Portland State Magazine Winter 2019

28 KELSEY PRIEST MPH ’14 does not judge her patients with opioid use disorder, even if they return to using substances. She says: “It’s not good. It’s not bad. It’s their journey. How can we best support them on their journey?" Priest believes a key step in stemming the U.S. opioid-overdose epidemic is decreasing the societal and institutional stigma that limits access to life-saving addiction medications. She sees this stigma in her clinical work as a medical student at Oregon Health & Science University and in her policy research as a Ph.D. candidate at the OHSU-PSU School of Public Health. "People are not receiving access to care we know works, and that is deeply and profoundly wrong," she says. More than 42,000 people died of opioid overdose in 2016, five times more than in 1999, according to the Centers for Disease Control and Prevention. Opioids include heroin, fentanyl and prescription medications such as oxycodone. Yet only about 15 percent of patients with opioid use disorder have access to life- saving medications such as methadone and buprenorphine, which reduce withdrawal symptoms and aid in recovery, Priest says. That’s because complex federal regulations and insurance barriers limit their distribution, and some doctors don’t know they can or should prescribe them, she says. The rules grew out of a deep social and racial bias that categorizes some drugs as deviant and their users as morally deficient. "The stigma is huge, and it goes back really, really far," she says. "People think it’s a spiritual failing. They think, ‘What’s wrong with you?’" PRIEST, who grew up in Washington County, comes from a family of scientists, nurses and physicians. Her father, who works for a software company, was diagnosed with Parkinson’s disease when he was 45 and she was 15. At first her family didn’t know what to expect and kept the diagnosis private. There was shame around the neurological condition, similar to the shame around opioid use, she says. After graduating from Willamette University with a degree in exercise science, she worked in the Balance Disorders Lab at OHSU on clinical trials for people with Parkinson’s, including her dad. The experience influenced her decision to follow her family’s footsteps into a medical and research career. "It demystified Parkinson’s for me," she says. "It was very therapeutic and healing." While working in the OHSU lab, she started taking pre-med science courses at PSU and earned a master’s in public health in 2014. Now a joint M.D.-Ph.D. student at OHSU and PSU, she works with Dr. Dennis McCarty on opioid research and spends ALUMNI IMPROVING OPIOID CARE