A nursing professor develops strategies to reduce opiate addiction

Dr. Chandra Speight knew early on that she was on a mission to improve North Carolina, but it took a few steps and a few lives to find the true north – to reduce the destructive threat of slavery, especially for rural mothers and medicine. parts of the government that need help.

Speight, an assistant professor in the Department of Nursing Practice and Graduate Nursing Education, grew up in Greensboro, but her family is from eastern North Carolina. After graduating from East Carolina University with a bachelor’s degree in English and being honored with the Chancellor’s Award for Excellence, he headed north.

His background in political science, and experience being part of the US AID solution, made him laugh. An abiding interest in health care policy prompted her to pursue a degree in nursing so that she could transition from thinking and teaching public policy to becoming a change agent instead. of the spectator on the sidelines.

So he quit teaching and went back to school.

“My plan was always to be a nurse, become a nurse and get a Ph.D. in nursing and studying health policy,” Speight said. “I understood that nurses are the key to providing health care in rural areas and I wanted to see them before I started studying. I saw.”

Over time, Speight’s interest waned – how registered nurses alleviate health care challenges in rural areas, particularly the ways in which alcoholism affects individuals and not. work like a spider’s web in society.

“I began to understand the opioid crisis as the biggest health care crisis facing the United States — certainly here in eastern Carolina — so I turned the research around. of opioids, the substance abuse problem and how nurses can impact that,” Speight said.

Speight was flummoxed by the divide between nurses who have a marginal role in providing rural health care, as is the case in eastern North Carolina, and federal restrictions on nurses. registered nurses (NPs) who can administer Suboxone, a powerful opioid medication. users reduce their dependency.

Restrictions were lifted in 2016, allowing NPs to finally administer Suboxone, which has been associated with a 50% reduction in all deaths for those dealing with opioid use disorder.

“That doesn’t make sense, you don’t have effective medicine,” Speight said.

Seeing how the effective use of treatment methods can reduce dependence led her research and service work to understand the obstacles that nurses face in treating substance abuse problems. Now she wanted to know how to translate that research into effective and practical educational programs for her health care colleagues, especially advanced practice registered nurses (APRNs).

Speight is collaborating with peers from the nursing and allied health sciences, as well as local medical partners, to form a multidisciplinary team to research and address substance abuse in the east. of North Carolina.

He and the team have received hundreds of thousands of dollars in grants — and applied for many more — to expand their research into unusual clinical settings such as feeding centers for the underserved and rare drug exchange programs. needles in rural eastern North Carolina.

One of the goals of the group is to establish a clinic for the problem of using drugs because the eastern part is the only part of the country without medical assistance that aims to help mothers to reduce or eliminate the use bad drug before, and up to a year after giving birth. .

“A lot of women, or pregnant women, are motivated to cut back on use during pregnancy, but after giving birth, the motivation tends to wear off, and there’s a lot of stress and people will start using again. and they lost patience,” Speight said. .

Speight’s research and clinical experience has shown that the problem will not require him to find a solution – he must go where the need is, which is often in his own backyard.

“North Carolina has some of the worst effects of opioids and related substances in the nation. In my county, Craven County, the overdose death rate is more than double the average state in North Carolina, and about 40% of children in foster care are there because they have a parent with a substance abuse problem,” Speight said.

North Carolina has poor maternal health statistics, Speight said, with nearly half of maternal deaths in a recent study resulting from overdoses, often from opioid abuse.

“The main way to reduce risk is to meet people where they are and let them set their own goals. Their goal may be to enter treatment or to continue using, and if they choose to continue using, we try to help them understand ways they can use more safely. , with the goal of keeping people alive,” Speight said.

Part of the solution Speight is working to achieve, through the grants he has received, and the academic and clinical partnerships he has promoted, is to create a sustainable framework that will attract like-minded students to study at carry the stream to future generations. of risk reduction care in rural areas of the country.

When an underfunded drug treatment network is combined with a highly marginalized population, it is difficult to teach students how to talk about addiction with patients. But Speight believes her colleagues at ECU and in the community are finding ways to teach future nurses how to overcome their prejudice and stigma to help people who depend on them for care.

“When I look at the opioid problem in eastern North Carolina and see that we have a shortage of doctors, we have to expand our solution to the problem,” Speight said. “We have a dental school, a medical school and all the APRN programs, and we have one nurse practitioner program in North Carolina, South Carolina or Virginia – we’re here to create a workforce.”

Speight said he’s seeing an increase in staff from the students he teaches and mentors, which is one of the bright spots in the already bleak landscape of harm reduction care in coastal North Carolina.

“It’s great to hear from students from their own communities, that they’re diagnosing and treating substance abuse — and they’re enjoying the work and it’s fulfilling,” Speight said. “They educate the doctors and NPs they work with — to help eliminate barriers because they’re going to save lives.”

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Name: Dr. Chandra Speight

Title: Assistant professor

Hometown: Jamestown, NC although I spent most of my childhood in eastern NC with my grandmother in Grifton and my mother’s family in Edgecombe County.

Colleges and degrees: ECU – BA English; Penn State – MA Political Science; ECU – MA English; ECU – MSN Family Nurse Practitioner; ECU – PhD Nursing

A PRIVACY PIRATE

Years in use at ECU: 13 total (3 in the College of Nursing)

What I do in the ECU: I am an Associate Professor in the College of Nursing in the Department of Nursing Practice and Advanced Education, teaching in the Doctor of Nursing Practice program.

What I like about ECU: I love the College of Nursing and its commitment to preparing Pirate Nurses to provide evidence-based care in underserved areas. I strive to ensure that my research is driven by our college’s mission to serve as a national model for transforming the health of underserved rural areas.

Research interests: (This can be deleted if not applicable): access to rural health care; substance use disorder; opioid use disorder

What advice do you have for students? Words are powerful and can heal or destroy. Think carefully about the words you use to describe people and the ways they die!

Do you like teaching class? Anything related to harm reduction, health care policy, and medication for opioid use disorder

QUESTION QUESTION

What do you like to do when you are not working? Traveling with my family in the mountains of North Carolina; playing word tips and other word games

The last thing I saw on TV: The Incredibles (and my kids)

First job: Belk Youth Board

Guilty pleasure: I love a good fancy water – bubbler is even better!

Favorite food: Anything my husband cooks for me – he is an amazing chef.

One thing most people don’t know about me: I have held faculty positions in three Departments at ECU: the Department of English, the Department of Political Science, and the Department of the College of Nursing and Graduate Nursing Education.