USU grad takes on Wisconsin's opioid epidemic
More than half of all drug overdose deaths today involve an opioid, according to the Centers for Disease Control and Prevention, which is more than quadruple the number of opioid-involved deaths each year since 2000. Across the country, health care providers and researchers are working to combat this growing epidemic, and in one particular northern Wisconsin region hit hard by the crisis, a Uniformed Services University (USU) graduate is striving to bring greater resources to her community – even helping to bring in hundreds of thousands of dollars in funding to develop addiction recovery services in this rural area.
After earning her PhD in Emerging Infectious Diseases from USU in 2011, Rachel Stankowski went to work as a scientific research writer at the Marshfield Clinic Research Institute in Marshfield, Wisconsin, focusing on helping physicians and researchers write grants and manuscripts. In 2013, she said, state leaders began to recognize the significant impact of the opioid crisis on the northern Wisconsin communities served by Marshfield Clinic, located more than three hours north of Madison, the state capital. Because of the epidemic, the Wisconsin Department of Health Services (DHS) issued a public health advisory in 2016, reporting that overdose deaths in the state nearly doubled over the last decade.
“Everybody here seems to have lost someone to an overdose or knows someone who has,” she said. “These communities are really feeling it, and they want to do something about it.”
In late 2014, Stankowski was approached by the Marshfield Clinic Center for Community Outreach and a clinical pain psychologist from Minocqua in northern Wisconsin. They asked her to help write a grant in response to a Wisconsin DHS request for proposals to establish rural opioid treatment programs on behalf of a federally-funded community health center, the Family Health Center of Marshfield, Inc. They wanted to band together to address the problem. The grant was awarded and they received about $2 million over five years from Wisconsin’s DHS to develop the HOPE (Heroin, Opiate Prevention and Education) Consortium, named after Wisconsin’s HOPE Agenda, a bipartisan legislative effort to combat the state’s opioid epidemic.
“We have built a robust opioid treatment program,” she said. “In 2016, we served 130 patients with an opioid use disorder diagnosis. In the first six months of 2017, we have served more than 180 patients. That’s pretty substantial.”
The consortium evolved into a partnership of 10 different partner organizations, including county and tribal agencies, medical and mental health care providers, and residential treatment centers from five counties and three tribal nations, she said. With a focus on expanding the availability of care and resources, consortium members created a regional network that offers support for adults in the region with an opioid use disorder, such as comprehensive outpatient counseling and medication-assisted treatments.
“HOPE Consortium partners represent a united front in northern Wisconsin and are committed to safe and effective practices for prescribing medication-assisted treatment ensuring that all providers have the support they need to implement best practices in their agencies,” she said. She added that in rural areas like northern Wisconsin, there’s no public transportation. This can make it especially difficult for those who need access to treatment and are unable to drive due to financial, legal, or other issues – even more of a challenge when they’re several hours away from treatment. So, the consortium has been working to help ensure these services are reaching those rural areas.
“We had to create a regional network so that people didn’t have to travel,” she explained.
In conjunction with the grant that developed the HOPE Consortium, Stankowski has also helped apply for several other grants to continue fighting against this epidemic, currently claiming the lives of as many as 65 to 100 out of every 100,000 people in certain areas of northern Wisconsin. Two grants from the Health Resources and Services Administration, for example, have helped establish the Family Health Center Alcohol and Drug Recovery Center in Minocqua, Wisconsin, and have helped expand the Marshfield Clinic’s telehealth services.
Since she became involved with this effort, Stankowski has transitioned to a new position as a project manager in the Marshfield Clinic Center for Community Outreach.
“In this role, I’ve had the opportunity to work with a lot of other substance abuse prevention and treatment initiatives,” she said. Thanks to grant funding from the Wisconsin Department of Justice Victims of Crime Act and work with the Marshfield Child Advocacy Center, she’s been able to help gain support for children who have experienced trauma, which can set them up for substance abuse later in life. “I get to work on both sides of the problem, looking at prevention, dealing with trauma and mitigating those effects, and then also trying to treat those people who have already developed a substance abuse problem.”
Most recently, she helped apply for federal funding to develop a new Marshfield Clinic AmeriCorps program, referred to as the Marshfield Clinic Health System Recovery Corps. About a month ago, she learned the request was approved by the Corporation for National and Community Service.
“This is a huge deal, especially because it’s rare to receive federal funding on the first application,” she said.
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| USU grad Rachel Stankowski, left, has been working to combat the opioid epidemic in northern Wisconsin, where she currently works as a project manager at the Marshfield Clinic Center for Community Outreach, in Marshfield, Wisconsin. Pictured here, Stankowski meets with a colleague to discuss an overarching departmental work plan. (Image credit: Rachel Stankowki) |
The funding was just more than $250,000 per year for three years, and is helping to bring in 20 full-time members who will be placed throughout the northern Wisconsin region served by the HOPE Consortium to support individuals and communities affected by substance abuse. Recovery Corps members will have had direct or indirect experience with substance abuse. They may be in recovery themselves, or had a parent, friend, or family member struggle with addiction.
“They’re paid a living allowance and are able to work with others seeking recovery,” Stankowski explained.
Having had the opportunity to help recruit and interview these members in late July, she said, many have expressed this is exactly what they want to do – help others overcome addiction.
“We’re giving people in recovery the opportunity to start over again, while giving them a chance to build their resume and work on their long-term goals,” she added.
It’s also extremely helpful to those seeking help, she explained, because nobody knows the struggle as well as someone who has lived it. These individuals will be trained to serve as peer recovery coaches and will be available to work with individuals affected by substance abuse at the time of arrest, release from jail, or hospitalization, offering support and resources for recovery. They’ll also work with communities to raise awareness of substance abuse treatment and recovery support services in the region, while working to reduce the stigma that surrounds addiction.
Stankowski noted she never quite envisioned working in this field, having studied infectious diseases in graduate school, but she truly enjoys it, and attributes much of her success to her mentors. At USU, she said, she was able to develop the ability to think critically and to problem solve, scouring literature to write grants and manuscripts, and had the chance to work collaboratively across disciplines – all skills that she is using in her career now.
“I feel really fortunate that I had the basic skills necessary to be able to go into any position where I could focus on my passion. I’m grateful that I was well prepared for this,” she said, adding that she loves being able to contribute to her community. “Community work calls my name. It’s really rewarding – I love what I do and I feel really passionate about it.”
Dr. Ann Jerse, a professor in Microbiology and Immunology, was one of Stankowski’s mentors while she was studying at USU. Jerse noted the novel contributions she made to the scientific field as a student -- Stankowski’s dissertation project led to the development of the first gonorrhea/chlamydia co-infection model, Jerse explained, which is significant since many individuals are often infected by both organisms (Neisseria gonorrhoeae and Chlamydia trachomatis), and it’s very challenging to conduct studies on animal models. Stankowski’s model is now being used in Jerse’s lab as well as in two other labs in the U.S., allowing researchers to study how co-infection may differ from infection by either single pathogen.
Jerse added that she is now using Stankowski’s model to develop dually-active therapies, and having this model has attracted the interest of biopharmaceutical companies, who are now working on antibiotics that may clear both infections.
“Continued advances in this area would not be possible without Rachel’s original model,” Jerse said.
Jerse is noticeably proud of her former EID student, who was also a USU Dean’s Fellowship Awardee.
“She was a fantastic graduate student and is now doing this work that is so important,” Jerse said. “She is a very strong and positive diplomat for USU.”
