The dramatic rise in the abuse of opioid drugs in the last two decades has been described simultaneously as a crisis and as an epidemic. Looking at the sobering statistics, it becomes clear that either term is painfully accurate. Opioids are a class of drug that include a number popular prescription painkillers, such as Oxycontin and Percocet, as well as illicit drugs such as heroin and fentanyl. Since 1999, the number of deaths associated with the abuse of these drugs has quadrupled. Every day, 91 Americans die from an opioid overdose; a rate that puts opioids ahead of both car accidents and gun related deaths on the list of the leading causes of accidental death in America each year. This crisis is straining community resources, raising healthcare costs and, most seriously, destroying individual lives.
There is a great deal of debate over the underlying cause of the opioid epidemic. One trend that is often cited is the increased availability of opioid class drugs, both through doctors’ prescriptions and through illicit channels. The number of prescriptions written for opioid painkillers has quadrupled since the late 1990’s. Enough pills are distributed by pharmacies each year to give every adult in the United States a two-week supply. There is also an increased availability of illicit opioids, particularly of the synthetic opioid known as Fentanyl. Traditionally, opioids have been derived from plants and so the supply is naturally restricted by agricultural processes. Fentanyl, however, can be created in a lab and so the supply is virtually limitless. However, the ready availability of the drugs is only part of the story. Studies have suggested that emotional, social, and economic factors can contribute to an individual developing a Substance Use Disorder (SUD) and so the rise in opioid abuse may not be as simple as access to the substances themselves.
Identifying and Treating Substance Use Disorder
In addition to the debate regarding the cause of the raging opioid epidemic, there is a lack of consensus on the best way to solve it. In 2010, the Affordable Care Act attempted to address treatment needs by classifying SUD as a chronic health condition.
This classification has allowed healthcare providers to treat substance abuse on the clinical level without having to refer patients to the judicial system. It has not, however, solved the debate over what that treatment should look like. One of the most common clinical treatment methods is known as Medication-Assisted Treatment (MAT). This method utilizes specialized medications that reduce the effects of other opioids, thereby removing the incentive to abuse them, as well as treating the often-unpleasant withdrawal symptoms that accompany reduction in opioid use. Studies have shown the success of MAT programs in reducing the likelihood of relapse, but critics of these method argue that the patient is simply trading one substance dependency for another.
One area that consensus does exist is that successful treatments for opioid addiction must go beyond the doctor’s office and include whole person care. SUD is a chronic condition that touches virtually every aspect of a patient’s life, including employment difficulties, related chronic health problems, and family relationships. Regardless of the method an individual has used to detoxify their system and start the recovery process, access to counseling services to assist them in coping with the trauma of addiction and the challenge of rebuilding their lives is essential to reducing the risk of relapse. Counseling services can also be beneficial for the friends and families of individuals suffering from SUD, both by assisting them in learning how to be a healthy support network for the patient and by helping them to cope with the distress that is often associated with substance abuse by a loved one. Along with traditional counseling services, a growing number of treatment programs are utilizing peer provider services. Individuals who have themselves recovered from SUD can be trained to act as peer mentors. These mentors can then draw on personal experiences as they support newly recovering patients.
Another area that has shown a great deal of promise in treating SUD is early intervention. The industry standard Screening, Brief Intervention, and Referral to Treatment (SBRT) program has been designed to detect and address the early signs of substance abuse. Care coordination technology can also be utilized in the goal of recognizing the early symptoms of SUD. When a concern can be addressed before it becomes a serious issue, it can reduce the financial costs of healthcare treatment, but more importantly, it can reduce the potential damage to an individual’s life.
Resources for Recovery
There is no “one size fits all” solution for treating SUD and so engaging the patient themselves in the recovery plan is essential. Once again, technology can be an important asset in this goal. An engagement portal can assist both the healthcare provider and the patient themselves in tracking the progress of care plans that have been developed together. Continuously improving communication technologies can allow for regular, but flexible, engagement between providers and patients. If individuals are unwilling, or unable, to regularly visit a doctor’s office, they can simply schedule quick meetings using video conferencing technologies such as Skype or FaceTime. Even the familiar hand-held breathalyzer can now play a role in recovery support. Most commonly associated with alcohol, newer models of the device can actually detect a number of different commonly abused substances. By regularly scheduling tests, patients can have instant feedback and accountability to help them track their own progress. These devices can also record and track real-time data, a capability that allows healthcare providers to quickly determine that a patient may be struggling and need intervention.
The reasons for the opioid epidemic are varied and being debated, but one thing is crystal clear, that it is costing lives. While the scope of the crisis may seem daunting, there is still hope. By focusing on the whole person and not just the condition, utilizing tools such as technology and support services, and including patients in their own recovering plan, we can save lives; one individual at a time.