Treating the Epidemic, Part 1: Problems From the Start
In our national conversations about the opioid epidemic in America, much attention has been given to the various factors and mechanisms which influenced the development of this wide-spread problem. In this 3-part blog post series, Treating the Epidemic, we will stand in the present day and look towards the future, exploring the important issue of how to help the millions of Americans who are currently living with an opiate addiction. Today, we start with Part 1: Problems From the Start.
Historically, patients with Opioid Use Disorder (“OUD”) have been forced to seek out Medication-Assisted Treatment (“MAT”) programs and navigate the complexities of our modern healthcare system by themselves. Patients are tasked with entering themselves into often expensive residential programs their insurance doesn’t want to cover or they can’t afford. If they can’t enter such a program, they may be left to piecing together outpatient providers (primary care physicians, addiction counselors, pharmacies) and attempting to get the care they need around barriers such as stigma, travel, cost, work, and child care.
In many cases, MAT programs prove ineffective, especially in short bursts. After OUD patients leave, they rarely receive appropriate transitions-of-care to ongoing accountability/assessment follow-ups and ongoing addiction therapy which is vital to lasting recovery. OUD has symptom recurrence rates similar to other chronic illnesses. According to research, the lack of a “lifeline” for patients as they return to daily life and all of its stresses can result in relapse rates as high as 60%.
If they don’t go to an inpatient program or intensive outpatient program, or they are transitioned from such a program, they might jump through disjointed primary care and therapy with little care coordination between them. Pharmacies have become less inclined to fill legitimate prescriptions for life-saving and addiction withdrawal medications, with some refusing to fill prescriptions for medications like Suboxone, which is considered by most prescribing practitioners to be safe and effective when used as directed.
Stay tuned for our next post in this series, Part 2: The Dangers of Disruption.