On Thursday, the city of Austin, Central Health and community partners delivered presentations to the Travis County Commissioners Court addressing ongoing opioid crisis abatement measures in the greater Austin area.
At present, major interventions include the distribution of naloxone (a lifesaving drug that can reverse opioid overdoses), overdose education, harm reduction services, pharmacological treatment and holistic services including meal and housing support.
Travis County has been awarded $1,476,519 from the Texas Opioid Abatement Trust Fund, a near match to the city of Austin’s $1,531,218. The fund is expected to award the county a total of $4,703,473 for opioid abatement programs, but this amount will be disbursed in various payouts over the next 18 years.
Having executed the directives of the original public health crisis declaration – including naloxone distribution, implementation of community listening sessions, pursuit of changes to the legal status of naloxone and expansion of sharps collection programs – the court’s available budget for opioid remediation is currently $787,589.
Opening Thursday’s presentations, Laura Peveto of Travis County Health and Human Services reviewed county finances and advised the court of their options for directing available funds – which they may do essentially at their liberty.
She also praised the productivity of monthly meetings between Travis County representatives, Health and Human Services, Austin Public Health and Central Health concerning investments in opioid abatement and remediation efforts.
“We do this to align our strategies, ensure we’re reducing duplication of efforts, reporting out on new initiatives and best practices in the area and then discussing the future funding opportunity,” Peveto said.
Several organizations came before the court with direct advice or requests for direction of funds.
CommUnityCare Chief Medical Officer Nick Yagoda recommended bolstering three initiatives: treatment with drugs such as methadone and buprenorphine (medications that can alleviate opioid withdrawal symptoms and blunt drug cravings), bridging resource gaps (including short-term barriers to medication access or social services) and addressing stimulant abuse (as street drugs and counterfeit pharmaceuticals are commonly laced with fentanyl).
Several presenters echoed the importance of access to medical treatment with methadone and buprenorphine.
Dr. John Weems, associate director of addiction medicine at Integral Care, emphasized the advantages of treatment with long-acting buprenorphine, an injectable version of the drug that eliminates gaps in treatment such as forgotten doses or impeded access to daily oral formulations of the drug.
Travis County currently maintains contracts with Community Medical Services and Addiction and Psychotherapy Services for methadone treatment services in the amount of $150,000 each.
Speakers from both organizations, along with CommUnityCare, discussed the urgent financial needs of medical addiction treatment providers.
The organizations Texas Harm Reduction Alliance and Vivent Health reviewed their harm reduction services including the provision of sterile syringes, safe injection sites, STI testing and naloxone education.
Texas Harm Reduction Alliance expressed needs for expanded mobile outreach range, mobile health capacities and increased access to emergency shelters and housing facilities. Texas Harm Reduction Alliance executive director Maggie Luna explained that enhancing the organization’s mobile health care capacities is a particularly urgent need as xylazine – a veterinary drug also known as “tranq,” which causes necrotic wounds upon injection in humans – becomes an increasingly common adulterant in the drug supply.
“Our nurses are identifying these these horrific wounds, and we need care for that,” she said.
“What I think would be helpful to me,” Commissioner Ann Howard stated at the conclusion of the presentations, “when we have the opportunity to fund programs, I’m going to fund a system of care, and I want you experts to design that system. I don’t want to just have competitive applications for the money. I want to know what all of us are doing together.”
The county’s initial budget for opioid abatement programming was drawn from its General Fund, but the court anticipated reimbursement from the Texas Opioid Abatement Trust Fund.
The county’s declaration committed an initial $350,000 toward efforts including naloxone distribution, public awareness campaigns, needle collection and other harm reduction efforts.
The trust fund is the major organ of the Texas Opioid Abatement Council. The fund redirects settlement funds recovered from high-profile opioid-related litigation – primarily lawsuits against major pharmaceutical companies and distributors – back into state and local opioid remediation programs.
Eleven presenting organizations, some of which were recipients of the county’s opioid abatement funds, walked the court through ongoing efforts and identified opportunities for future investment.
In 2018, City Council passed a resolution addressing the burgeoning opioid crisis, but a lack of funding ultimately left the plan toothless.
By May 2022, overdose deaths in Travis County skyrocketed.
Between January and June 2022, 118 Travis County residents died of fentanyl overdoses – as many fentanyl-related deaths as the entirety of the year prior. Mortality rates disproportionately increased among people of color and women.
In response, Travis County representatives worked with the Texas Harm Reduction Alliance to draft a policy declaring drug overdoses a public health crisis in the county. The declaration passed on May 24, 2022, and is set to expire on Oct. 1, 2024.
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Travis County Commissioners Court: The legislative body for Travis County. It includes representatives from the four Travis County Precincts, as well as the County Judge. The County Judge serves as the chair of the Court.
