‘In it together’ — UND responds to opioid crisis

In the classroom and across state, University experts have issued a clarion call about rising drug epidemic

“We used to say that what people don’t know won’t hurt them,” said Frank White, assistant professor of sociology. “Now, what you don’t know can kill.”

White teaches Sociology 355: Drugs and Society, to a packed classroom each semester. The class size has grown along with awareness of the opioid epidemic across the state and nation. White also works with the Harms Reduction Club on campus and speaks to schools, law enforcement officers and businesses.

“There is so much misinformation out there,” he said.

Drug and alcohol addiction hit home in Grand Forks a couple of years ago, when two teens died after taking fentanyl, an opioid 80 to 100 times more potent than morphine. More recently, heroin has also become a problem in the community and state, often starting with prescription painkillers and progressing to abuse.

“Concerns have increased significantly across the country,” said Andrew McLean, medical director for the North Dakota Department of Human Services. “In North Dakota, drug overdoses tripled in three years. In 2013 there were 20 deaths, in 2014 there were 43, and in 2015 there were 61 deaths.”

Despite the worrisome increase in overdose deaths in North Dakota, the rate of overdose deaths in the state is among the lowest when compared to other U.S. states.

“It’s a complex issue,” said McLean, who is also a clinical professor and chair of psychiatry and behavioral science at the UND School of Medicine & Health Sciences at the Fargo campus. “But we can solve the problem. We – meaning everyone. It’s a societal issue. It will take multiple parties to solve this.” He is helping coordinate a video series on the opioid issue for medical providers through the School of Medicine & Health Sciences Office of Continuing Medical Education.

Raising awareness

On campus, within the Grand Forks community and across North Dakota, faculty are working together to raise awareness, develop screening tools, educate students and health providers and conduct research to help solve the opiate epidemic. Some areas also offer free or low-cost counseling to North Dakotans.

“No one plans to become an addict,” said Laurie Betting, interim vice president for student & outreach services. “There isn’t a part of society that isn’t touched by alcohol and drug abuse.”

Betting said the problem is affecting younger and younger people, and she, along with the Grand Forks County state’s attorney’s office, helped find funding for Faded: Fentanyl’s Impact, a 2016 video documentary that follows four families who have been impacted by the drug. “The story is told through individuals impacted. It’s gripping and real.”

The documentary, a UND initiative, has been shown on campus, and is shown to students in Grand Forks schools. It is also shared with other communities and states.

“Nearly every kid in Grand Forks sees that video,” said Cindy Juntunen, dean of the College of Education & Human Development and a psychologist who has done addiction counseling. “You can’t talk about education anymore without talking about health in this area. Addiction is a major public health issue.”

The College has long had an addiction counseling program, said Juntunen, and they now integrate some of that training in other teaching fields.

Community response

“Community response needs to focus on prevention, treatment and recovery, and using science to enhance that,” said Thomasine Heitkamp, professor of social work at UND.

She and a UND team conducted a training workshop last November to give behavioral health professionals from across the state the skills they needed to better identify and reduce substance abuse. The “train-the-trainer” event featured national experts and was part of a grant-funded program at the College of Nursing & Professional Disciplines.

Heitkamp and others are also part of a project that trains students, along with health providers in communities across the state, to catch and reduce substance abuse.

The grant, the North Dakota Screening and Brief Intervention and Referral to Treatment (SBIRT), is a three-year, $556,000 award from the Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services. It was designed to train nurse practitioner and social work graduate students, and others have since been invited to take part. The project includes faculty from psychology, nursing, and social work.

“As a university, we want to be part of the solution and be a real partner at the table,” said Heitkamp. “We want to help develop evidence-based practices in the community. There has to be an inter-professional response to this.”

The funding is used to train nurse practitioner, master of social work, nutrition and clinical psychology students to ask questions of patients or clients about drug and alcohol use, do a brief intervention if necessary, and raise awareness of risky behavior, said Chris Harsell, clinical associate professor of nursing and a nurse practitioner. This can help people who are willing to decrease use, or refer people with dependencies to counseling. “The goal is to be more proactive and catch drug and alcohol abuse early,” said Harsell.

“Primary care is on the front lines,” said Harsell. “We hope intervention raises awareness. The state and community response has been amazing.”

Along with training, the University also offers low-cost counseling and other services across the state.

“If we are to make a dent in this problem, we need to take an interprofessional approach and work together,” said Maridee Shogren, chair and clinical associate professor, doctor of nursing practice program, who is also involved in the SBIRT project.

“Today’s students are the practitioners of the future,” said Shogren. “This model needs to be here so we can help North Dakotans.”