With Cincinnati at the epicenter of the opioid epidemic, individuals from healthcare providers, public health agencies, community organizations and local government are working together to improve health outcomes and survival rates for some of the city’s most vulnerable populations. Michael Lyons, MD, associate professor of Emergency Medicine and Director of the Early Intervention Program, is one of the professionals helping to lead these initiatives.
Lyons is a member of the Hamilton County Narcan Distribution Collaborative—a multi-agency group fighting back against the opioid epidemic in the Greater Cincinnati area. As a clinical researcher, Lyons is evaluating the group’s efforts to widely distribute Narcan to anyone who may be in a position to rescue someone from an overdose. This includes drug users, friends, family, health care professionals and good Samaritans. The goal of the program is to saturate the Greater Cincinnati area with the medication to see if it reduces overdose deaths.
“It's clear that the opioid crisis is among the most pressing health issues and that it demands a multi-agency, multi-component response from the community,” said Lyons. “Clearly, a huge part of that is health care. The UC College of Medicine and UC Health have recognized that need and are responding in a variety of ways—both in terms of providing care and conducting research—to help us understand how to respond to the epidemic more effectively.”
It’s too early for Lyons to definitively say whether the program is working, but anecdotal evidence from his experiences as an emergency department physician show signs of progress. According to Lyons, more emergency patients are arriving whose overdoses were reversed with take-home Narcan as opposed to waiting for EMTs to arrive for treatment. His clinical practice continues to remind him why his roles as a researcher and professor are so important.
“As a clinical researcher, many of your questions and motivations come from the clinical environment—things that you see as problems or that seem curious lead to our efforts to try to make the clinical practice better,” said Lyons. “On top of that, you're always looking to train the next generation of scientists; you want to provide opportunities for junior clinicians to become exposed to research. We want our students to understand how new knowledge is generated so that they can apply it in the future, but also to expose them to research in hopes that they consider becoming researchers themselves.”
In addition to his involvement with the Hamilton County Narcan Distribution Collaborative and positions as a clinician, researcher and professor, Lyons is also the director of the UC Early Intervention Program (EIP). The EIP is a population health-focused program using a systemic approach to address health needs in a more proactive way. The issues the EIP focuses on often overlap with health concerns faced by intravenous drug users targeted by the Narcan Collaborative—HIV and Hepatitis C, both of which are on the rise locally.
“I am always aware that the kinds of work we do are hard to describe. They're about looking at complex problems from all of the different angles and getting all the different stakeholders involved. And it's about allowing the community to reach into UC, and UC to reach out into the community,” said Lyons. “Diseases aren't distinct. HIV is influenced by opioids and vice versa. There are syndemics, where epidemics combine feeding into each other. We are trying to attack those really hard problems. We're looking at, ‘How do health services and populations interact?’ And, ‘How do we make that more efficient and more impactful?’ And that is complicated.”
Lyons recently received a research grant for the EIP’s HIV prevention efforts. He plans to continue his efforts, in collaboration with many health care and community partners, to increase health care outcomes and opportunities for those affected by the opioid epidemic, HIV and Hepatitis C. Lyons understands that these issues affect the entire community and creating solutions will require the entire community as well.