State of Addiction: Indiana
May 14, 2019
In 2017 alone, more than 1700 Indiana residents died from drug overdose. While much has been done to fight this addiction crisis within the state, there is always more for community members, business owners, and lawmakers to do in order restore hope and function to thousands of families.
Currently Senate Bill 33 has made its way to the governor’s desk where it will hopefully help establish three comprehensive addiction recovery centers across the state. These facilities are going to offer the full-range of evidenced-based treatment services for a variety of addictions. Additionally, recovery support programs would also be put in place to help with medication-assisted treatment, counseling, job training, and more.
It’s currently estimated that the opioid crisis has inflicted $44 million in economic damages over the past 15 years, in large part due to the lost productivity in the workplace. This lost productivity hurts the economy, hurts families, and hurts Indiana, so the more treatment centers available the better.
State of Addiction: Indiana
Drug addiction could be one of the worst public health crises in the state of Indiana. In the last decade, the state has continually ranked among the highest in the nation for overdose rates, methamphetamine lab incidents, and the rate of children in foster care.
According to data from the CDC:
- 1 in 20 people in Indiana have abused an opioid painkiller in the past year
- The number of fatal overdoses has increased 500% since 1999
- Indiana has one of highest rates of children in foster care
- Indiana experienced a record high of drug overdose deaths in 2017, up 21% from 2016
Indiana Alcohol Stats
- Alcohol is the most frequently used drug in Indiana and the United States.
- Among Hoosiers ages 12 and older, 50.4% drank alcohol in the past month.
- Young adults ages 18 to 25 had the highest rates of alcohol use in Indiana: 59.7% reported current alcohol use.
- Rates for heavy drinking were slightly lower in Indiana than in the United States (IN: 5.3%; U.S.: 5.9%)
- Among Indiana college students, 62.7% reported current (past-month) use of alcohol.
- Among Hoosiers 12 to 20 years old, 21.0% reported current alcohol use.
- 10.6% of Indiana youth ages 12 to 17 drank alcohol in the past month.
- 30.5% of Indiana high school students (grades 9 through 12) used alcohol in the past month, and 17.4% engaged in binge drinking.
- 13.2% of 8th graders, 22.9% of 10th graders, and 34.6% of 12th graders consumed alcohol in the past 30 days in Indiana.
- An estimated 5.9% of Hoosiers had an alcohol use disorder in the past year; the highest rate was found among 18- to 25-year-olds (12.5%).
- Most admissions to substance abuse treatment were due to alcohol; more than one-third of treatment admissions among Hoosiers (35.0%) were for alcohol dependence (U.S.: 36.3%).
- Alcohol abuse in the treatment population differed by race: 34.1% of whites, 39.0% of blacks, and 37.9% of other races indicated alcohol dependence.
- From 2000 through 2015, a total of 6,571 Hoosiers died from alcohol-induced causes.7 The age-adjusted alcohol-attributable mortality rate in 2015 was 9.4 per 100,000 Indiana residents.
- In 2015, a total of 8,642 alcohol-related collisions occurred in Indiana; 152 of these were fatal.
- In 2014, Indiana arrest rates per 1,000 population were 3.2 for driving under the influence (20,810 arrests), 1.1 for public intoxication (7,107 arrests), and 1.2 for liquor law violations (8,245 arrests)
Indiana Next Level Recovery
Since taking over the position of Governor in Indiana, Eric Holcomb has mobilized resources to comprehensively tackle the drug crisis. This includes creating initiatives to help residents access treatment and recover from substance use disorders, as well as arresting and prosecuting more drug dealers.
In addition, many public and private partners have joined forces to help amplify the positive effects of this coalition. This entire movement shift began when Governor Holcomb signed an executive order creating the position of Executive Director for Drug Prevention, Treatment and Enforcement.
Since then, many initiatives have begun and even more are in the works to help reduce the crisis level of drug addiction within the state of Indiana. Thus far, the state has seen the passage of several important laws:
Passed in 2017, this law implemented a 7-day limit on first time opioid prescriptions as well as established new guidelines for the management of acute and chronic pain. In 2018, opioid prescriptions decreased 23% from the prior year.
Signed in 2017, this allows municipalities to establish syringe service programs without needing state approval. Thus far, two counties have added syringe programs, with nine counties in total having active programs.
HEA 1540 & 1359
These laws stiffened penalties for pharmacy robbers and those who manufacture or distribute drugs that result in overdose death.
Along with the passage of these and other laws, the state also added five new opioid treatment centers across Indiana in 2018 in Allen, Johnson, Monroe, Tippecanoe, and Vigo counties. Nine more opioid treatment centers were authorized to open in 2019 as well.
Moving forward, the governor is focusing on several key issues related to substance use disorders. First is a push to reduce perinatal substance use disorder and neonatal abstinence syndrome by requiring providers to screen during pregnancy. The objective is to help identify substance use issues during pregnancy to help guide expecting mothers through treatment and successful pregnancy.
The governor is also focusing on expanding recovery housing, also known as transitional living, for Hoosiers dealing with opioid use disorder. The plan is to divert $2 million annually for the next two years from the federal opioid block grant to create at least 500 additional beds in recovery housing for men, women, and women with children. Currently, the state only has 1400 beds and 87 certified recovery residences.
Another focus is on establishing Medication-Assisted Treatment pilot programs for jail inmates. This would divert $3 million from the opioid grant to establish a pilot program and build a forensic workforce. Access to medication assisted treatment in jails is associated with reduced recidivism, decreased overdose rates, and improved health outcomes.
The governor also hopes to use some of this block money to provide over $2 million to the development of more evidence-based Family Recovery Courts, implement best practices, and serve more families.
Progress So Far in Indiana
From the beginning, the goal was to produce measurable outcomes in the long term. So far, preliminary data has shown that January through June 2018 saw an 18-20% reduction in drug overdose deaths. Ever since, that rate has been on the decline.
In addition, opioid pill prescriptions decreased 23%, with prescriptions down 12% and falling faster each month. Prescribing report cards are set to roll out in June to help medical practitioners evaluate and make better informed decisions.
Indiana’s Medicaid waiver has expanded access to addiction treatment to 1.6 million Hoosiers. From February of 2018 to March of 2019, nearly 50,000 Hoosiers received addiction treatment, with 31,000 receiving outpatient treatment and over 8,600 receiving treatment through Medicaid. Additionally, residential capacity in treatment centers has increased by roughly 36% since the inception of these laws and programs.
Thus far, the state has been attempting to place substance use treatment within an hour’s drive of every resident in the state. Five new opioid treatment centers have been planned in Delaware, LaPorte, Scott, Hendricks, and Knox with four more locations still in progress.
During 2018, the state of Indiana Department of Corrections managed to implement a strategic improvement plan called “Recovery While Intoxicated”, a multi-faceted approach that increases access to treatment for incarcerated individuals while incorporating evidence-based treatment programs and community-based services. So far, enrollment has increased across all of Indiana’s Correctional Facilities, with data still being evaluated for measuring success rates.
Naloxone In Indiana
So far, more than 44,000 Naloxone kits have been provided to local health departments, first responders, and family members with loved one in active drug use. Thanks to the state, people can now purchase naloxone over the counter without a prescription, increasing the amount of kits dispersed through each county.
Naloxone is a medication designed to reverse an opioid overdose. It is an opioid antagonist, so it binds to opioid receptors and can reverse and block the effects of other opioids. It will restore normal respiration and eliminate the euphoria, or high, in a person who has suffered from an opioid overdose. The effects of naloxone, name brand Narcan, will generally last 30 to 90 minutes, if medical attention is not sought out, the overdose may return.
Upon using the opioid antagonist in the case of an overdose, the medication will almost immediately reverse the life-threatening suppression of breathing. Naloxone works by knocking off the opioid from the opioid receptor and then blocking the receptor. Because it blocks the opioid receptor naloxone cannot be abused nor cause overdoses.
Naloxone is administered two ways, as a nasal spray and as a liquid injection. Upon the medication being used, the patient may begin experiencing withdrawal symptoms which may be uncomfortable, but are not life-threatening. Some symptoms that they may experience include headache, changes in blood pressure, rapid heart rate, sweating, nausea, and vomiting.
Narcan has become more popular over recent years as opioid use and overdoses have risen. A few common opioids that naloxone can be used for include methadone, fentanyl, tramadol, heroin, oxycodone and hydrocodone. Recently, some lawmakers have made efforts to make Narcan’s availability more widespread. First responders have begun to carry naloxone to respond to and treat opioid overdoses.
Law Enforcement in Indiana
In partnership with the DEA, the state police department in Indiana has collected over 63,000 pounds of unused medication since April of 2017. This includes 2500kgs of Marijuana, 93 kg of Heroin, 230 kgs of Methamphetamine, 153 kg of Cocaine, and 19 kg of Fentanyl. These seizures continue to carve into the black market drug trade that has contributed to the rising epidemic of drug addiction and violence.
Healthy Indiana Plan
Part of Indiana’s plan to address the opioid epidemic is the Healthy Indiana Plan. This initiative starts with creating more sensible legislation that better targets areas in need and a firm commitment to seek new and innovative treatment options. Governor Eric Holcomb is working to secure $60 to $65 million in additional funding for residential treatment and recovery options, with at least five new treatment facilities already being opened. The 21st Century Cures Act also provided Indiana with $10.9 million in additional funds for increasing residential treatment in high-risk areas of the state.
Youth Summit on Substance Abuse in Indiana
Dozens of students in Indiana recently partook in a massive substance abuse prevention summit hosted at the Indiana statehouse. This event was created to help highlight the growth of one program to reduce prescription drug abuse in schools, a special online program that walks students through scenarios and resources related to drug addiction, abuse, drug disposal, and intervention. The program was created in partnership with Attorney General Curtis Hill’s office.
So far, 19 schools have been using the program. Indiana State Superintendent of Public Instruction Jennifer McCormick says that more school systems in the state should be starting programs to help prevent substance abuse among students. It’s going to take effort and courage, but with a strong policy and mindset in place there can hopefully be monumental change. According to McCormick, roughly 6% of Hoosier youth have used an illegal substance besides cannabis. This is important, as research has show how teens who use substances early on are more likely to get addicted.
At Landmark Recovery, we offer a personalized treatment path forward for our patients suffering from addiction. Our residential alcohol rehab begins with detoxification and moves on to a series of group and individual therapy sessions for patients to learn how to maintain sobriety for years to come. If you would like more information please visit our website and reach out to our admissions staff today.