Proposal for a $1.1 billion multifaceted national effort to address opioid addiction.

Following on our discussion from Chapter 7 of Evicted, a PHS student writes:

Last week was Prescription Opioid and Heroin Epidemic Awareness Week, and the Obama administration emphasized the necessity for congress to fully fund a $1.1 billion effort battling the opioid and heroin addiction crisis. Among interventions geared towards expanding access to treatment, facilitating research, monitoring prescription distribution, improving mental health and substance use disorder treatment, advancing physician engagement, disposing of opioids safely and assisting rural and tribal communities was also facilitating housing support for the recovering population. I find this last portion that targets the housing environment extremely important as it likely draws many parallels to the “Evicted” chapter we all read. I also find this article interesting given it is an example of how large policy initiatives originate. The number of different organizations that fall under the web of the federal government and are prominent players is astonishing, as noted by the myriad councils, departments, administrations and services mentioned in the article. I will be very interested to see what congress decides!

 

More recent news reiterating the importance of this topic and more focused initiatives can be found on all major news venues. The link provided details an overview of the plan as of July 2016.

https://www.whitehouse.gov/the-press-office/2016/07/05/obama-administration-takes-more-actions-address-prescription-opioid-and

Note in particular the plan to address homelessness as an integral component of opioid and heroin use disorders. This echoes calls to establish “housing first” as a way to stabilize individuals so they can address their health needs (see for example, United Way of Dane County’s program here:  https://www.unitedwaydanecounty.org/housing-first/).

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4 thoughts on “Proposal for a $1.1 billion multifaceted national effort to address opioid addiction.

  1. I’m glad we read Evicted and that there’s fresh thinking and strategy around poverty, homelessness, drug use, and the multi-directional relationships between these kinds of issues. I’m currently trying to gather data around opioid, heroin, and prescription drug use for my group’s PHS 780 project, so am glad to see this post. Communities are facing huge challenges around the opioid epidemic, including the question of how to coordinate ACA implementation when most states’ substance abuse treatment centers operate outside of the mainstream healthcare system. See this article, “Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform” from May 2015 (http://content.healthaffairs.org/content/34/5/828.full). Policymakers serious about ACA should prioritize working out alignment of state/federal funding and substance abuse treatment to ensure people can easily access and pay for services through insurance.

    There’s also the challenge of keeping up with new opioids being used, like carfentanil (an elephant sedative), the effects of which require multiple doses of Narcan to reverse — if Narcan works at all. See NPR’s write up: “An Even Deadlier Opioid, Carfentanil, Is Hitting The Streets”, out this month (http://www.npr.org/sections/health-shots/2016/09/02/492108992/an-even-deadlier-opioid-carfentanil-is-hitting-the-streets). The article describes the difficulty of keeping up with new drugs and users, and suggests the need to improve information-sharing between researchers, first responders, and substance abuse treatment centers. Evicted does an excellent job of illuminating the cyclical disadvantage tied to drug use and the consequences of inadequate access to services.

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  2. In honor of National Prescription Drug Take Back Day, I want to show support for all those involved in this effort to “clean” up our community, which have become contaminated with opioids and other addictive and harmful drugs. Below is a link to an article that discusses the NPDTBD is greater detail.
    https://www.whitehouse.gov/blog/2016/10/20/october-22nd-national-prescription-drug-take-back-day

    As a team member of Kiersten, I too am working on finding implementation strategies that would help reduce the risk, burden, and incidence of opioid abuse in Wisconsin. Having said that, I found the outline of strategies introduced in this article to be of great interest. One such improvement strategy found within the “Encouraging Safe Pain Management Approaches” section, perked my interest. I agree with this plan to separate payment incentives for care providers that are tied to pain management survey questions, as this is likely affecting the likelihood that health care providers prescribe opioids to patients. In doing so, I believe more providers would feel less pressure in giving into patients pain related needs and ultimately, empower providers to act with the patients best intentions in mind (i.e. not prescribing addictive drugs if they suspect abuse).

    In all, I think this is one of many critical policy changes that need to be implemented in order to combat and effectively address this complex and multifaceted issue that is the opioid epidemic.

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  3. The prevalence of opioid addiction continues to grow and the implications can be seen through President Obama’s multifaceted national effort. I agree with your emphasis on housing. In order for the recovery process to begin, and individual needs to have a safe environment to live and recover. In Evicted, the life events of the main character led him to the trailer park which facilitated the propagation of his addiction. In this environment he had fairly consistent access to heroin and little outside influence to seek treatment.

    The parallel that I draw between Evicted and President Obama’s action plan against the opioid epidemic is pain management. Early on in the chapter, the main character’s downward spiral began with chronic back pain. His pain management, opioid prescriptions, ran out and he was left to obtain pain relief on his own. The root cause of the pain was never resolved. I believe that how we as providers and health care systems view pain and pain management is critical to the reversal of the increasing opioid epidemic.

    As stated in the article hospitals are scored on an array of criteria and receive payment from Medicare and Medicaid appropriately. It is great to see the proposal that the pain management survey questions would explicitly not contribute to the level of payment hospitals receive. Patient satisfaction is a large component of health care systems and too often a “quick fix” with opioids is often used to maintain high patient satisfaction. Opioids provide pain relief, but do not address the root cause of the pain. Hopefully by de-incentivizing pain relief, providers will focus more on fixing patient’s root cause, the pain source, with non-opioid therapies. Patient satisfaction can still be met with non-opioid therapies. There are definite cases for when opioids are needed, but I hope that in other instances, fewer opioids will be prescribed. In theory, I hope this will reduce the number of individuals becoming addicted.

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  4. I appreciated seeing the ways that a multifaceted approach to fighting the opioid epidemic in America might proceed. As fellow commenters have mentioned, I believe that support for homeless individuals and additional education for health professionals to ensure that pain medications are administered properly can make a difference. In Evicted, I saw that addiction becomes a serious problem as the result of many combined factors, including: chronic pain, lack of social support, access to drugs, and homelessness, as well as many others factors.

    I think that by improving the use of these harmful drugs, taking unneeded prescription drugs off the market, and by expanding the scope of professional, licensed, properly discriminating treatment, the government can slow the opioid epidemic.

    -Omar

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