The West Virginia Office of Drug Control Policy brought more than 150 addiction and recovery service providers and medical experts together virtually on Tuesday for its first open forum discussing potential changes to the state’s Substance Use Response Plan.
The plan — created through the Governor’s Council on Substance Abuse Prevention and Treatment — was initially released in 2018. It’s meant to reduce rates of drug, alcohol and tobacco use and dependence in West Virginia, which is home to some of the highest rates of substance use disorder and fatal overdoses in the nation.
Those who joined the forum Tuesday discussed the prevention part of the plan. Other forums — all held via Zoom — are scheduled through Dec. 14 to discuss other topics. The next will be held Nov. 16 and will focus on the community engagement and support section of the model.
Brian Gallagher, chairman of the governor’s council and associate professor at Marshall University’s Joan C. Edwards School of Medicine, said Tuesday’s forum was important for gathering crucial feedback from service providers, who often are the ones responsible for creating and operating resources on the ground.
“Without your feedback, we don’t know if this will really resonate or how effective it will be locally,” Gallagher said. “We’re trying to make this as inclusive as possible so don’t feel reticent for being participatory.”
Participants in Tuesday’s forum were split into 14 groups where moderators led discussions on the prevention portion of the plan and fielded suggestions and concerns from those in the group.
Currently, the prevention section is broken into six main goals ranging from monitoring opioid prescriptions and distributions in the state and enhancing cessation programs for tobacco and nicotine use to streamlining data collection and management and collaborating between groups.
Strategies are listed for each goal and include key performance indicators tied to specific actions that should be completed during 2022 to ensure the plan is moving forward.
After about 45 minutes in the breakout groups, participants came back together as the facilitators from each group shared three main points from their discussions.
Many called for improved collection and management for data on drug use trends, overdoses and recovery services.
Several groups noted that marijuana and, specifically, medical marijuana were not explicitly listed in the prevention portion of the plan. Some said they would like to see guidance from the state on how to discuss the potential benefits of medical marijuana — which was legalized in West Virginia in 2017 — in the context of also trying to reduce drug use rates in the state.
There were other requests for more state support, as well, including one group calling for the government to create a uniform curriculum for public schools to use when educating children on substance use disorder.
Kelli Caseman, founder and head of Think Kids West Virginia, said she wants to see more inclusion for children in the prevention plan. This would include providing education, but also physical services and resources for kids who are exposed to drug use and those who might themselves use drugs or one day use drugs.
Dr. Matthew Christiansen, head of the state Office of Drug Control Policy, said early trauma often can be an indicator for potential substance use later in life.
Caseman said the more resources that can be available to children and the agencies and entities tasked with serving them, the better those services — and the results — could be. Others in different groups called for the same, including suggestions to tailor marketing for education or recovery depending on who the target audience is.
One facilitator said her group discussed that those in K-12 schools or in college are more likely to be exposed to stimulants and marijuana in those settings, so those substances should be included in any plans.
In general, Caseman said, a lot of groups today do a lot of good work, but much of it is fragmented.
“It seems we’re at a moment when so many people are working on prevention issues. It seems almost all roads lead back to the drug crisis in our state,” Caseman said. “It would help to have a strategy to ensure we’re being as inclusive as possible, to bring those entities together and all on the same page for the people they are serving.”
Better communication between agencies across the state was included as a main point for several of the 14 groups.
Ash Orr, chairperson of the Morgantown Human Rights Commission, said they would like to see an effort to involve mutual aid groups in prevention efforts, and in general as a resource throughout the plan.
The current prevention section emphasizes “cross-system” collaboration and training, meaning different agencies — including law enforcement — should come together as collaborators to respond to issues and brainstorm solutions.
Orr had concerns about relying on law enforcement for collaboration, considering the concerns and prior experiences of the people they serve in Morgantown.
“I know we’re trying to address stigma, too, but there’s such a situation where our people aren’t being treated as human by law enforcement,” Orr said. “We have a lot of queer, Black people [and people of color] that are suffering with substance use disorder and, since these are marginalized groups, they are hesitant to go to law enforcement agencies to seek help. Those groups fall back on mutual-aid groups, and those groups save lives.”
A forum specifically on the law enforcement section of the response plan is scheduled for Dec. 9, and Gallagher said further discussion can be expected then.
Part of the issue, according to Gallagher, is a dearth of resources in West Virginia.
“It’s very difficult to have someone with a specialization in mental health care responding when you may only have one or two officers trained in that in the surrounding area,” Gallagher said. “Being a resource-challenged state, sometimes you don’t have the luxury of getting to choose who responds to that or a crisis.”
Orr and several others across the 14 groups were concerned with the plan’s lack of inclusion for people with lived addiction and recovery experience.
The current prevention piece does not include any points to bring people who are actively in recovery or addiction together to discuss how the plan would affect them.
“I would like to see them having discussions with people who are actively using substances or who are in recovery,” Orr said. “Those discussions would obviously need to be in a safe environment ... but we need to sit down with people who are making these policies and set things in motion to talk to people who are in recovery to prevent this more adequately.”
Reta Griffith, with the Pocahontas County Day Report Center, echoed Orr’s sentiments. Specifically, she said, any sort of media or marketing campaign should strongly involve people in active addiction and active recovery.
“We could ask them, ‘Would this have gotten to you,’ and get their feedback,” Griffith said. “A lot of times, we put a lot of stuff out there that we think looks really great, but the community we need to see it says, ‘Yeah, I don’t pay attention to that’ or ‘I wouldn’t see that.’ ”
Other suggestions Tuesday included providing educational training for communities, increasing access to harm reduction programs, incentivizing people to work with groups specializing in prevention and replicating programs proven to work in other areas.
Responding to the addiction crisis in West Virginia, Christiansen said, is “a marathon not a sprint.”
“[These forums] are critical to what we’re all trying to do and the incredible problem we’re facing,” Gallagher said. “Prevention is one of the biggest things we can do — with addiction, once you turn it on, you can’t turn it off. You can dim it, but you can’t turn it off. If we can prevent people from getting this disease and going down that road, we ... will save lives.”
Anyone who was unable to attend Tuesday’s forum and would like to provide feedback for the prevention portion of the plan may fill out a survey by Dec. 16 at https://www.surveymonkey.com/r/ODCP2022.
To preregister for future forums or review the current version of the Substance Use Response Plan, visit https://helpand hopewv.org/odcp.