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Psychiatrists Can, Should Help Address the Opioid Epidemic

Psychiatrists and mental health professionals have a vital role to play in addressing the national opioid epidemic, according to a viewpoint published in JAMA Psychiatry.

“We believe psychiatrists are uniquely skilled and ideally suited to be leaders in treating this epidemic,” Srinivas B. Muvvala, MD, from Yale School of Medicine, and colleagues wrote.

“Psychiatrists are unique among physicians in having specialty training in treating trauma, depression, and other co-occurring psychiatric disorders and assessing suicidal behavior; increasingly, there is a growing awareness of the association between suicide and opioid use,” they continued. “Psychiatrists can provide integrated mental health care and relapse prevention counseling and therefore are uniquely qualified to provide office-based addiction treatments efficiently.”

In this viewpoint, Muvvala and colleagues argued that all psychiatrists should have training in assessing and treating patients with opioid use disorder. To respond to the epidemic, they recommended more psychiatrists complete the 8-hour training needed to prescribe buprenorphine, psychiatrists include buprenorphine treatment in routine psychiatric practice, and all residency programs require buprenorphine education for physicians in training.

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Psychiatrists can incorporate buprenorphine treatment into outpatient practices easily and safely and recent evidence supports the safety and feasibility of physicians initiating buprenorphine treatment at home, according to the viewpoint. Mentoring programs are available to help physicians overcome any concerns when prescribing buprenorphine.

“Psychiatrists are in an excellent position to meet the requirement that buprenorphine be given in conjunction with psychosocial services,” Muvvala and colleagues wrote. “Psychiatrists can provide in-house counseling and also work collaboratively with other disciplines (eg, psychologists, social workers, nurses and counselors).”

In addition, Muvvala and colleagues wrote that U.S. general psychiatry residency programs are lacking in basic areas of training and only require 1 month of addiction treatment experience.

“Training programs need to broaden the exposure of residents to effective treatments in addiction, particularly in outpatient settings that include competency in prescribing medications for [opioid use disorder],” they wrote. “Buprenorphine training should be a required competency of psychiatry training.”

Ensuring that mental health clinicians know resources for training and mentoring psychiatrists to prescribe buprenorphine exist is critical, the authors wrote.

“Addressing the national opioid epidemic is the responsibility of every psychiatrist,” Muvvala and colleagues wrote. “With commitment and a modest investment in further training, the expertise of psychiatrists in treating other psychiatric disorders can be extended to the effective treatment of [opioid use disorder].” – by Savannah Demko

Disclosure: One author reports consulting for Alkermes; no other relevant financial disclosures were reported.

Muvvala SB, et al. JAMA Psychiatry. 2018;doi:10.1001/jamapsychiatry.2018.3123.

Original article here on Healio.com.

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