Missouri scientist to discuss overdose crisis, need to improve addiction treatment systems, policies

LAWRENCE — Longtime disinvestment in health and social supports, roadblocks to treatment, historical trauma and the addition of fentanyl to the drug supply have combined to put Black communities at great risk for drug overdoses and deaths. In St. Louis, Black residents have the highest rates of drug-involved deaths of any demographic group or region in Missouri.

Interventions and programs studied by a leading substance-use scientist in the state are aimed at changing those figures and improving health in Black communities. Rachel Winograd, associate professor in the Department of Psychological Sciences at the University of Missouri-St. Louis and the Missouri Institute of Mental Health, will discuss three Missouri-based projects to reduce drug overdoses and deaths at 10:30 am Friday, April 22. The virtual talk is presented by the Cofrin Logan Center for Addiction Research & Treatment at KU and is the final lecture in the center’s spring seminar series.

Efforts in Missouri center around improving naloxone distribution and training in harm reduction to prevent fatal overdoses, increasing access to medical treatment for opioid use disorder in publicly funded treatment programs and investing in the health and well-being of Black individuals who use drugs in St. Louis.

Winograd said that just as a “housing first” approach has been used to address homelessness, a medication-first approach is needed to treat opioid use disorder.

“The goal of both approaches is to provide rapid and secure access to a life-saving resource with as few barriers as possible,” she said.

The idea is not only for people with opioid use disorder to get stabilized with medication as quickly as possible to reduce withdrawal symptoms, but also that maintaining that stability long-term is paramount. Anything that gets in the way of staying on life-saving treatments, like requirements to participate in other services, or arbitrary medication time limits or rules requiring complete drug abstinence, end up serving as barriers for people who would be better off maintaining their access to medication, according to Winograd.

“This causes more harm than good,” she said. “So, medication should both be ‘first’ in terms of treatment chronology but also ‘first’ in terms of our priorities for keeping people safe and alive long-term.”

Winograd will discuss efforts to create substance use system changes and help build a funding, policy and accountability landscape that values and listens to Black individuals affected by addiction and invests in local Black-led organizations and networks, she said.

Michael Amlung, associate director for training at Cofrin Logan Center and associate professor in the KU Department of Applied Behavioral Science, said the talk and other seminars offered by the center are a key component of the educational and outreach missions of the center.

“This seminar is another example of the Cofrin Logan Center's goal of disseminating addiction science to broader audiences,” Amlung said. “The lessons learned from Dr. Winograd's efforts in Missouri provide hope to Kansas communities also facing the growing overdose crisis.”

The Cofrin Logan Center for Addiction Research & Treatment is a part of the KU Life Span Institute. It brings together researchers, practitioners, KU students and community partners to address challenges in addiction.