A nearly $4 million grant from the Centers for Disease Control and Prevention (CDC) could give Texas physicians new tools to handle national opioid and mental health crises, which have made it difficult to identify patients at risk for substance use disorders.
The money will assist Texas health officials in preventing and reducing drug poisonings and overdoses by focusing on improved data collection and analysis, and on early intervention.
About $1.6 million of the five-year Overdose Data to Action (OD2A) grant from CDC will go toward expanding and modernizing data systems. The Texas Department of State Health Services (DSHS) will lead the charge on the health information improvements; the Texas Health and Human Services Commission will use the remaining $2.3 million of the grant to implement solutions based on DSHS’ findings.
Michael Sprintz, DO, a pain and addiction specialist and member of the Texas Medical Association’s Committee on Behavioral Health, says patients commonly do not receive interventions for substance use until they’re demonstrating serious complications.
“Part of what we can do with this money is really invest in predictive analytics, machine learning, and AI (artificial intelligence) to help with the early identification of high-risk patients, which helps us optimize the efficiency of our health care delivery and improve patient outcomes,” he said.
CDC’s OD2A state program emphasizes collecting data on community characteristics, nonmedical drivers of health, and health equity, and calls on state health departments to implement actionable strategies based on science and data.
Serving that goal, the OD2A state program provides support for clinician education and training, as well as for health information technology (IT) infrastructure improvement. DSHS has not yet announced specific plans for the funding, but the program emphasizes initiatives that have wide impacts, such as:
- Ensuring that clinician education efforts lead to change in clinical practice aligned with the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain;
- Reducing stigma and removing barriers in access to evidence-based care for pain and substance use disorders; and
- Increasing positive interactions between clinicians and people living with pain and those who have experienced an overdose or are at high risk of overdose.
Other prevention and early intervention strategies include enhancements to state prescription drug monitoring programs (in Texas, the Prescription Monitoring Program), as well as:
- Community-based linkage to care;
- Harm reduction;
- Public safety partnerships/interventions; and
- Clinical/health system engagement.
DSHS informed Texas Medicine Today that any new or expanded programs to result from O2DA data analysis likely will happen toward the latter end of the grant’s five-year period.
The measured approach may prove useful at a time when other strategies seem to fall short, Dr. Sprintz says.
“Recent efforts, while well-intentioned, have not been effective in decreasing overdose deaths, and in fact, overdose deaths are still increasing,” he said. “The question then becomes, what’s going on, and what changes can we make to slow the overdose rate and save more lives?”
According to Dr. Sprintz, what’s going on is a dangerous convergence of multiple factors: increasing amounts of fentanyl and xylazine in drugs purchased off the street, and an overwhelming wave of behavioral health challenges.
“We're not just in an opioid crisis, we’re in a total substance abuse crisis,” he said, noting that increased alcohol use nationwide can have disastrous effects in combination with pain medications. “But bigger than that, we have a massive mental health crisis going on in our country. Since COVID began, we’ve been experiencing a society-wide trauma from a behavioral health perspective.”
With so many factors at play, and behavioral health notoriously nuanced, Dr. Sprintz says it’s difficult for physicians to distinguish which patients are at risk for substance misuse and abuse, making early interventions challenging and sometimes, nigh on impossible.
“We have a massive population of people that are under-identified and under-treated for a lot of behavioral health issues that increase the probability of developing a substance use problem and/or overdose,” he said. “We have a problem educating our medical community about identifying patients who are at risk, or who may have problems with a substance use disorder.”
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