crisis. I am delighted to see Dr. Horn and her colleagues taking the lead on this important initiative that represents for us the first Patient Centered Outcomes Research Institute sponsored project.”

Consortium leaders will gather in May at Virginia Tech in Blacksburg, Virginia, to talk about next steps, including sharing resources, conducting joint research trials, and providing a research training platform for students.

“Collaboration will be our key success factor,” said Robert Trestman, chair of psychiatry and behavioral medicine at Carilion Clinic and the Virginia Tech Carilion School of Medicine. “All of us understand we cannot do this important work in a vacuum. We owe it to our patients and to our community to continue to strengthen our partnerships. This grant will enhance the work that is already under way.”

Leaders intend to establish an open, team-science culture comprising organizational and individual partners across higher education, private health care systems, state government, and community organizations. Most importantly, community and patient engagement is the centerpiece of this effort.

“When we talk across siloes and institutions, with a tighter lens of the needs of our communities, we can make serious headway in our efforts to help the people of Appalachia,” Horn said.

The Roanoke Valley Collective Response to the Opioid and Addiction Crisis, a new group that comprises more than 70 organizations and nearly 200 members representing professionals and community members, will serve as ORCA’s initial community advisory group.

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