Student-run mobile health initiative is tackling opioid crisis

Participants of Boiler Rx debrief after a recent reachout initiative. The mobile health initiative aims to reach across Indiana. (Photo/John Hertig) Download image

WEST LAFAYETTE, Ind. — Purdue University students and faculty have joined the fight against the state’s opioid crisis.

A group of three faculty and 20 student volunteers from the colleges of Pharmacy, Engineering, and Health and Human Sciences have created BoilerWoRx, a mobile health initiative intended to reach each of Indiana’s 92 counties.

It is needed. Over the last 15 years, the widespread opioid epidemic has affected communities and families across the country. Opioid-related overdoses increased 70 percent in the Midwest compared with 30 percent for the rest of the U.S., according to the Centers for Disease Control and Prevention.

BoilerWoRx is intended to provide prevention education, health services and build awareness. While helping around the state, the initiative also will give the students the opportunity to gain real-world experience in public health and advocacy through direct community interaction and counter a national public health crisis.

The mobile program’s services are offered in Tippecanoe and Marion counties, but the initiative’s goal is to leverage Purdue’s existing Extension service across the state and provide health services beyond addressing opioid addiction, such as delivering immunizations and diabetes management.

Opioids are a class of drugs commonly prescribed to treat pain.

According to the Institute of National Drug Abuse, in the late 1990s, claims by pharmaceutical companies that opioids were not addictive led to higher prescription rates by doctors until misuse became evident. By 2015, an estimated 2 million Americans suffered from a prescription opioid-related addiction. Every 12.5 minutes, a person dies from an opioid overdose.

In April, the U.S. surgeon general issued a public advisory urging more Americans to carry the life-saving drug naloxone, which reverses the effects of an opioid overdose.

“We will be looking at heat maps for naloxone usage to identify areas where it is most commonly used,” said Carol Ott, clinical professor of pharmacy practice at Purdue. “The overarching goal is to get out into the community and break down the barriers and stigmas.”

Naloxone is an FDA-approved medication that is delivered by nasal mist or injection to help reverse an opioid overdose. It has no effect unless an individual has opioids in their system, said Nicole Noel, director of Purdue's pharmacy. This fall, the BoilerWoRx program will be distributing 150 doses of Naloxone in Tippecanoe County.

Many factors are behind why the Midwest has been hit harder when it comes to the opioid crisis than other parts of the country, said John Hertig, associate director at Purdue Pharmacy's Center for Medication Safety Advancement and one of the co-leads of the program. One factor, he says, is the region’s historically industrial and manufacturing economy. Advancements in technology are displacing workers and leading to joblessness, while areas with a historic use of other drugs such as methamphetamines also are contributing to misuse.

People are turning to other drugs such as opioids due to recent crackdowns on meth; and when opioids are not available, people turn to heroin, which is cheaper, he said.

“It is a moving target. That is why having these collaborative public health programs is so important, Hertig said. “It is not just stopping the opioid crisis but making people better holistically so they don’t just move on to the next drug of abuse.”

The BoilerWoRx team’s services include wellness education on topics such as the risks of hepatitis A and B, HIV, and STD screening; information on how to access needle exchange services to stop the spread of communicable disease; drug disposal kit distribution; naloxone training and public policy advocacy.

BoilerWoRx is partnering with county health and education boards, regional community centers such as the Lafayette Transitional Housing Center's Homeless Services Program, and the Purdue chapter of the Institute for Healthcare Improvement, a nonprofit that supports community-based programs dedicated to improving patient health care.

“The students don’t often encounter people like our population of guests,” said Jennifer Shook, development director at the Lafayette Transitional Housing Center Homeless Services. “Some people have negative stereotypes about the homeless, but when you spend some time here you realize that they are just people. These are people who have met a series of bad circumstances, or people with physical and mental challenges. The encounter does seem to change the perspective of the students in an exciting way.”

 During an April event at the Lafayette Transitional Housing Center, the public health nurse and pharmacy students provided:

• 27 hepatitis A immunizations, which help to reduce burdens on the health care system brought on by the disease.

• Counseling on addiction and the increased risk for hepatitis A to more than 60 homeless people.

• Information on appropriate pain management.

• How to access treatment, support services and public insurance options.

• Proper naloxone use and treatment.

Shook pointed out that outside of Tippecanoe County, there are communities lacking many resources, and that it will present an important challenge for the program as it looks to engage in other counties.

Nonmedical student volunteers were also in attendance at the recent outreach event. “I am an industrial engineering major, so I usually don’t get that kind of patient interaction,” said Adam Goodman, an incoming senior and member of the Institute of Healthcare Improvement. “It definitely reinforced that I want to go into health care to be upfront, close and personal. It was eye-opening how thankful they were that we were there and hearing their life story.”

Emily Maegerlein, a nursing student and health justice chair for IHI, helped plan the April event.

“A lot of people who were there were not addicted to opioids but knew someone who was and wanted to know how to help a friend or react to someone who has overdosed,” she said.

“I think what makes our work unique is, one, that we can move around, and, two, that we are partnering with communities that need our help the most,” Hertig said. “It keeps us going to these really high-risk areas, so that people don’t have to travel long distances to access us.”

“They want us everywhere,” Ott said.

BoilerWoRx is funded by a $100,000 endowment from the Chaney Family Foundation to make a substantial impact on public health in the state of Indiana. 

Media Contact: Amy Patterson Neubert, Purdue News Service, 765-494-9723, apatterson@purdue.edu 

Writer: Anna Katrina Hunter, 765-494-4709, hunte134@purdue.edu 

Sources: John Hertig, 317-275-6085, jhertig@purdue.edu

Nicole Noel, 765-496-7728, nlnoel@purdue.edu

Carol Ott, 317-880-5431, caott@iupui.edu