With six doctors, 12 therapists and a waiting list of more than 600 people, Dr. Rolly Sullivan's clinic serves as just one example of West Virginia's overwhelming need for treatment options in the face of its opioid addiction crisis.
"Some of them will never get in," he said. "The reality of what that means is that it will be a couple of years before their number comes up."
Dr. Clay Marsh, West Virginia University's vice president for health sciences and executive dean of the School of Medicine, and Sullivan, director of the Comprehensive Opioid Addiction Treatment Clinic for WVU Medicine, visited Charleston Tuesday along with nearly two dozen other providers, public health officials and politicians for a roundtable discussion with the leader of the U.S. Food and Drug Administration.
The event provided a chance for West Virginia's stakeholders to highlight the state's problem with opioids - a problem that killed more than 700 people last year alone.
Sullivan said that problem is made worse by a lack of available services. According to a study published by the Bloomberg School of Public Health at Johns Hopkins University, only 22 percent of opioid users in the U.S. participated in any form of addiction treatment between 2009 and 2013.
In West Virginia, about 15,000 people received some form of drug or alcohol abuse treatment in 2014, according to the West Virginia Behavioral Health Providers Association. In contrast, nearly 60,000 West Virginians were identified as in need of substance abuse treatment, according to the state Department of Health and Human Resources.
"Nobody goes into medical school thinking, 'I want to take care of drug addicts.' It just doesn't happen," he said. "They want to take care of children, or deliver babies, or perform surgery, so there are very few doctors who are trained to do this kind of work. Most doctors you interact with have gotten next to no training on addiction, despite the fact that it's our biggest problem here."
The WVU School of Medicine is working to change that, and Sullivan said he plans to begin giving providers interested in treating drug addicts the training and support they need. Sullivan hopes to visit physicians and use teleconferencing to facilitate the training through WVU.
"We're going around the state trying to find any willing practicing physicians who want to learn how to treat addicts, and if they do and they contact us, we will provide sometimes hands-on, sometimes teleconsultation to them," Sullivan said. "Right now I'm working with [Cabin Creek Health Systems] in Kanawha City, for example, and spent an afternoon with a doctor who has no knowledge of drug addiction, but was willing to learn."
Sullivan said he plans to continue regularly guiding the Kanawha City clinic by teleconference until they're able to work independently, and hopes to do the same at similar clinics across the state. Doctors interested in providing the same level of treatment Sullivan's clinic does must apply for special prescriptive authority with the U.S. Drug Enforcement Agency, which requires taking a course in addiction treatment.
"My hope is that as we continue to do this around the state, we will be able to increase capacity and manpower," he said.
Marsh said the university hopes to focus on curbing addiction through both treatment and education. When The Centers for Disease Control and Prevention issued new recommendations in March for health care providers on prescribing opioids for treating pain outside of cancer treatment and palliative care, WVU joined the White House and schools across the country in urging the Association of American Medical Colleges to include a requirement that students be taught in line with the CDC's new prescriber guidelines.
"Treating addiction is very difficult, but treating pain is even more difficult," Marsh said. "Part of the challenge is, we're now trying to take some of our students through simulation-based training with patients, so that they can get a feel for that navigation and negotiation."
WVU is exploring alternatives to opioids, Marsh said, acknowledging that it is often hard to promote alternative pain management strategies that aren't covered by insurance over medications that are.
"We have so many patients in West Virginia who are already on opioids that it's almost impossible to move them off opioids, in spite of how dangerous they are," Sullivan said. "They're very seductive, because every time someone with a bad back takes an opioid, they feel better. Everytime I tell someone like that 'Your opioids aren't really helping you - they're just making you more sensitive to pain,' every time you'll get a negative response."
Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.