Laurie Meschke believes opioid addiction must be addressed from many directions.
That’s why Meschke, a professor and director of the PhD program in the Department of Public Health, has been educating Union County fifth graders about the dangers of opioids. And why she’s working with faith-based organizations to protect addicts from harm until they’re ready for treatment. And why she’s part of a team looking at using drones to deliver much-needed medications to recovering addicts in rural areas.
“We can’t focus on one person at a time,” she says. “We need to change the attitudes and thinking about addictions in our counties.”
The Tennessee Bureau of Investigation reports that about 70,000 Tennesseans are addicted to opioids, a class of drugs that includes heroin, synthetic substances such as fentanyl and carfentanil, and prescription pain relievers such as oxycodone, hydrocodone, and morphine.
Meschke has spent nearly three decades trying to improve the health of adolescents and women. Her current efforts, which include three state-funded and federally funded interdisciplinary and inter-agency programs, focus on curbing opioid abuse.
Finding Her Calling
Meschke grew up in a small town in Minnesota. The oldest of three children, she was in elementary school when her father sought treatment for alcohol use disorder.
“I remember how hard it was when he was drinking and never home, and never knowing what to expect when he did come home,” she says. “Addiction makes people very unpredictable. It supersedes any love they can have for any person or individual.”
A first-generation college student, Meschke attended Macalester College in Saint Paul, Minnesota, with thoughts of being a pediatrician. Organic chemistry persuaded her to change her major to psychology.
Through a series of internships with autistic toddlers, mentally ill adults, runaway youth, and emotionally and behaviorally disturbed adolescents, she discovered her niche.
“I fell in love with adolescents, and I found that was where my calling was,” she says. “I loved the challenge they presented. I loved their push for increased autonomy—and that I could be a part of helping them do that.”
But after working in the field, Meschke was dismayed to learn that many practitioners weren’t employing the latest research in their work.
“I knew my graduate degree had to be looking at adolescent development and how we bridge research and practice to make better decisions about how we treat young people.”
Starting with Fifth Graders
Meschke is wrapping up a three-year project called Combating Opioid Use in Rural Appalachia with Grace and Evidence, or COURAGE.
Funded by a $1 million grant from the US Health Resources and Services Administration, the program partnered UT with organizations in Tennessee’s Union, Claiborne, Campbell, and Cocke Counties to improve treatment and recovery for opioid use disorder with an emphasis on youth and their adult caretakers.
The COURAGE team spent three years working with fifth graders at Paulette Middle School in Maynardville, Tennessee, in Union County. They taught the kids about addiction, the stigma associated with addiction, and factors affecting risk and recovery.
“We have to help them understand that addiction is a disease of the brain, that withdrawal happens, and there are ways we can help people recover with dignity,” Meschke says.
The kids brainstormed topics to explore further, such as the trouble that people with histories of addiction have finding employment and the link between athletic injuries and painkiller addiction. The youth then created campaigns to share their knowledge with the larger community.
During a presentation to parents and community officials, one student told those listening, “My mom and dad both have this issue. I want to live with them again, and I want us to be a family.”
Missy Fugate, principal of Paulette Middle School, said students looked forward to working with the UT team each month.
Fugate says that in addition to information about the dangers of drugs and the importance of making safe, healthy choices, students learned that “someone who becomes addicted is not a bad person. A person with addiction can get better.
“This is such a powerful message for students who have so many personal experiences with family addiction,” she adds.
Meschke says the team hopes the grant will be renewed; they’ve also applied for funding to expand COURAGE to two more East Tennessee counties.
Working with People with Addiction
Meschke is also involved in projects that work directly with people with addiction.
With $100,000 funding from UT System’s Grand Challenges program, she is leading a team that’s developing a “Samaritan toolbox” to help faith-based organizations provide harm reduction care to people with addiction.
Even more recently, Meschke and an interdisciplinary team of UT faculty received a four-year grant of over $1 million from the National Science Foundation to look for ways to improve outcomes for people with addiction, mental health challenges, or a combination of both in rural areas around Knoxville and in Jefferson County.
One of the unconventional ideas they’ll explore: delivering patients’ medications by drone.
Meschke is a co-principal investigator for the team, which is led by Zhenbo Wang, an associate professor of mechanical, aerospace, and biomedical engineering. Other members are UT colleagues Courtney Cronley, a professor of social work; Liem Tran, a professor of geography and associate dean for academic programs in the College of Arts and Sciences; and Jennifer Tourville, executive director of the Substance Misuse and Addiction Resource for Tennessee initiative in the Institute for Public Service.
Calming the Perfect Storm
Meschke says the opioid epidemic is the result of “a perfect storm.”
Pharmaceutical giants and regulatory agencies long maintained that opioids weren’t addictive. It became far too easy for people to get opioid prescriptions. Society has viewed addiction as a failing, not an illness. Rural and poor areas, often the hardest hit, lack treatment resources.
“Lots of people in poor areas like Appalachia are in labor jobs,” she says. For those who became injured and lacked sick leave or quality health care, “taking painkillers was life support for a lot of people because it kept them working.”
Although the fight against opioid use disorder remains an uphill battle, Meschke says wide-ranging efforts like hers are chipping away at the problem.
“I see progress every day in my communities,” she says.