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Talk Poverty
April 3, 2018 | Debbie Weingarten

Kendra Colburn spent a decade uninsured. During those years, she worked as a carpenter near her hometown in rural Vermont, earning just enough that she didn’t qualify for low-income health care, but not enough to afford health insurance on her own. While uninsured, she suffered two major work injuries that landed her in the emergency room—once, a nail shot through three of her fingers, and another time, a piece of wood kicked back on the table saw and sliced her arm. When she was unable to pay the emergency room costs, her credit took a hit for years.

Today, Colburn works on her brother’s farm and is covered by Medicaid. As a manual laborer, Colburn has developed nerve damage, which flares up in her hands and wrists with overuse. “I cut back my hours to deal with it. I can’t afford to not be able to use my hands,” she says. “That’s how I make all of my money.”

As a child who grew up in a farming community, Colburn says she observed that pain is just a part of being a farmer. “It’s taken for granted that your body hurts every day, that your back always hurts.” That’s true for workers employed in some of the most dangerous jobs: Many manual laborers with high rates of injury and repetitive stress injuries are also more likely to be uninsured. In fact, a 2015 study found that 65 percent of commercial farmers identified health insurance costs as the most serious threat to their farms.

Alana Knudson, co-director of the Walsh Center for Rural Health at NORC at the University of Chicago, prefers to discuss rural health care in terms of strengths, but she does recognize the real barriers demonstrated by statistics. “Overall, we know that people who live in rural communities are likely to have lower incomes than their urban counterparts,” she says. Rural residents are also more likely to have multiple chronic conditions and lower educational attainment, and they’re more likely to face barriers in accessing transportation to medical care.

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In this highly-subscribed webinar, speakers explored strategies to help patients manage pain while minimizing the danger of opioid misuse. They discussed a community-based campaign to reduce access to unused prescription drugs, collaborations to improve adherence to prescribing guidelines for acute and chronic pain, the latest research on alternative pain management treatments, including virtual reality, and more. 

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Recently, the University of Arizona Center for Rural Health received a $2.2 million grant to work with the Arizona Department of Health Services. 

The Substance Abuse and Mental Health Services Administration awarded the grant to train first responders to administer naloxone, an opioid reversal agent. In the wake of 790 deaths in Arizona alone throughout 2016, Governor Doug Ducey declared a public health emergency. 

In response, Taylor George, a UA alum and ADHS section chief of the Bureau of Emergency Services and Trauma System assisted in obtaining the grant and will lead the project.

AzCRH will help with educational elements, teaching police and other first responders how to identify symptoms and use naloxone. 

“But we also want to go beyond that,” said AzCRH Director Daniel Derksen. "We want to do screening and brief intervention so we’re not just addressing the immediate issue of the overdose.”

In many cases, when overdoses take place in rural areas the nearest hospital or police station is 30-40 miles away. 

“If you overdose with an opioid and stop breathing, it only takes about four minutes to do irreversible brain damage,” Derksen said. 

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KVOA.com | Written By Eric Fink

TUCSON - The opioid epidemic is killing three Arizonans a day. 

Doctors and researchers at the University of Arizona hope a new multi-year $2.2 million dollar grant will go a long way to helping both the patient and the protector.

The university's College of Public Health is now taking the lead across the state to make sure every first responder, no matter where they live knows how to use Narcan, a nasal spray that can reverse the effects of an overdose. Narcan has proven a force in the fight against the crisis.  

"When you're a distance from a health facility, the difference between life and death can be seconds and minutes," Dr. Daniel Derksen with the College of Public Health at the University of Arizona said.  "If someone recognizes someone is in an opioid overdose situation, administering Naloxone, reverses those effects very quickly that it can save lives."

Brian Keeley is with Northwest Fire in Tucson.

All of its firefighters and first responders are trained and carry Narcan on their trucks.

"When you give this medication, it works within 30 seconds," Keeley said. "This is absolutely the lifesaver for any heroin or opioid overdose. It's the one thing that will instantaneously counteract and save a person's life."

Keeley stresses it should only be used as a last resort. 

"It should not be relied upon as it's okay to take or abuse these medications or these drugs because there is something that counteracts it out there," he said. 

KJZZ | Jan. 23, 2018 | By  Will Stone

When a patient came into her practice not long ago with a broken jaw, it wasn’t a difficult diagnosis for Dr. Christina Goldstein-Charbonneau.

“Obviously I could see her jaw was big as anything,” said Charbonneau, a primary care physician in Bullhead City.

Dr. Christina Goldstein-Charbonneau is a primary care physician who practices integrative medicine in Bullhead City.

But she did something that may have seemed overly cautious in years past.

“In today’s climate, the way it is right now, I actually went over there and said ‘I’m sorry I can’t give you anything,’” she said. “‘Let’s hold off, let me go and get your X-rays.’”

The patient had actually gone to the emergency room first where they had refused to give her pain medication. Charbonneau hurried to get the medical records and only once confirmed did she prescribe an opioid.

This hypervigilance has become the norm for doctors in this remote, underserved corner of northwest Arizona — a place hard hit by opioid abuse and overdose deaths.

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Vicki Karr | Tucson News Now | January 31, 2018

A federal grant will allow the state and the University of Arizona to ramp up their efforts to combat the opioid crisis in communities across the state.

Since mid-June, 5,512 people have suffered a suspected overdose from opioids. More than 800 of the cases turned deadly. Click here to see the latest numbers in real time.

The $3 million grant from the Substance Abuse and Mental Health Services Administration will allow state and university workers to help train first responders in rural communities.

First responders will be trained to identify the symptoms of opioid abuse, and they will also be equipped with the drug Naloxone. Also known as Narcan, it’s used to block the effects of opioids especially during an overdose.

But Dan Derksen with the U of A said the grant will allow them to go beyond administering the drug. They will be trained on things like opioid screening, brief intervention, and referral to treatment curriculum.

Derksen said in many cases patients who overdose have overdosed before, so he hopes providing resources will help stop the addiction cycle before it turns deadly.

Derksen said with people in Arizona dying daily, there’s no time to waste.

“We have to be doing something different than we have been doing. There’s been more than two Arizonans dying every single day of opioid overdose. More than half of which are related to prescription overdose,” he said.

The money will also be used to train people in the community. The grant funds will be put into the communities over the next four years.