Each year some 68,000 people in Colorado and across the U.S. die from opiate overdoses, largely due to lack of treatment, and federally qualified health clinics in southwestern Colorado are pioneering an effort to give people access to care at the same place they get their annual medical, dental and vision checkups.

Jeanne Marotta, a family nurse practitioner with Axis Health System in Pagosa Springs, said getting people onto alternative medications can save lives.

"Medication Assisted Treatment works," Marotta said. "We can roll it out quickly, we can get people over onto this other medication very quickly. And we can prevent those deaths that otherwise are going to continue to happen on a daily basis."

Marotta said the increased use of powerful synthetic opiates, including fentanyl, has led to a high number of unintentional overdoses. The treatment gives patients medicines that are safer than opiates as those people work to move past addiction.

Since 1999, the number of opiate-related deaths has increased every year, and overdoses have risen by 44% since the onset of the pandemic.

Taylor Miranda Thompson, a senior quality initiatives manager with Colorado Community Health Network, is working with Axis staff on clinical guidelines, policies, best practices and workflows for Medical Assisted Treatment. She said because of the health centers' unique team-based approach, patients have access to both medical and behavioral professionals throughout the process.

"A patient may get a prescription. At the start maybe it's just a couple of days," said Miranda Thompson. "They take it on a daily basis at home, and then they would come back to their primary-care provider, their treatment team, to see 'how are you doing? Is it working for you?'"

Marotta encouraged anyone struggling with addiction to check in with their primary-care provider. Even if they are not ready to quit, there are ways to prevent accidental death. Make sure you're not alone when using, and have Narcan on hand, which can reverse the effects of opiates in the event of overdose.

Narcan is available without a prescription at most pharmacies and can be administered by anyone nearby who happens to witness a potential overdose.

"Even if you decide that medication assisted treatment is not the best option for you at this time, part of harm reduction is making choices - if you are going to use opiates - to do so in the safest manner possible," Marotta said.

Health disparities in Texas are not only making some people sick, but affecting the state's economy.

A new study shows Texas is losing $7 billion a year because it does not adequately address quality-of-life issues and the health care needs of its lower-income residents.

The research was sponsored by the Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas, and St. David's Foundation.

Brian Sasser, chief communications officer for the Episcopal Health Foundation, said health care includes more than doctors' visits and medication.

"Everything from increasing access to affordable health insurance to investing in under-resourced neighborhoods to give them more options, whether that's exercise options or food options," Sasser outlined. "Look at policy changes that expand health insurance coverage for new moms."

The report breaks down the economic costs of preventable health differences for every Texas county. It found Bexar, Dallas, Harris, Tarrant and Travis counties are losing the most money annually because of health disparities.

The amount of the economic impact depends on the racial and ethnic makeup of the county and the size of its working-age population. Sasser added the report shows Black and Hispanic children are more likely to grow up in neighborhoods with high poverty levels, and higher rates of diabetes and obesity.

"What can we do to work to make sure that the rate of diabetes isn't dramatically different between white households and Black households?" Sasser asked. "That we can make sure the food insecurity isn't dramatically different between someone who makes over $100,000 and someone who makes less than $30,000?"

The Texas Legislature has passed laws to address some of the disparities, including House Bill 12. It extends Medicaid health coverage for 12 months for new mothers, and pays for maternal health services for community health workers and doulas.

There is light at the end of the tunnel for Tennesseans struggling with opioid addiction, as a bill has been passed to increase access to treatment for opioid use disorder at Community Health Centers.

More than 3,800 lives were lost to overdose in the state in 2021, according to the Tennessee Department of Health.

Emily Waitt, policy and advocacy manager for the Tennessee Primary Care Association, said the original bill limited the number of patients nurse practitioners and physician assistants could treat with buprenorphine. The update removes the limitations, allowing more Tennesseans to access medication assisted treatment in their communities.

"It allows NPs and PAs to prescribe to 100 patients at a time, versus 50," Waitt explained. "Basically doubling the number of patients that they can prescribe to."

Community Health Centers serve more than 423,000 patients across Tennessee, regardless of their insurance status or ability to pay. About 7.7% of Tennesseans do not have health insurance.

Libby Thurman, CEO of the Tennessee Primary Care Association, said bringing the treatment to rural health centers expands access to a crucial service for patients who otherwise could not afford it. She noted it is important because people in remote areas often face challenges finding specialists and treatment facilities.

"We really wanted to work on this issue, because we know our Community Health Centers are where patients go for care," Thurman emphasized. "We really believe in an integrated model. So we want to treat the whole person, including if they are struggling with an addiction issue or a substance abuse disorder issue."

Health Centers offer behavioral health care, including counseling, along with treatment. The clinics also focus on creating a supportive network to help patients with family resources, job assistance and community connections.

While Black Maternal Health Week is wrapping up, health disparities for pregnant Black women continues to be an issue.

From April 11-17 this year, the high death rate of Black mothers is in the spotlight. Black women are three times more likely to die from pregnancy-related causes than their white counterparts.

Dr. Patricia Egwuatu, a family practice physician at Kaiser Permanente in Seattle, said racism is at the root of the disparities, which create barriers to health care access. She pointed out lack of access can lead to problems during pregnancy that are preventable or treatable.

"They may exist prior to pregnancy and then it gets worse during pregnancy if it's not managed as part of that maternity care," Egwuatu emphasized. "There are more pregnant women that have chronic conditions such as hypertension, diabetes and heart disease that are amplified during pregnancy."

The White House released a proclamation recognizing Black Maternal Health Week. The Biden administration began recognizing the week in 2021.

Egwuatu noted there are some warning signs any pregnant woman should be aware of and check in with their physician if they develop.

"You might get some changes in your vision that is not your normal. So, like, fuzziness, you can't see as well, or an excruciating headache," Egwuatu outlined. "You could also develop new swelling in your lower extremities that's making it difficult to get around or even new shortness of breath."

Egwuatu stressed physicians also need to recognize the role of racism in medicine. She argued continuous medical education is important for learning how to confront biases, and it is important for doctors to understand how they can provide people with resources.

"Asking the questions about personal barriers," Egwuatu suggested. "Does a patient have issues with getting to work, child care, transportation? What's their education, what's their cultural background and language? And do they even have a cell phone so we can connect with them?"