ACP: Substance use disorder is a chronic medical condition

Substance use disorder should be approached as a chronic medical condition, with treatment programs in place of incarceration and improved training programs with which physicians can treat patients with substance abuse.

Such programs are among the eight major recommendations the American College of Physicians has made to improve the nation’s approach to preventing and treating substance abuse in a position paper released March 27 (Ann Intern Med. 2017. doi: 10.7326/M16-2953).

The ACP’s recommendations address the growing rates of opioid addiction, as well as the financial burden of substance abuse on the medical system.

“In 2014, 22.5 million people in the United States needed treatment for an illicit drug or alcohol use problem, but only 18% received any treatment,” according to the paper’s authors. “The medical complications of untreated substance use disorder also drive up health care system costs. Hospitalizations for opioid use disorder rose from nearly 302,000 to more than 520,000 from 2002 to 2012, and costs for such care quadrupled to $15 billion in 2012.”

The complete list of the ACP’s recommendations are:

1) Substance abuse should be approached as a chronic medical disorder. Substance abuse can be treated through evidence-based health programs, according to the ACP. Effort should be put into developing research initiatives, as well as combating the social stigmas associated with substance use disorders.

2) The ACP encourages the establishment of substance abuse programs as a replacement for incarceration. Treatment for substance abuse is a time-sensitive matter, which should be given to patients as soon as possible, including those found guilty of the sale or possession of illegal substances.

3) Policy makers should consider reducing the punishments for drug-related crimes committed by nonviolent offenders. Officials should consider decriminalization, legalization, or treatment alternatives for crimes regarding certain drugs based on the potential risk associated with that drug, the accessibility of treatment in criminal facilities, any disproportionate affects on different sections of the population, and the potential decrease in rates of abuses.

4) There should be multiple stakeholders involved in the creation of programs to eliminate substance abuse. Physicians, policymakers, advocacy groups, and health care professionals are encouraged to work together to create strategies to combat and prevent substance abuse, including programs that expand naloxone access for opioid users or the establishment of a national prescription drug monitoring program. Extensive education programs on proper pain reduction methods should also be made available to physicians to help prevent future dependencies.

5) Coverage of substance use and mental disorder treatments should be mandatory for health insurance companies. Evidence-based treatments for mental health conditions and substance abuse, including counseling, medications, legal services, and education, should be covered by patients’ health insurance. The ACP asserts strict oversight would be essential; however, it is also essential that patients receive nonpharmacologic treatments, which are usually not covered by insurance.

6) There should be an increase in professionals trained to treat substance abuse. There are 4,500 health care professionals in the United States who have mental health and/or substance abuse training, according to the Health Resources and Services Administration. This number shows a high demand for those qualified to treat mental health conditions and substance abuse. Efforts should also be focused on creating a more ethnically diverse group among trained professionals to further increase access to these services.

7) Substance abuse treatment methods should be added to professionals’ continuing medical education. In 2000, 17% of primary care physicians felt very prepared to identify illegal drug use, and 30% could identify drug misuse, according to a study conducted by the National Center on Addiction and Substance Abuse. In response, education for physicians “should be rigorously evaluated to ensure effectiveness and continued access to care and should be designed to prevent onerous burdens on patients and physicians,” according to the paper’s authors.

8) Further study should be conducted on effectiveness of substance abuse programs. Current substance abuse intervention methods should be evaluated to see how effective they are. Among those, safe injection sites should especially be encouraged, as these initiatives have proven effective in reducing unsafe needle sharing in Canada, Australia, and Denmark.

The researchers had no relevant financial disclosures.

[email protected] On Twitter @EAZTweets

Substance use disorder should be approached as a chronic medical condition, with treatment programs in place of incarceration and improved training programs with which physicians can treat patients with substance abuse.

Such programs are among the eight major recommendations the American College of Physicians has made to improve the nation’s approach to preventing and treating substance abuse in a position paper released March 27 (Ann Intern Med. 2017. doi: 10.7326/M16-2953).

The ACP’s recommendations address the growing rates of opioid addiction, as well as the financial burden of substance abuse on the medical system.

“In 2014, 22.5 million people in the United States needed treatment for an illicit drug or alcohol use problem, but only 18% received any treatment,” according to the paper’s authors. “The medical complications of untreated substance use disorder also drive up health care system costs. Hospitalizations for opioid use disorder rose from nearly 302,000 to more than 520,000 from 2002 to 2012, and costs for such care quadrupled to $15 billion in 2012.”

The complete list of the ACP’s recommendations are:

1) Substance abuse should be approached as a chronic medical disorder. Substance abuse can be treated through evidence-based health programs, according to the ACP. Effort should be put into developing research initiatives, as well as combating the social stigmas associated with substance use disorders.

2) The ACP encourages the establishment of substance abuse programs as a replacement for incarceration. Treatment for substance abuse is a time-sensitive matter, which should be given to patients as soon as possible, including those found guilty of the sale or possession of illegal substances.

3) Policy makers should consider reducing the punishments for drug-related crimes committed by nonviolent offenders. Officials should consider decriminalization, legalization, or treatment alternatives for crimes regarding certain drugs based on the potential risk associated with that drug, the accessibility of treatment in criminal facilities, any disproportionate affects on different sections of the population, and the potential decrease in rates of abuses.

4) There should be multiple stakeholders involved in the creation of programs to eliminate substance abuse. Physicians, policymakers, advocacy groups, and health care professionals are encouraged to work together to create strategies to combat and prevent substance abuse, including programs that expand naloxone access for opioid users or the establishment of a national prescription drug monitoring program. Extensive education programs on proper pain reduction methods should also be made available to physicians to help prevent future dependencies.

5) Coverage of substance use and mental disorder treatments should be mandatory for health insurance companies. Evidence-based treatments for mental health conditions and substance abuse, including counseling, medications, legal services, and education, should be covered by patients’ health insurance. The ACP asserts strict oversight would be essential; however, it is also essential that patients receive nonpharmacologic treatments, which are usually not covered by insurance.

6) There should be an increase in professionals trained to treat substance abuse. There are 4,500 health care professionals in the United States who have mental health and/or substance abuse training, according to the Health Resources and Services Administration. This number shows a high demand for those qualified to treat mental health conditions and substance abuse. Efforts should also be focused on creating a more ethnically diverse group among trained professionals to further increase access to these services.

7) Substance abuse treatment methods should be added to professionals’ continuing medical education. In 2000, 17% of primary care physicians felt very prepared to identify illegal drug use, and 30% could identify drug misuse, according to a study conducted by the National Center on Addiction and Substance Abuse. In response, education for physicians “should be rigorously evaluated to ensure effectiveness and continued access to care and should be designed to prevent onerous burdens on patients and physicians,” according to the paper’s authors.

8) Further study should be conducted on effectiveness of substance abuse programs. Current substance abuse intervention methods should be evaluated to see how effective they are. Among those, safe injection sites should especially be encouraged, as these initiatives have proven effective in reducing unsafe needle sharing in Canada, Australia, and Denmark.

The researchers had no relevant financial disclosures.

[email protected] On Twitter @EAZTweets

Substance use disorder should be approached as a chronic medical condition, with treatment programs in place of incarceration and improved training programs with which physicians can treat patients with substance abuse.

Such programs are among the eight major recommendations the American College of Physicians has made to improve the nation’s approach to preventing and treating substance abuse in a position paper released March 27 (Ann Intern Med. 2017. doi: 10.7326/M16-2953).

The ACP’s recommendations address the growing rates of opioid addiction, as well as the financial burden of substance abuse on the medical system.

“In 2014, 22.5 million people in the United States needed treatment for an illicit drug or alcohol use problem, but only 18% received any treatment,” according to the paper’s authors. “The medical complications of untreated substance use disorder also drive up health care system costs. Hospitalizations for opioid use disorder rose from nearly 302,000 to more than 520,000 from 2002 to 2012, and costs for such care quadrupled to $15 billion in 2012.”

The complete list of the ACP’s recommendations are:

1) Substance abuse should be approached as a chronic medical disorder. Substance abuse can be treated through evidence-based health programs, according to the ACP. Effort should be put into developing research initiatives, as well as combating the social stigmas associated with substance use disorders.

2) The ACP encourages the establishment of substance abuse programs as a replacement for incarceration. Treatment for substance abuse is a time-sensitive matter, which should be given to patients as soon as possible, including those found guilty of the sale or possession of illegal substances.

3) Policy makers should consider reducing the punishments for drug-related crimes committed by nonviolent offenders. Officials should consider decriminalization, legalization, or treatment alternatives for crimes regarding certain drugs based on the potential risk associated with that drug, the accessibility of treatment in criminal facilities, any disproportionate affects on different sections of the population, and the potential decrease in rates of abuses.

4) There should be multiple stakeholders involved in the creation of programs to eliminate substance abuse. Physicians, policymakers, advocacy groups, and health care professionals are encouraged to work together to create strategies to combat and prevent substance abuse, including programs that expand naloxone access for opioid users or the establishment of a national prescription drug monitoring program. Extensive education programs on proper pain reduction methods should also be made available to physicians to help prevent future dependencies.

5) Coverage of substance use and mental disorder treatments should be mandatory for health insurance companies. Evidence-based treatments for mental health conditions and substance abuse, including counseling, medications, legal services, and education, should be covered by patients’ health insurance. The ACP asserts strict oversight would be essential; however, it is also essential that patients receive nonpharmacologic treatments, which are usually not covered by insurance.

6) There should be an increase in professionals trained to treat substance abuse. There are 4,500 health care professionals in the United States who have mental health and/or substance abuse training, according to the Health Resources and Services Administration. This number shows a high demand for those qualified to treat mental health conditions and substance abuse. Efforts should also be focused on creating a more ethnically diverse group among trained professionals to further increase access to these services.

7) Substance abuse treatment methods should be added to professionals’ continuing medical education. In 2000, 17% of primary care physicians felt very prepared to identify illegal drug use, and 30% could identify drug misuse, according to a study conducted by the National Center on Addiction and Substance Abuse. In response, education for physicians “should be rigorously evaluated to ensure effectiveness and continued access to care and should be designed to prevent onerous burdens on patients and physicians,” according to the paper’s authors.

8) Further study should be conducted on effectiveness of substance abuse programs. Current substance abuse intervention methods should be evaluated to see how effective they are. Among those, safe injection sites should especially be encouraged, as these initiatives have proven effective in reducing unsafe needle sharing in Canada, Australia, and Denmark.

The researchers had no relevant financial disclosures.

[email protected] On Twitter @EAZTweets