Five Questions With: Dr. Elinore McCance-Katz

Dr. Elinore McCance-Katz, an internationally known addiction medicine expert, intends to make Eleanor Slater Hospital a teaching site for medical, nursing and social work students in Rhode Island.
Dr. Elinore McCance-Katz, an internationally known addiction medicine expert, intends to make Eleanor Slater Hospital a teaching site for medical, nursing and social work students in Rhode Island.

Dr. Elinore McCance-Katz is the new chief medical officer for Rhode Island’s Department of Behavioral Healthcare, Developmental Disabilities and Hospitals. Earlier, she was chief medical officer of the U.S. Substance Abuse and Mental Health Services Administration and the medical director for the California Department of Alcohol and Drug Programs. Internationally known for her expertise in psychiatry and addiction medicine, McCance-Katz holds a joint appointment with Brown University.

PBN: We know that you’re a relatively new transplant to Rhode Island, yet you’re an expert in opioid addiction. Why does Rhode Island have such a significant problem with opioid addiction?

MCCANCE-KATZ: Although the increases in opioid addiction, overdose and death are an urgent national issue, Rhode Island, given its small size and population, has been greatly affected. In the last 20 years, we have seen huge growth in prescriptions for opioid medications – such as Oxycontin – for chronic pain. When people become tolerant to the effects of the medications, they must take more of the opioid to get the desired effect. Through education, doctors and other prescribers have stopped, or greatly reduced, prescribing opioids. As a result, individuals who are addicted then look for other sources of opioids, such as heroin. People frequently turn to heroin, an inexpensive opioid alternative, when they can’t get prescriptions for opioid pain medications.
PBN: Tell us how you are going to change the direction Rhode Island has been moving in terms of opioid addiction?
MCCANCE-KATZ:
Gov. Gina M. Raimondo understands the toll opioid addiction is taking in Rhode Island in terms of increasing numbers of addicted individuals, many of whom suffer overdoses and death. She formed the Overdose Prevention and Intervention Task Force that has spearheaded a plan for Rhode Island. Reversing the current course will take a multipronged effort, with a major focus on treatment of opioid use disorder and medication-assisted treatment, which has been shown to be safe and effective for opioid addiction. The plan also calls for addiction prevention efforts, with peer outreach as a major component. These interventions should help reduce opioid overdoses and deaths and provide people with access to the treatment they need.

PBN: What cohorts of individuals here are opioid addicts, and how will you reach out to them?
MCCANCE-KATZ:
Addiction to opioids now touches not only those addicted to heroin, but others – from adolescents to the elderly – who may have received prescribed opioid pain medications and then get into difficulties with those medications. The governor’s plan includes outreach through novel and widespread approaches to prevention and treatment interventions, which will provide options for addressing this problem to those individuals affected and their communities.

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PBN: How do you plan to make Eleanor Slater Hospital a training site for medical, nursing and social work students?
MCCANCE-KATZ:
Eleanor Slater Hospital is an absolute treasure for health care practitioner education. This is an institution that cares for the most ill among us – in terms of both physical and mental illnesses. I will be reaching out to our Rhode Island educational institutions to establish training experiences at Eleanor Slater Hospital in a number of clinical areas. As a teaching institution, Eleanor Slater Hospital enhances the care of patients, stimulates our staff to provide the best care possible and prepares the next generation of clinicians to provide excellent and empathic care.
PBN: What are the unique challenges providers face in treating those who have serious mental illnesses?
MCCANCE-KATZ:
Rhode Island lacks an adequate number of psychiatrists, advance practice nurses, other physicians, psychologists, nurses and other health care professionals willing to work with this population. We need to step up our efforts to attract people into the field. We must develop new and better ways of delivering care and we must seamlessly integrate health care services so that people with these disorders get personalized care that meets their needs over time; these are chronic illnesses without a “cure.” However, treatment is effective and people who access that treatment and ongoing recovery supports can live productive lives in their communities.

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