INDIANAPOLIS -- Improving access to treatment and recovery services is a key strategy in fighting the opioid epidemic. But not all of Indiana's medical providers are armed with the latest tools to best help patients.

Just 1-in-3 people with opioid-use disorder are receiving Medication Assisted Treatment, which can reduce the risk of overdose death by half. Dr. Amnah Anwar, senior director at the Indiana Rural Health Association, explained there are misconceptions about the nature of both addiction and Medication Assisted Treatment.

"People want to go to a provider, get cured and come back and live their life normally," Anwar said. "We have to understand that this is a chronic disease, it is lifelong management and Medication Assisted Treatment is a method to improve the survival of the patient and it's not necessarily replacing one drug with the other."

MAT combines behavioral therapy and one of three medications that help with withdrawal, cravings and relapse prevention.

The Indiana Rural Health Association and UnitedHealthcare are offering free MAT training for physicians, nurses, physician assistants and psychiatrists on March 17 in Indianapolis. Once the training is complete, providers will have access to support and guidance to treat patients with opioid-use disorder from community-based clinicians through a virtual network.

Anwar said they also can then apply for a waiver to use Medication Assisted Treatment.

"So any primary-care provider in rural Indiana, if they get this waiver, they are able to prescribe buprenorphine and taking care of their patient population that is suffering from opioid-use disorder," she said.

Chief Medical Officer with UnitedHealthcare in Indiana Dr. Julie Daftari said they are committed to tackling the opioid epidemic and are collaborating with state partners, providers, health systems and community organizations on prevention, treatment, recovery and harm reduction.

"It's important for all stakeholders to work together," Daftari said. "It's a problem that doesn't occur in isolation, and it's going to take a collective effort to really make an impact."

Indiana has been particularly devastated by the epidemic. Since 2007, drug deaths in Indiana have tripled from 8 per 100,000 residents to nearly 24 deaths per 100,000.



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Legislation in Congress, co-sponsored by U.S. Sen. Richard Durbin - D-IL - could expand treatment choices for people with opioid use disorder.

Current federal regulations mandate that people battling addictions use government-approved treatment programs to receive methadone - a drug that curbs opioid cravings.

Senate Bill 644 would expand access through board-certified addiction specialists, who could prescribe methadone in a clinic or doctor's office.

Lindsey Vuolo - vice president of health law and policy at the nonprofit Partnership to End Addiction - said the measure would remove hardships for people who need help.

"The fact that methadone can be prescribed for pain without these restrictions really demonstrates that there isn't medical justification for these types of restrictions," said Vuolo. "And so, it's really crucial to make effective treatment low barrier - or ideally, no barrier - so that people who are in need of these medications can access them without undue restrictions."

Opponents of expanding methadone access have concerns about possible misuse, or that the drug could be distributed or sold illegally.

The bill is in the Senate Committee on Health, Education, Labor, and Pensions, and has been there since February. Nearly 3,300 people died from opioid overdoses in Illinois in 2022.

Under the current restrictions, the government-approved programs are the only option for people getting methadone treatment.

Vuolo pointed out that there aren't enough of these programs, and people receiving the treatment must undergo counseling - which can create even more hurdles to getting care.

"People have difficulty using their insurance to access care and can't afford to pay for the cost out of pocket, and lack of access to providers," said Vuolo. "There's a workforce shortage, so there aren't enough trained providers who are able to provide treatment for opioid use disorder and substance use disorder. Behavioral health in general, there's also lack of mental health providers."

The Illinois Department of Public Health says in 2022, the state's mortality rate from opioid use was 26 deaths per 100-thousand residents.

March Madness is in full swing, and depending on where you live, you might be able to place a bet on a college basketball tournament game. Wisconsin hasn't fully embraced the movement, but experts still advise people to avoid unhealthy habits.

A 2018 U.S. Supreme Court ruling paved the way for states to decide if they want to legalize sports betting. That helped fuel the presence of online platforms where people can place wagers through their smartphones. Wisconsin limits live bets to tribal casinos. But bettors can flock to some neighboring states for online access.

Rose Blozinski, executive director of the Wisconsin Council on Problem Gambling, said they're neutral on these laws but still have concerns.

"We know that more people are going to do it, and we also know that more people are going to become addicted to gambling," she said.

Since the legalization wave, Connecticut officials havehave reported a 200% increase in calls to gambling addiction hotlines.

To protect yourself from falling into traps, prevention experts recommend only betting what you can afford. If troubling patterns emerge, they suggest things like deleting betting apps and switching to flip phones. Nearly 40 states allow some form of sports betting, but some do have restrictions for college games.

The financial impacts of problem gambling can be obvious, but Blozinski noted that compulsive gamblers also have a higher suicide rate. And with mobile betting marketed toward young adults, she said this demographic should be considered high-risk.

"They're at a time where they're high risk-takers to start, and gambling fits right in with that, especially the sports betting. It makes them feel important; if you're winning, you can brag to all your friends," she added.

She said a big problem in helping young adults falling into addiction is that Gamblers Anonymous resources are outdated in the age groups they cater to. Industry leaders note their ads come with disclosures about problem gambling and where to seek help. But prevention experts say they're not easy to understand, and called for broader funding to carry out assistance programs.


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Communities across the Commonwealth want to minimize traumatic experiences for the state's youngest residents - as a way to help stem the drug epidemic, and prevent future generations from struggling with substance-use disorders.

According to Kentucky Youth Advocates, at least one in five Kentucky kids has had at least two Adverse Childhood Experiences or 'ACEs.'

These include physical, sexual and emotional abuse, neglect, having family members with a substance-use disorder, witnessing domestic violence, and parental incarceration.

Dr. Connie White, deputy commissioner for clinical affairs with the Kentucky Department for Public Health, said research shows ACEs can increase risky behaviors and the development of chronic diseases - and even lead to a shorter lifespan.

"All of these things contribute as that child's neural pathways are developing," said White, "as they're learning how to make choices - healthy choices, unhealthy choices - as they're chronically stressed and their cortisol levels are chronically elevated."

White added that it's becoming clear that interventions promoting safe, stable environments for kids can strengthen the building blocks for healthy coping mechanisms - and reduce their likelihood of dependence on alcohol or drugs in adolescence or adulthood.

Barry Allen is president and CEO of the Gheens Foundation. It's a member of BLOOM Kentucky, a statewide coalition pushing for policy changes to prevent ACEs.

He said increasingly, communities are recognizing the correlation between addiction and childhood trauma.

"And so, a small group of us grantmakers proceeded to seek an audience with then-Attorney General Daniel Cameron," said Allen, "to plead the case to apply at least half of the opioid abatement settlement dollars - over $400 million - to apply those to prevention."

This legislative session, Bloom Kentucky says it's advocating for sustained funding for school-based mental health providers to improve access to services, for establishing a process to automatically expunge an eviction from a family's record after a reasonable amount of time, and to prohibit minors from being named in eviction filings.




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