Nursing school leads effort to combat opioid abuse

The School of Nursing has been awarded two grants totaling more than $4 million to educate Bexar County first responders in how to identify and reverse opioid overdose.

Lisa Cleveland, Ph.D., RN, assistant professor of nursing, received the grants from the Texas Health & Human Services Commission. The grant funding originated at the national level under two U.S. presidents’ efforts to fight the national opioid crisis.

Dr. Cleveland is a national expert on opioid use disorder whose research focuses on the care of pregnant women who use opioids and their newborns, who often are born with neonatal abstinence syndrome, or opioid withdrawal.

“Overdose is a leading cause of maternal mortality in Texas and these deaths typically involve opioid use,” said Dr. Cleveland.

In April, Dr. Cleveland received a four-year, $2.2 million contract from the state to purchase naloxone (brand name NARCAN), to provide training to first responders on how to identify and reverse an overdose using NARCAN, and to educate people about where to refer opioid users in the community for further treatment. The training is for traditional first responders, such as emergency medical technicians, police officers and firefighters, as well as non-traditional first responders, such as family members and friends of opioid users.

Texas is one of 21 states awarded grants for this effort through the federal First-Responders Comprehensive Addiction and Recovery Act Cooperative Agreement. The federal funding was allocated to states through the Substance Abuse & Mental Health Services Administration. The funds were then distributed by the Texas Health and Human Services Commission. The School of Nursing is partnering with the San Antonio Council on Alcohol and Drug Abuse (SACADA), which received $1 million in funding to provide recovery coaching.

Dr. Cleveland also received $1.87 million for the first year of a two-year program to bridge the gap between EMS response to opioid overdose and referral of opioid users into peer recovery and substance use treatment services. Naloxone also is included in this grant funding, which was authorized by the 21st Century Cures Act signed by President Obama in 2016.

“The purpose of this grant is to create an infrastructure that will help individuals with opioid use disorder to access treatment services and achieve long-term recovery,” Dr. Cleveland said. “We will be partnering with the San Antonio EMS Mobile Integrated Health Unit, SACADA and several local opioid use disorder treatment providers on this grant.

While awaiting funding for these projects, Dr. Cleveland’s team has already completed a community needs assessment and has been working with community partners and stakeholders to coordinate training and services. They also have purchased NARCAN valued at more than more than $1 million that will be distributed throughout San Antonio through the program.

Dr. Cleveland has six consecutive years of funding for community-based programs on neonatal abstinence syndrome. This includes a Neonatal Abstinence Syndrome study involving Kangaroo Mother Care, and the Maternal Opioid Morbidity Study. She helped develop The Mommies Toolkit: Improving Outcomes for Families Impacted by Neonatal Abstinence Syndrome, a community-based program developed in San Antonio with funding from the Texas Department of State Health Services, There are now 12 new Mommies Programs throughout the state and the program has spread nationally as a model of care.

She also served as a representative of UT Health San Antonio and the Association of Women’s Health Obstetrics & Neonatal Nurses on a national, inter-professional committee that crafted the Alliance for Innovation on Maternal (AIM) Health guidelines on Obstetric Care for Women with Opioid Use Disorder. This AIM guideline “bundle” currently is being implemented for the first time in Texas, including San Antonio.

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