Constructive Approaches to Addiction Treatment in the Height of an Abuse Crisis
How to bring individualized, evidence-based treatments to a broad range of patients
By Chris Diamond and Dr. Michael Frost, Sunspire Health
The opioid addiction crisis is now front and center on the national stage following President Trump’s announcement declaring a national public health emergency. While this is an important step for our national conversation, data show we still have many challenges ahead of us if we are to slow and ultimately reverse the upward trajectory of drug and opioid abuse in the U.S.
More than 64,000 Americans died from drug overdoses last year, and according to a new report from the U.S. Centers for Disease Control and Prevention, we’ve seen about a 20 percent increase in overdose deaths between year-end 2015 and 2016. Furthermore, overdose deaths from opioids, which represent more than three out of five overdose deaths, have more than quadrupled since 1999, whether through prescription pain relievers, heroin, or synthetic opioids such as fentanyl. In addition, many people with an alcohol or substance use disorder also have a co-existing mental health disorders.
While preventative measures are an important part of managing this epidemic, that is just one aspect of a much larger overall solution. We must address this epidemic at its roots by treating the illness, including those currently addicted. We know there is no such thing as a ‘one size fits all’ treatment. Therefore, successfully addressing this crisis requires proactively bringing comprehensive and personalized solutions to people who are suffering from or at risk of addiction.
Changing the Dialogue to Affect Change
As a nation, we need to adjust the way we understand, talk about and therefore take action to combat this epidemic. Addiction is not an acute illness and yet we continue to treat it at such, both in thinking and in medical practice.
In its 2016 report “Facing Addiction in America": The Surgeon General’s Report on Alcohol, Drugs, and Health,” the U.S. Department of Health and Human Services (HHS) states, “We must help everyone see that addiction is not a character flaw – it is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer.”
At Sunspire Health, we agree wholeheartedly with HHS. As a society, if we consider addiction to be a character flaw, we create an unfair and destructive stigma that hinders productive change from patients, caregivers, healthcare providers and policy makers, among others. Likewise, our medical approaches to treating addiction will continue to be managed with finite courses of therapy, rather than with long-term, multifaceted clinical care that we afford to similar chronic diseases such as diabetes and heart disease.
Decades of comprehensive research have helped us to understand that addiction is a disease, not an opinion. It has significant effects on the brain as well as the rest of the body and can develop as a result of biological or environmental factors, or often a combination of the two. As a verified and scientifically validated disease, addiction also deserves the same level of attention and care provided to patients and treatment programs for other illnesses.
Everyone has a role to play in addressing addiction and helping to combat our substance abuse crisis. It is not enough to expect that any specialized group can provide a solution. Leaders and citizens must come together from a point of education and understanding to mobilize and synchronize services in our communities that contribute to a holistic effort, ensuring strong and safe systems of health care, education, legislation, and beyond, so that each individual has the opportunity to thrive.
Personalized, Evidence-Based Treatment Methods are Critical
Treatment for substance abuse disorders should employ a multi-faceted regimen of evidence-based methods customized to each individual. Everyone approaches addiction with a different background, lifestyle and set of experiences, and it is imperative to meet them where they are with a treatment program that is accessible, realistic and sustainable. Treatment should include access to a full spectrum of evidence-based care, including withdrawal management, inpatient and outpatient care, and medication-assisted treatment in settings that are designed to help promote healing.
Furthermore, addressing and treating co-occurring mental health disorders should be a key component of every patient’s recovery process. Treatment for substance use and co-occurring mental health disorders should be provided by specialists with extensive expertise in the field of addiction medicine and mental health counseling.
The Need for a Community-Based Approach
The opioid epidemic and addiction crisis often tear families apart and have devastated entire communities, leaving a trail of crime, homelessness and poverty in its wake. A community-based approach to treatment can help build a constructive and compassionate support system for patients in the surrounding area by providing important aftercare services that contribute to long-term recovery, including sober living, doctor’s appointments and group or individual therapy sessions, among others.
Receiving treatment close to home can enable patients to maintain a sense of normalcy and connectivity to their family and community as they undergo their journey to recovery. Family involvement is a critical part of addiction treatment and can improve communication among individuals, rebuild relationships and aligning a patient’s progress with their support system. By undergoing treatment nearby, patients can involve family in the process towards recovery in a controlled setting.
Actively involving local organizations, businesses and individuals in the establishment of an integrated network of services and support can help empower and encourage behavioral changes within the community as well. Behavioral health facilities that are rooted in the community can more easily reach and help patients of all backgrounds from the surrounding areas access evidence-based treatment in a safe and supportive environment.
Unmet Needs are Holding Us Back
While acknowledging and beginning discussions about our nation’s opioid epidemic is a step in the right direction, there continues to be significant unmet medical need among people suffering from substance abuse disorders, largely stemming from an inability to access long-term and quality care. It is critical that payors continue to work with healthcare providers to enable patient access to quality care and if required, medication assisted treatment.
Since the 1970s, there have only been about five new classes of medicine developed to treat addiction. There is a significant need for funding to generate and incentivize the development of innovative and clinically validated treatment options for people suffering from substance abuse disorders. Federal funding is important, but it is equally as critical that funding is properly dispersed at the state level so that local solutions can be better implemented based on the specific needs of the area.
At a time when “machine-sized” treatment centers have reduced patient care to the billable bare minimum, it is more critical than ever for healthcare providers to focus on creating a comprehensive, positive and evidence-based patient experience from beginning to end. Treatment plans need to be tailored specifically to each patient’s needs during their care at a facility and after their course of treatment ends.
Every patient needs a specialized and dedicated treatment team responsible for designing a long-term approach that surrounds the patient and fits into their life and community. This way, patients have the best possible tools at their disposal to help them achieve lifetime recovery.
Chris Diamond is President and Chief Executive Officer of Sunspire Health, a nationwide network of addiction treatment facilities offering personalized treatment and addiction recovery services across the United State.
Dr. Michael Frost is a nationally recognized specialist in treatment of addictive diseases and Medical Advisor to Sunspire Health. Board certified in both Addiction Medicine and Internal Medicine, Dr. Frost is responsible for overseeing clinical and medical programming at Sunspire’s nationwide facilities and is also heavily involved in conducting clinical research trials, and consulting with numerous companies regarding clinical development and healthcare policy.