Addressing the Opioid Crisis: A Path to Saving Lives and Empowering Communities

10/20/2023
By Holly L. Chapman and Jacqueline D. Silva

The opioid crisis has become a harrowing reality in recent years, with devastating consequences for communities across the United States. An alarming rise in overdose deaths has reached epidemic proportions and urgently requires intervention and awareness. We are deeply concerned about this emergency in Galveston County, Texas, where we are both completing our doctoral work, and so we have dedicated personal time to establish the Community Overdose Response and Recovery Effort (CORRE). Having taken a stance to fight this crisis in Galveston, we now urge you to join us by strengthening the CORRE of your own community.

A Grim Reality

Opioids are a drug class that includes both illicit drugs, like heroin, and prescription pain relievers, such as oxycodone. While highly effective at treating pain, opioids can lead to life-threatening respiratory depression, which is the primary cause of opioid overdose deaths. Overdose deaths in the United States have surged to unprecedented levels, marking the opioid crisis as one of the most pressing public health challenges of our time. Over 108,000 drug overdose deaths were reported in 2022 alone, with 76% caused by opioids. Additionally, 221,562 nonfatal overdose emergency-department visits were reported in 2021, an artificially low number due to overdose events in 30 states that did not report to the Centers for Disease Control and Prevention (CDC).

Since 2011, federal and clinical guidelines have lowered the number of opioid prescriptions. However, the mortality rate linked to opioid use continues to escalate. Fentanyl, a synthetic opioid 100 times more potent than morphine, has emerged as a major culprit in the ongoing crisis. In 2020, fentanyl became the leading cause of death for adults aged 18 to 45. The US Drug Enforcement Administration (DEA) has highlighted the prevalence of fentanyl in illicit drugs, emphasizing that six out of every ten fentanyl-laced fake prescription pills contain a lethal dose of the synthetic opioid.

Holly Chapman providing OENA training to UTMB’s School of Public and Population Health (Left). Holly Chapman and Jacqueline Silva providing OENA training to the Medical Reserve Corps of the Galveston County Health District (Right).

The DEA’s awareness campaign, One Pill Can Kill, underscores the dire risks associated with fentanyl-laced substances. Tragically, many individuals are unaware that what they are purchasing could contain a poisonous or lethal dose of fentanyl. The swift onset of a fentanyl overdose can lead to unconsciousness within minutes, to brain damage from lack of oxygen after 7 to 15 minutes, to coma, and then to death. Fortunately, the opioid overdose-reversal medication, naloxone (brand name Narcan), is available in a few forms, including an easy-to-administer nasal spray, recently available over the counter.

Holly Chapman (left) and Jacqueline Silva (right) at the Innovation in Life Sciences Summer Camp hosted by UTMB’s Innovation and eurship studio, where they were invited as panelists and hackathon mentors.

A Personal Journey

Against the backdrop of this crisis, and as doctoral students whose work relates in part to substance use disorders, we decided to embark on a mission to help empower our Galveston community. Our endeavor was catalyzed by participating in Incubate Galveston: A Collective’s Innovation Hackathon, a platform for diverse teams to devise innovative solutions to pressing community issues, organized by Vision Galveston and BlackStone Launchpad in 2021. The skills and connections we made as teammates during the hackathon primed us to develop CORRE. We decided to combine Chapman’s research experience in substance use disorders, Silva’s dedication to helping people in the grips of addiction, and our mutual educational outreach interests to provide free services to residents of Galveston County. So, we established CORRE in August 2021, and we have offered our services ever since.

Our work has been much more than an educational and business experience because we have both personally contended with the opioid crisis.

Holly Chapman and Jacqueline Silva at Startup Grind Global Conference.

In 2015, Silva broke her ankle, and after surgery, she received potent prescription opioids that she took for an extended time. This initiated a struggle with substance dependence. She eventually sought life-changing resources, was relieved from the desire to use opioids, and has been abstinent for nearly seven years. She shares her story in an effort to persuade people to seek other methods of dealing with pain, in order to prevent them from developing a devastating substance use disorder. Not everyone has been as fortunate as she has, especially considering the lack of sufficient strategies to treat substance use disorders, coupled with the inflated costs of recovery and rehabilitation programs and the stigma attached to substance use. This realization led her to respond with a resounding “Yes” when Chapman approached her about the idea of establishing CORRE.

In the early 2000s, Chapman’s life changed when her mother suffered a collapse and hospitalization that resulted in retrograde amnesia. With no memory of her two children, aged twelve and eight, or husband at the time, Chapman’s mother had to be slowly integrated back into family life. The doctors never offered any rationale for the collapse, but after years of research in addiction sciences, Chapman was able to piece together that an extremely high dose of opioids prescribed for pain long-term, even if taken as prescribed, could lead to major health and psychiatric consequences. The ability to move into community educational awareness and make a difference outside of her research efforts, afforded by establishing CORRE, was an easy decision.

After putting our heads together, our goal quickly became clear: to provide opioid education and naloxone administration (OENA) training and create a community ready to combat the opioid crisis head-on. We have employed science-backed information and evidence-based training methods and have combated the spread of false statements—for example, “A person can die from touching a small amount of fentanyl”—with scientific facts—“Incidental skin exposure to fentanyl is extremely unlikely to cause immediate harm.” CORRE’s initiative has yielded promising results. To date, we have successfully trained over 200 individuals, including school nurses, police officers, service industry workers, and high school students, and we have distributed 192 doses of naloxone in our community.

Jacqueline Silva providing OENA training to the UTMB Police Department.

Trained participants have reported recognizing and reversing opioid overdoses in Galveston County on multiple occasions. One community member reported, “With no response from the chest rub, I administered the first dose of NARCAN. Within about a minute, her eyes began to flutter, and she started ‘waking up.’ EMS arrived and took over. She was transported to the hospital. I am so grateful for the training [that] my team [and I] received that equipped us with the knowledge and confidence to know what to do if/when an emergency like this takes place.” This achievement is particularly significant when considering the stigma surrounding substance use disorders. In several states including Texas, the absence of medical amnesty contributes to hesitancy in calling 911, posing a significant barrier to prompt intervention. In addition to continually training and updating the community, we recently welcomed a new partner, Chris Lewis of LifeInSight. With his help, we plan to launch a phone app that enables a rapid response to opioid events—imagine an app similar to Uber but designed for community emergency responses. In the long term, we are also considering a wearable device that can both detect opioid overdoses and send out alerts.

Our journey, however, has not been without its challenges. In addition to fighting misinformation and the stigma surrounding opioid overdose and substance use disorders head-on, we have had to develop business acumen to keep our mission alive. As biomedical-science graduate students with no prior experience in entrepreneurship, we have faced the daunting task of navigating entrepreneurial language as we have worked to convince potential investors about the importance of our vision. Balancing our full-time commitment as graduate students with this work has been a continuous struggle. Fortunately, our university’s Innovation and Entrepreneurship team has provided us not only with opportunities to strengthen our business capabilities but also with limited funding to support our outreach efforts. Furthermore, while naloxone accessibility has been a hurdle at times, we have, fortunately, received support from the Texas Targeted Opioid Response, which has provided at least 96 doses of Narcan for us to distribute to our community.

A Call to Action

In the face of this crisis, we know that individual efforts and community involvement are both essential to implement change. A sad truth for our Galveston community is that it took several breaking-news stories – and being listed as the Texas county with the second highest overdose rate – before people started recognizing this crisis as a problem that hits home.

CORRE now offers opportunities for individuals to make a difference by spreading awareness, participating in training, and, if necessary, performing life-saving services. We know that naloxone is key to our efforts: nationally, naloxone administration by nonmedical personnel reversed 26,000 opioid overdoses from 1996 through 2014. At the same time, we understand that not everyone is equipped or prepared to perform life-saving interventions. Therefore, we tailor our training to our audience, which enables us to cater to diverse groups, including youth, medical professionals, and laypeople. Our focus also extends beyond direct intervention: we provide current statistics, explain policies, discuss other harm-reduction strategies, and provide general opioid education.

A Collective Effort

Because the opioid crisis continues to devastate communities across the country, it demands not just action by individuals but also a collective response. We are proud of the fact that CORRE’s work surpasses conventional community training. For example, we have collaborated with first responders in Galveston County, a partnership that has confirmed the critical importance of swift identification of overdoses and of timely naloxone administration during emergencies.

By reaching out, we have also found some other wonderful partners. Some examples of Galveston County stepping up to the crisis deserve a special callout: Les McColgin, a resident who started the Gulf Coast Outreach Services to raise awareness about fentanyl, has provided access to free naloxone via several “vending machines” throughout the community; the Bay Area Council on Drugs and Alcohol has worked to equip all county first responders with naloxone; and some local organizations are sponsoring upcoming substance-use recovery and prevention meetings, such as the What’s Next Recovery Symposium hosted by Open Door Ministries. Recently, in an effort to join all community forces, the Galveston County Health District has implemented the Galveston County Opioid Defense Effort (GCODE), an alliance of all Galveston organizations, including CORRE, that are working together to solve this crisis.

We welcome all who are interested in training, investing, or volunteering to visit our website at CORRE-app.org or to email us directly at CORREapp.info@gmail.com. Our organization offers free education, both in-person and virtual, coupled with the distribution of naloxone (when available) to participants. Through education, awareness, and access to life-saving tools, communities can be empowered to recognize and respond to opioid overdoses effectively. As the journey continues, we hope that we can turn the tide together and that we can save many lives through perseverance, education, and collaboration. By working together, we can bring an end to the opioid crisis and can create a safer, more resilient society.

Holly L. ChapmanHolly L. Chapman, MS, is a fourth-year doctoral candidate in the Human Pathophysiology and Translational Medicine Graduate Program in the Graduate School of Biomedical Sciences at The University of Texas Medical Branch (UTMB) and cofounder of Community Overdose Response and Recovery Effort (CORRE). Her graduate research focuses on preclinical neuroscience, behavior, and substance use disorders within UTMB’s Center for Addiction Sciences and Therapeutics. Chapman’s multifaceted role within CORRE includes managing education and outreach for opioid overdose assessment and naloxone administration (OENA) training, seeking grants and funding, and overseeing technical developments. She earned her MS from the University of Houston – Clear Lake.

Jacqueline D. SilvaJacqueline D. Silva, BS, is a fifth-year doctoral candidate in the Pharmacology and Toxicology Graduate Program in the Graduate School of Biomedical Sciences at The University of Texas Medical Branch (UTMB) and cofounder of Community Overdose Response and Recovery Effort (CORRE). Her personal experience with substance use disorder, research expertise in neuropharmacology, and exceptional people skills have well-equipped her for carrying out CORRE’s mission. Silva’s graduate research is conducted within the Mitchell Center for Neurodegenerative Diseases, where she develops drug repurposing strategies to combat these diseases. She shares responsibility for CORRE’s community education and outreach, grant applications, funding endeavors, and technical advancements. She earned a BS in Chemistry from the University of New Orleans.

This article was originally published in AWIS Magazine. Join AWIS to access the full issue of AWIS Magazine and more member benefits.