Strengthening the state’s response to the opioid crisis: Inslee’s plan builds on efforts to tackle public health emergency

Masitsa’s opioid use disorder began when she was prescribed Percocet after the birth of her first daughter 10 years ago.

“I went to seeking them on the street and buying them that way,” said the 34-year-old mother. “And then someone told me, ‘Heroin is cheaper and it lasts longer.’ I said I would never take heroin. Well, never say never.”

After five years struggling with heroin use, Masitsa, pregnant with her second child, heard about an inpatient program through Swedish Medical Center that supports pregnant and parenting women with substance use disorder.

She was in her second trimester when her mom took her to the program on Aug. 3, 2017.

“I was a little apprehensive, a little nervous,” Masitsa said. “I didn’t know what to expect. From the beginning, they were really, really nice, where other places I had felt judged.”

The 20-day medication-assisted treatment (MAT) program combines the use of medication, counseling and behavioral therapies to treat patients diagnosed with opioid use disorders. This program is supported through the Affordable Care Act Medicaid expansion.

In addition, Masitsa took classes to prepare her for welcoming her new baby and recovery, and got intensive outpatient treatment after she completed the inpatient program. She continues to attend a support group with other moms in recovery.

“I felt confident leaving that I had a plan,” she said.

Opioid response has been a priority for Gov. Jay Inslee who launched a response plan in 2016 to reduce the number of prescribed opioids in our state, increase public education, and make treatment more available through a hub and spoke opioid treatment model.

Inslee rolled out his $19.3 million proposal today to further build upon the statewide effort against opioid use disorder. This includes enhanced treatment for pregnant and parenting women like Masitsa through providing start-up costs for four new 16-bed sites that enable mother and child to live together during treatment.

Gov. Jay Inslee is joined by local leaders, health care providers and patients to announce next steps in the state’s efforts to combat opioid abuse disorder (Office of the Governor photo)

“People need this treatment, especially the parents raising our next generation,” Inslee said. “And that’s what we’re going to do.”

Inslee highlighted how a major federal grant award of more than $7 million will go toward service gaps in emergency departments, jails and homeless facilities. He made the announcement at Harborview Medical Center’s Adult Medicine Clinic.

“Harborview has been with us from the beginning. It was one of our first treatment hubs and a prime example of behavioral and physical health care integration–that’s treating the whole person, not just fragmented treatment, separating the mind and body,” Inslee said.

Opioid overdose deaths are now the leading cause of accidental deaths in nearly every part of our state. About two people a day died from opioid overdoses in Washington last year, according to the Department of Health.

Dr. Vania Rudolf, an addiction medicine specialist at Swedish, helped treat Masitsa. Rudolf said the program helps overcome barriers that keep women from accessing care, whether that is complex medical needs, mental health needs, or homelessness.

“We find that women embrace recovery with humility and grace; we appreciate their vulnerability and try to boost their recovery skills and medication stability,” Rudolf said.

Masitsa has been in recovery for a year and a half. Her 11-month-old daughter, Nala, is healthy and outgoing, hitting every developmental milestone.

The program completely changed her life, she said.

“It gave me a second chance, and it showed me I was strong and I can do this,” Masitsa said. “They really put value on you as a mother and as an individual. They were compassionate, and made me feel like I was a human being with a disease. It overrode my feelings of worthlessness and made me want to do better.”

The governor is proposing 2019 legislation and opioid response funding, which includes:

· Enhanced peer support. Create a substance use disorder ‘peer service’ for Apple Health (Medicaid) clients, and fund the training and certification program. Peer support is an evidence-based approach that connects those in recovery.

  • More access to treatment for pregnant and parenting women. Provide start-up costs for four new 16-bed sites that enable mother and child to live together during treatment.
  • Alternative pain management. Provide Apple Health clients access to nonpharmacological interventions, such as chiropractic care for spinal pain diagnoses.
  • Services for those involved in the justice system. Those who are incarcerated or are being released from a Department of Corrections (DOC) facility often face barriers to treatment. Inslee proposes funding transportation and registered nurses to support access to treatment for newly released individuals, and additional substance use disorder assessments for those entering a DOC facility.
  • Ensuring more access to Naloxone. Legislation that permits the Department of Health secretary to issue a statewide standing order for this life-saving medicine that treats narcotic drug overdoses, and authorizes hospital emergency prepacks of Naoloxone.

“Our state is making substantial progress toward serving more of those who need opioid-related treatment, and preventing substance use disorder in the first place,” Inslee said. “But there is more to do. We need to focus on some of our most vulnerable populations to get them the help they need when they need it.”

WATCH: Inslee’s press conference on opioid treatment and prevention