Evidence-Based Solutions to Fight the Opioid Epidemic

Evidence-Based Solutions to Fight the Opioid Epidemic
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Congress will consider a comprehensive opioid package this week. It is a step in the right direction, but we cannot rely solely on Congress alone to provide a solution to this historic national epidemic. As the public debate on how to combat the opioid epidemic rages on, Americans continue to fall victim to this terrible addiction. Young people are dying, children are forced into foster care, and the criminal justice and healthcare systems are overwhelmed with the rise in crime and overdoses resulting from the crisis.

Addiction has plagued our nation for decades, but the opioid crisis is unique. One recent news story referred to it as the “epidemic of epidemics,” leaving a trail of destruction in its wake. The statistics are devastating. An estimated 27 million people use illicit drugs or misuse prescription medications in the U.S. each year. In fact, drug overdose is the leading cause of death for Americans under the age of 50. All that, plus our yearly death toll is rising faster than ever, primarily due to opioids. In 2015, one in every 50 deaths was directly related to drugs. Last year, drug overdoses killed more Americans than guns or car accidents. To put this into perspective: deaths from opioid abuse each year exceed the HIV epidemic at its peak.

Still, too often, the conversation around addiction – and around those who have succumbed to opioid abuse, in particular – is that it's a moral failing.  No, it's a medical condition just like diabetes, or hypertension.

Understandably, lawmakers and policy experts often get wrapped up in assigning blame for the epidemic: drug manufacturers, doctors, an eroding culture and economy. Americans want answers, and sometimes it’s easier to point fingers than to consider solutions. Of course, it’s essential we address problems where they exist; but it’s essential we do so without attaching a stigma to addiction along the way.

The truth is, there isn’t a single cause of the opioid crisis. Addiction – and the opioid epidemic, specifically – is caused by a multitude of factors. That’s why we need to shift the conversation away from blame, and toward a more positive conversation around treatment: increasing access to it and offering the right treatment for the right patient. Some might be surprised to learn that despite the skyrocketing numbers of Americans succumbing to addiction, a mere 10 percent of those suffering get help. That has to change. 

As a psychiatrist, I have seen firsthand the various paths that lead people to addiction. There is not one way to get addicted, and just the same there isn't just one way to get sober. Treatments must be individualized and tailored to meet patient needs.

Integrative medicine allows physicians to assess patient needs and provide them with the best course of treatment. For addiction this could mean medication-assisted treatment such as FDA-approved Methadone, Buprenorphine, and Naltrexone, as well as psychotherapeutic interventions, peer support groups, and family therapy. No one way will work for everyone, but all options must be on the table.

While peer support groups on their own may work for some, others may need medication assistance. In fact, patients who receive medication-assisted treatment for opioid addiction are 50 percent less likely to die from this awful disease. As physicians, we must focus on evidence-based solutions to pressing problems, instead of allowing our emotions to interfere.

If we do not act decisively and urgently, the death rate will continue to rise, and more people will fall prey to addiction. As physicians, it is vital that we keep researching solutions that lead to better outcomes for more patients.

I have spent my career researching and treating addiction, considering the severity of how opioids are impacting individuals, communities and our country, and thinking about the wide range of treatment options for patients who are suffering from this disease. We must work together -- physicians, pharmaceutical companies, policymakers and average citizens – to fight back against this epidemic.

Dr. Michael Genovese is the Chief Medical Officer of Acadia Healthcare.

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