Responding to Indiana’s Addictions Crisis

Americans are now almost twice as likely to die from a drug overdose as a car accident. Life expectancy has fallen in the United States for the third year in a row. Historically, this is typical only in countries ravaged by war or famine.

Indiana University, in partnership with Indiana Gov. Eric J. Holcomb; the state’s largest health care system, IU Health; and others has embarked on a comprehensive effort to combat the crisis, not just in Indiana, but across the country. IU’s Responding to the Addictions Crisis Grand Challenge is the largest, most comprehensive response to the addictions crisis in the nation led by a university.

Indiana University’s Grand Challenge is going to go such a long way to help turning the tide of this crisis of addiction. It’s going to give more hope to the far too many hopeless,” Eric J. Holcomb Governor of Indiana

Launched in 2017, this $50-million initiative is working to harness the resources of the university and the state to reduce deaths associated with substance use disorder, ease the burden of drug addiction on local communities, and improve health and economic outcomes.

Already 31 research projects are underway. Project leaders are working with partners to test school interventions, support addiction counselors in rural communities, search for more effective treatments, reduce stigma, help people fighting addiction stay in the workplace, examine policy obstacles, and better understand the long-term consequences of addiction.

Exploring Non-Addictive Pain Treatments

IU scientist Andrea Hohmann is working to understand what causes pain at a basic biological level. The aim is to transform those insights into medical treatments for the millions suffering from chronic pain in the United States. Hohmann’s lab has found evidence that a drug previously proven safe for human use could potentially prevent the side effects that lead to addiction when used in combination with opioid-based pain medications.

Hohmann, a Gill Chair at IU’s Linda and Jack Gill Center for Biomolecular Science, and her colleagues are re-examining a largely forgotten drug in an attempt to harness its ability to act upon the body’s own pain-blocking receptors to produce relief. Promisingly, Hohmann’s initial work suggested the compound reduced two side effects associated with opioid addiction: physical dependence and tolerance.

Now, as part of IU’s Responding to the Addictions Crisis Grand Challenge initiative, Hohmann and others at IU are conducting additional preclinical research on the compound to confirm its safety, as well as developing a proposed roadmap on how to most effectively move toward new human trials. The hope is the process will move faster than the typical decades-long effort because the compound has already passed many key regulatory hurdles.

Andrea Hohmann works in her lab
The potential to quickly begin using this compound in combination with opioid-based medication to treat pain and reduce addiction makes this discovery very significant,” Andrea Hohmann Linda and Jack Gill Chair of Neuroscience, Indiana University Bloomington College of Arts and Sciences

Training Tomorrow’s Clinicians and Addictions Specialists

The lab is only one arena where IU experts are fighting addiction. IU is leading efforts to close the gap between the state’s need for medication-assisted addictions treatment and the available number of behavioral health professionals, which has been estimated at 7,000.

The IU School of Social Work at IUPUI is part of the Community Behavior Health Academy—a  partnership, led by local health care provider Community Health Network, to increase the number of people entering the workforce with dual licensure as a clinical social worker and a clinical addiction counselor.

Starting this fall, the first students will enter the program. Upon graduation, these students will represent a new wave of licensed social workers entering the community to treat thousands of patients. Lessons from the program will be openly shared with any interested parties.

IU Health employee distributing free Naloxone

In April, 2019, the National Academy of Medicine (NAM) enlisted Indiana University to join a powerhouse collaborative dedicated to preventing opioid-related deaths and reversing national trends in opioid misuse and overdose. The collaborative brings together over 100 universities, hospitals, non-profits and other medical organizations to share research and best practices in the national fight against opioid addiction.

The Behavioral Health Academy aligns with our commitment to our patients and the communities we serve. By creating a pipeline of qualified, specially trained therapists, we will strengthen our fight against the opioid epidemic and change the lives of those with addiction,” George Hurd Vice President of Community Behavioral Health.

Eliminating Regulatory Obstacles and Identifying Policy Priorities

Another project has been working with federal and state legislators and government officials to help eliminate regulatory obstacles to, and prioritize policy options for, effective responses to substance use disorders.

At the request of members of Indiana’s congressional delegation, IU experts on health law
Nicolas Terry, Ross Silverman, and Aila Hoss produced a report on “Legal and Policy Best Practices in Response to the Substance Abuse Crisis.”

This was followed by a study and report, “Innovations in Opioid Law and Policy Interventions,” providing examples of effective interventions in four primary areas: rethinking criminalization; strengthening public health; increasing and improving treatment; and effecting change.

Nic Terry stands in a library

Nicolas Terry
Executive Director of the William S. and Christine S. Hall Center for Law and Health 

IU faculty have also partnered with the Addiction Policy Forum to meet with congressional staff, brief agency officials, and host workshops on Capitol Hill. Terry also has delivered testimony in front of the U.S. Senate Special Committee on Aging, during a hearing titled “Preventing and Treating Opioid Misuse Among Older Americans.”

In addition, the university has partnered with the Indiana Supreme Court and state agencies to help train almost 1,000 court and law enforcement officials on Medically Assisted Treatment for addictions, and led a coalition of nonprofit groups and government agencies to distribute Naloxone kits and provide training in their use across Indianapolis.

Fueling Progress

Responding to the Addictions Crisis is one of three Grand Challenge initiatives at IU. The other two are working to advance individualized precision health and to help communities, businesses, and individuals prepare for environmental change. All have three objectives in common: address critical issues facing the public; work with key partners to provide holistic, practical recommendations; and create replicable models.

Robin Newhouse, principal investigator
A challenge that is this complex requires a comprehensive response. Together with our partners and community, we are responding with an integrated, multidisciplinary approach that can help us understand and address the factors that contribute to addiction now and in the future.” Robin Newhouse Dean of Indiana University’s School of Nursing and Principal Investigator of the Responding to the Addictions Crisis Grand Challenge.