Larry S. Smith
The numbers tell the story.
According to a report published in January by the National Institute on Drug Abuse, the United States reached a gruesome milestone in 2021: 100,000 people died of drug overdoses in just one year. Not only is this the highest number of overdose deaths in our country’s history, but the trajectory shows that these numbers are increasing every month.
Some have called the overdose crisis an “epidemic lost in the pandemic.” And, in some ways, it surpassed COVID-19. In 2020 and 2021, more than 57,000 Americans between the ages of 18 and 49 died from COVID-19, according to CDC data. By comparison, during about the same time period, nearly 79,000 people between the ages of 18 and 45 died from fentanyl overdoses alone, according to analysis of data from the organization Families Against Fentanyl. In fact, fentanyl overdoses have become the leading cause of death for adults between the ages of 18 and 45 in this country.
Yet as this tragedy unfolds, our society has failed to implement effective measures to combat it. According to the same report cited earlier from the National Institute of Drug Abuse, in 2020 only 13% of people with drug use disorders received treatment.
Immediate and aggressive action is needed, focusing on both prevention and treatment. The good news is that there is plenty of evidence telling us how to start, and one of the first steps is to break down the barriers that prevent people from getting help.
Barrier 1: Addiction is a chronic disease
It is important that we eradicate the view of addiction as the result of moral failure, unwillingness or unwillingness to quit. Addiction is a chronic disease that shares many characteristics with other chronic diseases, including heritability, onset and course influenced by environmental and behavioral factors, and most importantly, the ability to respond to appropriate treatment.
Like chronic illnesses such as diabetes or cardiovascular disease, addiction can be treated, often through long-term lifestyle changes. Viewing addiction care through the lens of chronic disease management instead of repeated episodic treatment is a model that is sustainable, evidence-based, and holds great promise.
However, many people do not seek addiction treatment for reasons directly related to the stigma that stems from a failure to view addiction as the medical condition it is; they are simply ashamed of their disease. Changing this approach is key to getting people into treatment.
Barrier 2: Access to treatment
Addiction crosses all geographic, demographic and sociological boundaries, but not access to health care.
Also, addiction is not a nine-to-five disease, although traditional treatment resources often work as such. The current best practice addiction treatment plan calls for an approach that works in the life of a recovering addict, rather than becoming their life. It is important to enable those seeking recovery to access help where and when they need it.
Ideally, we would provide access to treatment at the first signs of a crisis, and then provide ongoing care for a long period of years (not months). This approach not only leads to better health outcomes, but also saves countless dollars on medical care, legal complications, labor shortages, and a host of other expenses associated with healthcare. abuse and untreated drug abuse.
If there has been a positive outcome from the COVID-19 pandemic, it is increased access to and comfort with digital medical platforms, both among patients and behavioral health providers, that have previously been slow to adopt the technology.
These platforms can bring addiction care to people who would otherwise not have the opportunity to seek it. With telemedicine, people in treatment can have 24/7 access to professional care from clinicians and counsellors.
Having immediate access to a licensed professional counselor has been shown to lead to better outcomes for people in the throes of a crisis or on the verge of relapse. The digital access process also enables caregivers to collect and analyze data that can, in turn, lead to better overall mental health outcomes.
Barrier 3: Incarceration is not the answer
Studies have shown that moving away from punitive responses to nonviolent drug offenses not only leads to better outcomes for those affected, but relieves a costly and overburdened prison system.
Diversion programs, which send people to rehabilitation programs instead of incarcerating them, are not a new concept, but they have been gaining popularity in recent years. People sent to these programs have higher recovery rates and lower recidivism rates than those sent to prison. Such programs ensure that addicts receive treatment they otherwise could not obtain and provide budget savings without increasing the risk to public safety.
Now is the time to act
In 2020, the Oklahoma Department of Mental Health and Substance Abuse Services launched a five-year strategic plan that lists the overall reduction of substance abuse in the state as one of its three primary goals. Achieving this goal will require removing these barriers to treatment and focusing on long-term mental health outcomes.
This will require a change in the way we think about and approach addiction itself. The bottom line is that there is no easy solution to the drug epidemic facing our nation and our state. The complexity of solving this problem requires out-of-the-box thinking, strategic public-private partnerships, and an assertive approach that leverages education, cutting-edge technology, and a global mindset shift.
It’s a big challenge, but it’s absolutely necessary.
Larry S. Smith is the CEO of the Grand Lake Mental Health Center and the 12&12 Addiction Recovery Center. He is a contributor to the National Research Institute and lead architect of My Care, an app that assists in the delivery of mental health crisis services.
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