Thenral Mangadu and Aliviane representatives, Wednesday, July 17, 2019, in El Paso, Texas. Photo by Ivan Pierre Aguirre/UTEP Communications
A road trip through West Texas’ border counties last summer exposed Thenral Mangadu, M.D., Ph.D., to the challenges that rural communities face to combat opioid use disorder (OUD).
As opioid-related deaths rise across the United States, rural areas have been hit especially hard. According to The Pew Charitable Trusts, the rate of drug overdose deaths in rural areas surpassed the rate in urban areas in 2015. Drug overdose deaths also increased 325 percent in rural counties between 1999 and 2015.
“I went to these communities because I needed to see what is going on,” Mangadu, associate professor of public health sciences at The University of Texas at El Paso, said about her two-day fact-finding trip to Hudspeth, Culberson, Presidio, Brewster and Jeff Davis counties with a collaborator from the Texas Department of State Health Services’ Office of Border Public Health (OBPH).
In Presidio, Mangadu also met with local stakeholders from the border town of Ojinaga, Chihuahua, Mexico, and learned about the health professional shortages and health disparities in the border rural counties.
“The consensus in these areas is that we need more treatment and prevention services, a bigger health care workforce, more research and more coordinated care,” she said.
Mangadu’s fact-finding mission was the basis for a new project funded by a $200,000 grant awarded to Aliviane Inc. from the Health Resources and Services Administration’s (HRSA) Rural Communities Opioid Response Program (RCORP). UTEP’s new Minority AIDS Research Center (MARC) is one of the grant’s subrecipients.
The RCORP is a multi-year opioid-focused initiative supported by HRSA, an agency within the U.S. Department of Health and Human Services, aimed at reducing the morbidity and mortality of substance use disorder, including opioid use disorder, in high-risk rural communities.
In May 2019, HRSA awarded $24 million in RCORP grants to rural organizations across 40 states to combat the opioid crisis in the U.S.
The Aliviane grant established a multi-sector consortium focused on developing strategies for preventing and treating substance use and opioid use disorder in high-risk rural communities along the Texas-Mexico border.
The consortium, which involves Aliviane, MARC, OBPH and the Center Against Sexual and Family Violence (CASFV), will develop a plan for opioid use disorder response in Hudspeth, Culberson, Presidio, Brewster and Jeff Davis counties.
“The proximity of these counties to the Mexico border is a high risk for opioid use,” said Guillermo Valenzuela, Aliviane’s chief corporate officer. “Mexico remains the primary source of heroin available in the United States, according to all available sources of intelligence, including law enforcement investigations and scientific data.”
The consortium is one of six projects underway by UTEP’s MARC. Founded in 2019 by Mangadu and Nate Robinson, UTEP assistant vice president for facility security in the Office of Research and Sponsored Projects, the center aims to advance research and treatment for minority populations relative to HIV/AIDS, with complementary work in substance abuse.
Projects address AIDS-related health disparities such as substance abuse, mental health, and exposure to violence in vulnerable populations locally and worldwide.
In addition to working with community partners such as Aliviane, a nonprofit drug treatment center in El Paso, MARC also has established international partnerships in Eastern and Southern Africa through its Global Alliance for Healthier Populations (GAHP).
“The consortium is among UTEP’s many efforts toward improving our border community and the levels of community engagement,” said Robinson, MARC’s deputy director. “The goal for MARC is to support our partners, like Aliviane, the grant’s lead recipient, in building greater capacity and reach and its formal bringing together of a public private partnership to address disparities.”
Over the course of one year, the consortium will lead the efforts to conduct a regional needs assessment and workforce development plan in Texas Health Service Region 10, which includes the five West Texas rural counties.
According to Aliviane, these counties are vulnerable to substance use and opioid use disorder because of low socioeconomic status, lack of access to care, transportation barriers, immigration policy-related barriers, proximity to violence, access to drugs, health professional shortages, and low health literacy.
“These counties have more availability to high-purity, low-cost heroin, and Fentanyl and other synthetic opioids, which are now the most lethal category of opioids used in the U.S.,” Valenzuela said. “Synthetic opioids are primarily sourced from China and Mexico.”
The consortium’s researchers will conduct a SWOT analysis – strength, weakness, opportunity, threat – to identify opportunities and gaps in OUD prevention, treatment, and/or recovery services within the five counties. Data will be used to develop workforce, service delivery, and sustainability plans that focus on prevention, treatment and recovery.
“We’re going to be looking at many things like social determinants of health, the gaps in treatment services, health professional preparation and workforce development,” Mangadu said. “Each of the community partners in this consortium has a vested interest because this is what we’ve been doing for many years – substance use disorder and HIV-related action research. This HRSA grant is an opportunity for us to come together to make an impact in opioid use disorder in Texas’ rural areas.”
Author: Laura L. Acosta – UTEP Communications