Dr. Jennifer Lanzillotta, a nurse anesthetist at Highland District Hospital and professor of nursing at the University of Cincinnati (UC), wanted a way to give back to the Highland County community.
“When I came here, I saw the needs of the community, and I just felt like they’re my family, so I thought, ‘I have to do something to help the community and these patients,’” Lanzillotta said. “I started looking, and this program came out, and I thought, ‘This is perfect for this community. This is what we need.’”
Lanzillotta ultimately applied for and received the Rural Community Opioid Response Program (RCORP) Planning and the RCORP Implementation grants. The grants are funded through the Health Resources and Services Administration, or HRSA.
The grants provided funding for Lanzillotta’s Highland County Collaborative Opioid Response Implementation Project (CORE).
During CORE’s planning phase, Lanzillotta worked to build a team of community partners and public entities known as a consortium, analyze Highland County’s needs, and gather data.
“They do that to set us all up to be successful,” Lanzillotta said. “In rural communities, it’s really hard to form your consortium of partners, do your needs analysis of the community, and figure out a strategic plan without some sort of planning phase.”
With the help of agencies and organizations like HDH, the Highland County Health Department, REACH for Tomorrow, and UC’s College of Nursing, Lanzillotta was able to create a plan that could realistically work in Highland County.
The planning phase ran from September 2018 to September 2019.
The implementation phase began in September 2019 and will continue until September 2022, Lanzillotta said.
This phase will focus on educating community members and providers about substance use disorder (SUD) and opioid use disorder (OUD), reducing barriers to treating the disorders, providing timely treatment for people with the disorders, strengthening community collaboration, and creating plans that can be sustained even after the project ends.
One of the programs that stemmed from this project was the naloxone program REACH for Tomorrow and the Highland County Quick Response Team announced in November 2019, which provides naloxone kits and training for interested community members.
QRT Health Specialist Creed Culbreath told The Times-Gazette back in November that many of the community members who had participated in the training at that time were members of civic groups and churches and those whose family members and neighbors were dealing with OUD.
Lanzillotta said there are several reasons that Highland County is an ideal place for a project like CORE: the county’s high rate of OUD, the high rate of overdose fatalities, the high risk of HIV and hepatitis C outbreaks, the prevalence of neonatal abstinence syndrome, and the low ratio of medical and mental health resources to community members.
The list seems long, and many of these issues build on one another.
“It’s a complicated problem. Then you put all of this data together, and you realize: oh my goodness, our community needs so much help,” Lanzillotta said.
Other than searching for funding for prevention, treatment and recovery resources to get individuals with OUD and SUD well and back into the workforce and community, Lanzillotta said one of the key parts of CORE is educating the community as a whole.
Lanzillotta and her team conducted a community survey in Highland County and a similar South Carolina community. The survey included questions like “Do you see substance use disorder as a real disease, such as diabetes or heart disease?” as well as bias- and stigmas-related questions. Both communities’ surveys found the same thing, Lanzillotta said.
“It turns out the people who have the most bias, the most stigma, about the disease model of substance use disorder are the ones who don’t think it’s a real disease,” Lanzillotta said. “It’s really important that we educate the community that substance use disorder is a real disease. It’s just like treating someone for diabetes or heart disease — it’s a chronic relapsing disease.”
According to Lanzillotta, SUD and OUD are caused by a combination of factors, which include stress, genetics and epigenetics, which are influenced by family and community.
“Another thing we’ve uncovered is that people with some sort of underlying trauma or adverse childhood event will often turn to drugs or alcohol to alleviate those feelings of distress, so we need to recognize that some people with SUD have underlying needs that need to be met through counseling,” Lanzillotta said. “Unfortunately, people aren’t receiving the care they need, a lot of times because of the stigma and bias that surrounds addiction and substance use disorder and the lack of resources dedicated to it.”
The Highland County Collaborative Opioid Response Implementation Project (CORE) will be funded until 2022, though Lanzillotta said they may at some point seek further funding depending on the project’s progress.
Reach McKenzie Caldwell at 937-402-2570.