UC nursing faculty gets federal grant to fight the opioid epidemic

Working as a certified registered nurse anesthetist (CRNA) at Highland District Hospital in Hillsboro, Ohio puts Jennifer Lanzillotta, PhD, an assistant professor at the University of Cincinnati (UC) College of Nursing, on the front lines of the opioid epidemic. Thanks to a Health Resources and Services Administration one-year grant for $200,000 from the U.S. Department of Health and Human Services for the Rural Communities Opioid Response Program Planning, Lanzillotta is launching an ambitious project that she thinks could be a model for other communities across the nation battling the opioid crisis.

Highland County is one of 220 counties nationwide identified by the Centers for Disease Control and Prevention on a list of vulnerable counties and jurisdictions experiencing or at-risk of HIV and Hepatitis C outbreaks due to injection drug use.

“The opioid epidemic is rampant there,” says Lanzillotta, whose post-graduate research work focused on opioids. “A community survey and a health care provider survey was conducted, and those surveys indicated that the number one problem in the county was opioid abuse disorder. With all the fentanyl in the opioids, they are seeing an upsurge in methamphetamines. People are starting to turn to meth more.”

Lanzillotta says one of the requirements of the grant is building a consortium, which she has done with the UC College of Nursing, Highland District Hospital, Prevention FIRST! (a coalition-building nonprofit in Cincinnati) and R.E.A.C.H. for Tomorrow, a nonprofit organization that works in Highland County.

The first step, according to Lanzillotta, is assessing health care in the community and determining how many medication assisted therapy (MAT) providers there are who can prescribe buprenorphine and naltrexone (i.e. brand name Vivitrol), and looking at the rate of substance abuse, naloxone use and overdoses. Discussions with health care providers will help identify gaps needing to be filled. All that information will help create a strategic plan to address the issues in Highland County.

“There is lack of care coordination, harm reduction strategies, medication assisted treatment and opioid use disorder support services in this medically underserved county,” she says. “Through this planning process, we will build an infrastructure designed to transform opioid use disorder health care in Highland County.”

Lanzillotta says Sharron DiMario, director for the Area Health Education Center at the College of Medicine, reached out to her, saying she had some medical science students who were in need of hours in a rural community which worked out perfectly for this project.

“This is perfect for us,” she says. “They can work with teaching the students in elementary and high school, and they can also do provider education. So we can have those students in the community teach these students to be part of this quick response team. Once that’s established, it can be done every year and it’s sustainable.”

The chief CRNA at Highland District Hospital, who is a friend of Lanzilotta’s, encouraged her to work at the hospital with her background in opioid research. Her affinity for the job makes the little more than one hour drive each way from her Clifton-area home “totally worth it.”

“It’s a rural community, so it’s a chance to give back,” she says. “I love the hospital. This is my favorite clinical job I’ve ever had because the people are fantastic. The operating room staff is really, really good, the hospital is great. The people are appreciative, it’s a good environment.”

In September of 2018, Lanzillotta delivered a presentation on the opioid epidemic at the American Association of Nurse Anesthetists Annual Congress in Boston. Her presentation, “The Opioid Epidemic Gripping America: Pain, Euphoria and Avarice: How Big Pharma, Medicine and the Search for Deliverance Created a National Crisis and & Effective Mitigation Strategies” is based on research she did on the history of opioids.

“My purpose for that talk was to track the opioid epidemic for the CRNAs,” she says. “How did we get here? In order to fix the problem, you have to understand how we got this problem.”

In her talk she discussed research she had done on the history of the opioid epidemic, referencing articles from the New England Journal of Medicine, the American Pain Society along with other sources and then discussed how the crisis can be mitigated. That research produced what she calls the Lanzillotta Model for communities to battle the opioid epidemic.

“It’s designed around a central service hub, with spokes of medication assisted therapy, quick response teams, clinical providers, data tracking and more,” she says. “It can be used in a small community like Hillsboro or a larger one like Cincinnati. My vision is for Highland County to be an example for the rest of the country on how to combat this crisis and succeed.”

Lanzillotta’s work is not going unnoticed. In April 2018, she won the 2018 Ohio State Association of Nurse Anesthetists Educator of the Year award, which is given to a CRNA who has excelled in his or her teaching and mentorship of a student nurse anesthetist.