Description of the Issue:
In 2008, unintentional drug poisonings became the leading cause of accidental death in the United States, and since that time the associated mortality rate has continued to climb. Prescription opioid abuse and heroin use have contributed significantly to this epidemic and created an even greater need for addiction treatment than was present previously. Currently, only 1 in 10 people with substance use disorder receive any sort of documented treatment for the disease of addiction. Given these facts, there is a critical need for an increase in quality and quantity of comprehensive addiction treatment throughout the United States. Unique models of service delivery and reimbursement, including tele-health and condition-based payment, need to be evaluated in order to make significant strides on this issue. Considerations for integrated vs collaborative models should be taken into account given the challenges of finding qualified providers and the breadth of the problem across our country (including suburban and rural areas).
The Treatment Component of a Solution
The latest medical evidence is clear about how to treat this biopsychosocial disease. Through a combination of appropriate medications, and in conjunction with psychological and social support, many patients can find a path to meaningful long-term recovery. This mantra is now supported by every state and federal agency in the field (ASAM, SAMHSA, NIDA), as well many private entities such as Hazelden Betty Ford. Treatment not only provides life saving recovery to those suffering from the disease of addiction, it also provides the best return on investment for any dollars spent on the issue of drug abuse.
For every dollar spent on substance abuse treatment,
the return is between $7 and $18 to society.
The Components of Treatment: “All Treatment is NOT Created Equal”
Regardless of the severity of the illness, each patient requires some portion of each of the categories above. As with all chronic relapsing diseases, every person will require their own unique multi-modal treatment plan. However, rarely does one of these components of therapy work alone. For those treatment organizations that are incapable of providing comprehensive integrated treatment, they should strive for close collaboration with others to achieve the optimal care for their patients. In order to achieve stable long-term recovery, treatment should include investigation of and solutions for the core issues that resulted in addiction. That complicated treatment plan will likely include further collaboration with medical and psychological professionals such as psychiatrists and pain management physicians.
In summary, the 3 key components of treatment are:
- Medical Treatment including appropriate withdrawal management, access to all forms of Medically Assisted Treatment (buprenorphine, naltrexone, etc.)
- Psychological Therapy by licensed professionals (Individual, Group, and Family) and in collaboration with psychiatrists when necessary
- Social Support/Case Management in order to ensure complete evaluation and treatment of the patient and eliminate barriers to successful recovery