Un programa estatal en Kentucky tiene como objetivo proporcionar credenciales y vías para una carrera en trabajo social para las personas en recuperación por trastornos de uso de sustancias. Los defensores dicen que el programa Career Ladders in Mental and Behavioral Health o CLIMB-Health es vital para que el estado impulse la salud mental y los servicios sociales.
Carl Wilson, miembro sénior de desarrollo e iniciativas de atención médica del Consejo de Educación Secundaria de Kentucky dice que también ofrece oportunidades para las personas en recuperación, para ganarse la vida y ampliar sus horizontes profesionales.
"Con este programa se pueden obtener tanto credenciales profesionales como un empleo a nivel profesional," asegura Wilson. "Por lo tanto, el programa ofrece a las personas con experiencia una vía personalizada."
Los colegios comunitarios de todo el estado, que atienden a más de 100,000 residentes, trabajan ahora con personas que han recibido la certificación estatal de especialistas en apoyo entre pares, para transferir su formación a licenciaturas en Trabajo Social. El programa CLIMB-Health comienza en los campus del Sistema de Colegios Comunitarios y Técnicos de Kentucky en los condados con mayor número de muertes por sobredosis.
Wilson dice que los residentes de los 120 condados en programas de tribunales de drogas enfrentan obstáculos para encontrar empleo.
"Cuando llegan a la entrevista de trabajo, y el empleador verifica sus antecedentes, y ve un problema de adicción, en la mayoría de los casos, se ve la participación de la justicia, y se quedan sin oportunidades," reconoce Wilson.
Agrega que el objetivo es llenar los vacíos urgentes en el sistema de salud del estado e impulsar la estabilidad económica a largo plazo para las personas que viven en recuperación.
"Tenemos aproximadamente entre 50,000 y 60,000 trabajadores desaprovechados para nuestra mano de obra en Kentucky que no han tenido la oportunidad de contar con un programa especializado que este dirigido a ellos."
Mientras que las tasas de sobredosis en otros estados están disminuyendo, Kentucky se encuentra entre los diez estados con mayor número de muertes por sobredosis de drogas en el país, según el CDC.
La Fundación Lumina proporcionó apoyo para este informe.
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CORRECTION: The number of traffic fatalities in 2024 in Tennessee represents all traffic deaths, not just those that were alcohol-related. (8:18 a.m. MDT, Apr. 10, 2025)
Lebanon, Tenn., is one of more than 90 cities across the country taking part in Saturday's "Walk Like MADD," a five-kilometer event to help prevent impaired driving.
In 2022, alcohol-impaired driving claimed 364 lives in Tennessee.
Norris Skelley, chairman of the public policy committee for Mothers Against Drunk Driving-Tennessee, said his family became victims of impaired driving three decades ago. He noted 364 lives lost is fewer than in some years, but still indicates a crisis.
"The last two years before that, where both of those years in Tennessee, there were over 400 fatalities in alcohol-related traffic crashes," Skelley reported. "From 2019 to 2023, fatalities rose over 36% in Tennessee and 35% nationwide."
Last year saw more than 1,200 traffic fatalities in Tennessee.
State law imposes harsh penalties for driving under the influence, with first-time offenders facing jail, fines, and license suspension and repeat offenders facing longer jail sentences.
Skelley pointed out they are seeking volunteers for their outreach programs to speak in schools and to other groups about the risks associated with alcohol and drug use. He added raising public awareness is a key strategy for reducing DUIs in the state.
"It happens every day, every 78 seconds, somewhere in this country, someone is injured or killed in an alcohol-related traffic crash," Skelley emphasized. "I think education and public awareness is one of the best things we can do."
He noted volunteers have a chance to share their powerful personal stories of loss, survival and resilience.
Tracia Jungkurth volunteers with the group. Her eight-year-old son, Christopher and his father, Joseph, lost their lives in a drunken driving crash in 1996. Tracia and another son were injured but survived. She will be part of Saturday's walk.
"We will not forget, because there are generations coming behind us that we've got to stand up," Jungkurth stressed. "Because if we don't keep the roads safe, history is going to repeat itself. So that's our goal, is to educate. And prevention and safety."
As a therapist, Jungkurth turned personal pain into purpose by writing a book and founding Christopher Ministries. As DUI crashes rise in Tennessee, she urged people to drive sober and take highway safety seriously.
"The walk is one avenue to show support for the people that are gone," Jungkurth observed. "But I want Tennesseans, as I want all people, to realize that this is preventable and that we, as human beings, need to be responsible for our actions."
She emphasizes MADD's commitment to educating young people in particular about how early drug or alcohol use can negatively affect brain development and judgment.
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The Kentucky Board of Medical Licensure recently proposed new changes to regulations around the prescribing and dispensing of buprenorphine, also known by its brand name Suboxone, a Food and Drug Administration approved medication used to treat opioid-use disorder.
Experts say the changes would increase barriers for people who rely on it to keep their lives stable.
Michelle Lofwall is a professor in the Departments of Behavioral Science and Psychiatry at the University of Kentucky. She said the stricter rules send a discouraging message to people in recovery.
"And we know," said Lofwall, "low-barrier care, where patients can really get access to the medication and they can add on what's needed when they're not doing well, is really important."
The new regulations would limit doses patients can receive, mandate participation in counseling services, and require frequent drug testing, among other changes.
Critics of expanding access to buprenorphine, classified as a schedule III substance, argue the drug itself is an opioid that people can become addicted to - and don't address the root causes of substance-use disorders.
The board did not respond to an email request for comment for this story.
Lofwall pointed to the numerous reasons why requiring regular counseling and drug testing can prevent people from being able to access the medication they need.
The new rules would require clinicians see patients using buprenorphine every ten days, or at two-week intervals, in the first few months - and then every few months after two years of treatment.
"A lot of people have jobs that don't let them take off from work to come every week," said Lofwall. "They can be discriminated against because, all of a sudden, they're late, or they just don't have the benefits of a job that allows sick days."
Lofwall said she's confused by the board's actions, given the research showing significant declines in overdose deaths among people taking buprenorphine.
"The Kentucky Board of Medical Licensure just really has had a lack of transparency, I think," said Lofwall, "about the rationale for some of these changes."
According to the Centers for Disease Control and Prevention, in 2023 Kentucky ranked among the top five states for buprenorphine dispensing rates nationwide, along with West Virginia, Vermont and Maine.
Support for this reporting was provided by The Pew Charitable Trusts.
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The incidence of drug overdose is decreasing in Indiana and one reason could be the efforts of an organization offering free training to anyone willing to help someone struggling with addiction.
Indianapolis-based Overdose Lifeline works to address the basic needs of families, individuals and communities, showing them how to administer the overdose reversal drug naloxone, or Narcan.
Justin Phillips, founder and CEO of the Overdose Lifeline, explained naloxone can reverse the effects of fentanyl, currently the most prevalent synthetic opioid in the drug supply.
"We want to make people understand opioids and the class and family of opioids," Phillips emphasized. "Then we talk about stigma and harm reduction, and we give people the signs and symptoms of an overdose, and then we provide them with free overdose reversal kits."
She pointed out with proper training, someone can be better suited to reverse an overdose than administer CPR. The training lasts about an hour. In the second quarter of last year, the Marion County Public Health Department reported 124 overdose deaths. It said 56 happened at a residence and 28 at a hospital, 25% fewer than the same time in the previous year.
Phillips noted anyone may know someone who is struggling with addiction. But conversations about drug use and overdoses can be uncomfortable, which she argued reinforces the need for training.
"Sometimes, we're not as willing to go to a pharmacy to acquire Naloxone or talk to our doctor," Phillips acknowledged. "Which is why we do these community events and we make it available, easily accessed in the community, so that you can avoid some of that stigma and judgment."
She added Overdose Lifeline also partners with CareSource for a free program to support Indiana school nurses to implement a naloxone Emergency Preparedness and Response Plan in schools. The program provides free naloxone, emergency medication boxes and staff training.
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