MORGANTOWN, W.Va. — West Virginia has the highest rate of opioid overdose deaths in the country, and yet 21 percent of the state’s 55 counties don’t have a counselor for individuals with substance use disorders to turn to.
“Now this is all counselors. We don’t break out addictions counselors,” said Frankie Tack, clinical assistant professor of WVU’s Department of Counseling, Rehabilitation Counseling and Counseling Psychology. “I suspect if we looked at just addictions counselors, we would find that this number is even higher. Counties might have a counselor or therapist in the county, but have no one who is a specialist in addictions available for services.”
Futhermore, while the national average of counselors per 100,000 population is 112.1, West Virginia has only 40.7 counselors per 100,000.
“While this is a national issue, we are even worse off as far as having trained professionals ready to work with this population when we are the state that has the biggest problem,” Tack said. “That’s a disturbing juxtaposition to be in.”
These statistics are troubling, Tack said, because counseling is an important aspect of treating addictions.
“We know that addiction is a very complex psychosocial, biopsychosocial disease,” she said. “When people have developed addiction over a period of time, their behaviors have adapted as well, and so what we want to do is help people develop new coping skills instead of coping with substances. We want to help them develop skills for relapse prevention, we want to help them deal with the shame and stigma that come along with having addiction, and we want to also work with any underlying trauma that might be there relative to why they initiated addiction to start with.
Though the problems in workforce development is not new, Tack said it has been excaberated by things going on in the state. Some of those obstacles include the incredibly high demand in West Virginia and the state’s aging workforce.
Many entered the field in its infancy in the 1960s, 70s and 80s, “many of whom were in recovery, saw this as an opportunity to give back and help others, and they’re now aging out,” Tack said. “Part of what’s happened is we’re not attracting young people to the field, so we’re seeing a real deficit right at a critical time.”
Access to also a major problem for those in West Virginia, keeping most of those in need of addictions treatment from receiving it.
“As a matter of fact, statistics and research show only 10 to 11 percent of those who need treatment are actually receiving it, and there’s plenty of reasons for this,” Tack said. “Living in a remote location, lack of treatment providers, lack of insurance coverage and stigma that keeps people from stepping out and getting treatment.”
Fortunately, however, the denial and shame that surround addiction is slowly decreasing, as more recognize it as a disease of the brain, urging more individuals to seek their needed treatment.
Also, more people have been able to seek treatment thanks to the Medicaid expansion and the estimated 2 million who gained insurance because of the Affordable Care Act.
“So for the first time, we had people who had insurance, and they had insurance that covered substance use disorder treatment,” Tack said. “That was all wonderful, but it caused more people to seek treatment in a system that was already understaffed. Then the opioid epidemic hit.”
The dramatic spike in opioid use began in 2010, though statistics were increasing prior to that, and the issue has not yet peaked.
The U.S. Bureau of Labor Statistics predicts a 20 percent growth in the demand for substance use and behavioral disorder counselors from 2016 to 2026, an addition of over 20,000 counselors.
To prepare for that growth of demand, West Virginia University is attempting to get ahead of the curve by adding new addiction studies programs to the Department of Counseling, Rehabilitation Counseling and Counseling Psychology.
“In our department, we have taken on the idea that we want to be a part of the solution, and how we can do that is to begin to develop formal training programs for addictions counselors at the bachelors and masters level,” Tack said.
Once implemented, this program would be instrumental for West Virginia’s substance use issues, as nothing like it currently exists in the state.
“There’s two community colleges that have associate level programs, but none at the bachelors and masters level,” she said. “If we go out to our research one institutions in the region, there are other programs at the masters level and bachelors level. So we’re a little bit behind here in West Virginia, and we’re trying to catch up.”
Tack said the first step of implementation is a new addiction studies minor that is already pending approval from the university.
“We are targeting training for people who want to work primarily in addictions training, but we’re also targeting training of allied professions who may not be doing this as their primary role, but they may be working in other venues where they’re coming in contact with people with substance use disorders and can do some early intervention, screening and ectera.
That includes students in majors such as social work, psychology, sociology, public health, nursing and others.
“Education, especially early childhood education and those students who are focusing on family and youth,” Tack said. “Sport and exercise psychology, that one might surprise you, but our governor has an iniative around high school football this season because athletes, especially high school athletes are at high risk of engaging in opioids. They’re sore, they’re getting hurt and treating injuries, so they’re a target population.”
The minor composed of five courses totaling 15 credit hours, including Introduction to Addiction Studies, Addiction Screening & Assessment, Addiction Counseling Techniques, Families & Addiction and an Addiction Studies Capstone.
“We offered the intro course for the first time this semester. I’ve got 11 students in there, and I’ve got a variety of majors, so that’s exciting,” Tack said. “This spring, because we’re still in the approval chain, we’re going to be offering that course again, along with a special topics course.”
Pending approval from faculty government, Tack is optimistic the minor will be offered for the 2018-2019 academic year. Ultimately, she also hopes to develop a concentration in the existing Masters of Arts in Counseling program.
“The faculty government’s process has been extremely supportive, administration all the way up to President E. Gordon Gee is extremely supportive, and we’re seeing a big interest from the majors and programs on campus as students are hearing about it,” she said. “We’re being told that we’re going to have a real big problem on our hands, and that’s too many students, but that’s a problem that I would love to have.”