Difference between revisions of "Improve Access to Quality Treatment Programs"

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Primary care providers are highly likely to come in contact with individuals who are struggling with substance use disorders however, only about 3,600 physicians are board-certified in treating addiction. <ref>https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care</ref> Approximately 4% of all physicians nationwide are certified to prescribe medication for opioid use disorder.  <ref>https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care</ref> A majority of individuals must obtain their medication from Methadone clinics. While these clinics are helpful in assisting people in getting their medication, it is difficult for specialty clinics to meet the demand for services. This calls for more primary care providers to obtain the training and certifications to treat complex cases of substance use disorders. One possible solution for getting more primary care physicians to assist in this issue is to incentivize the screening and treatment of addiction. There are many challenges that primary care providers may face when choosing to treat addiction patients, including stigma, the complexity of this population, and reimbursement for services.
Primary care providers are highly likely to come in contact with individuals who are struggling with substance use disorders however, only about 3,600 physicians are board-certified in treating addiction. <ref>https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care</ref> Approximately 4% of all physicians nationwide are certified to prescribe medication for opioid use disorder.  <ref>https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care</ref> A majority of individuals must obtain their medication from Methadone clinics. While these clinics are helpful in assisting people in getting their medication, it is difficult for specialty clinics to meet the demand for services. This calls for more primary care providers to obtain the training and certifications to treat complex cases of substance use disorders. One possible solution for getting more primary care physicians to assist in this issue is to incentivize the screening and treatment of addiction. There are many challenges that primary care providers may face when choosing to treat addiction patients, including stigma, the complexity of this population, and reimbursement for services.
= Relevant Research =
'''This article''' provides a review and meta-analysis of treatment services for patients with alcohol use disorders. The research found that pharmaceutical interventions when used with psychosocial co-interventions, resulted in better outcomes. This supports the advantage of the strategy of adding medication to treatment programs for opioid users. <ref>Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings: A Systematic Review and Meta-analysis | Research, Methods, Statistics | JAMA | JAMA Network. (n.d.). Retrieved December 5, 2019, from https://jamanetwork.com/journals/jama/fullarticle/1869208</ref>
'''Cost/Benefit Analysis.''' Drug treatment programs are known for being expensive and difficult to find. Current research suggests that when people are able to enroll in treatment,  the benefits impact not only on individuals living with a substance use disorder but also healthcare administrations, law enforcement, and the criminal justice system. Recent data suggests that every dollar spent on substance use treatment centers saves $4 in health care costs and $7 in criminal justice and law enforcement involvement. <ref>https://americanaddictioncenters.org/rehab-guide/public-assistance</ref> Over $8,200 can be saved on health care and productivity costs per individual who spends at least 60 days in a quality substance abuse treatment program. <ref>https://americanaddictioncenters.org/rehab-guide/public-assistance</ref> Thus, it is effective to invest taxpayer dollars and government resources to implement accessible, affordable, and quality treatment centers -- regardless of access to insurance or financial status.


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[[Category:SAFE-Treatment and Recovery]]
[[Category:SAFE-Treatment and Recovery]]

Revision as of 15:44, 1 August 2024

Introductory Paragraph

Over 20 million Americans ages 12 and older are addicted to drugs or alcohol, but only about 11% receive treatment. [1] There is an increasingly important need to provide options for individuals who may benefit from quality and affordable alcohol and drug treatment programs. The demand for treatment is met with a shortage of quality recovery centers in America, which makes it difficult for individuals to receive the care they need. The small populations in rural communities, for example, cannot support the specialized treatment or trained primary care practitioners who are willing to treat individuals living with addiction. This leads many individuals to either go without care or join waitlists for treatment.

Those living with substance use disorders are among the highest cost of healthcare users. [2] Overdose patients in particular place a heavy burden on first responders, emergency departments, and the foster care system. [3] Some options to solve this issue could include innovations such as expanded use of online tools and assessments, integration of primary care treatment, and virtual reality. [4]

Key Information

Most recovery support services fall under the Recover-Oriented Systems of Care (ROSC) model which is based on the idea that severe substance use disorders are treated most effectively through chronic care management which involves outpatient care, recovery housing, recovery coaching, and management checkups. These are meant to be culturally sensitive and easy to navigate. ROSC follows recovery-related values and beliefs which include the following concepts: [5]

  • People who suffer from addiction have essential worth and dignity.
  • The stigma related to addiction is something that prevents many people who are addicted from seeking help and this must be combated.
  • There are many paths to recovery.
  • Access to treatment is a human right, even though recovery might mean something more
  • People who are in recovery, as well as their families, have valuable experiences and support to offer to those who are still struggling with substance abuse.

Treatment Options

Many treatment programs are based on the 12-Steps of Alcoholics Anonymous (AA), but there is little scientific evidence showing that the AA process is effective. Dr. Lance Dodes stated in the documentary The Business of Recovery that 12-Step programs are typically only helpful for 5-10% of people who partake in them, meaning that they are largely ineffective for the vast majority of people. Treatment programs that are based on AA's 12-Step program, therefore, are not necessarily providing effective treatment, but are still charging exorbitant prices, especially considering that AA is a fellowship that is free to participants outside of treatment programs. [6]

Other treatment programs include recovery coaching, recovery housing, recovery management, peer-led recovery community centers, and recovery-based education. Medication-Assisted Treatment (MAT) is available in accredited and certified private and public clinics across the United States. A combination of medication, counseling, and behavioral therapy is regarded as the most effective in treating opioid dependency. [7] The Substance Abuse and Mental Health Administration (SAMHSA) is responsible for overseeing the certification of opioid treatment programs which use Buprenorphine, Methadone, and Naltrexone. [8]

Implementing treatment in the Primary Care Setting

Primary care providers are highly likely to come in contact with individuals who are struggling with substance use disorders however, only about 3,600 physicians are board-certified in treating addiction. [9] Approximately 4% of all physicians nationwide are certified to prescribe medication for opioid use disorder. [10] A majority of individuals must obtain their medication from Methadone clinics. While these clinics are helpful in assisting people in getting their medication, it is difficult for specialty clinics to meet the demand for services. This calls for more primary care providers to obtain the training and certifications to treat complex cases of substance use disorders. One possible solution for getting more primary care physicians to assist in this issue is to incentivize the screening and treatment of addiction. There are many challenges that primary care providers may face when choosing to treat addiction patients, including stigma, the complexity of this population, and reimbursement for services.


Sources

  1. ↑ https://drugfree.org/drug-and-alcohol-news/new-data-show-millions-of-americans-with-alcohol-and-drug-addiction-could-benefit-from-health-care-reform/
  2. ↑ https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care
  3. ↑ https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care
  4. ↑ Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-Assisted Therapies—Tackling the Opioid-Overdose Epidemic. New England Journal of Medicine, 370(22), 2063–2066. https://doi.org/10.1056/NEJMp1402780
  5. ↑ The Surgeon General’s Report on Alcohol, Drugs, and Health. (2016), Drug-Free Communities, Retrieved from: https://obamawhitehouse.archives.gov/sites/default/files/ondcp/dfc/AdministratorEnomotoMeetDFCTeamPresentation.pdf
  6. ↑ Inside The $35 Billion Addiction Treatment Industry. (n.d.). Retrieved December 5, 2019, from https://www.forbes.com/sites/danmunro/2015/04/27/inside-the-35-billion-addiction-treatment-industry/#c20c67817dc9
  7. ↑ https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions
  8. ↑ https://www.samhsa.gov/medication-assisted-treatment
  9. ↑ https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care
  10. ↑ https://www.commonwealthfund.org/publications/2017/sep/focus-expanding-access-addiction-treatment-through-primary-care
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