You can’t read the news these days without seeing information on the increasing problem of substance use disorder (SUD). Whether it’s because individuals with SUD are at higher risk for complications from COVID, or looking at how many of us have increased alcohol and drug use during the pandemic, or the latest announcement on a state’s opioid settlement – it’s clear that SUD has a tight grip on American society, government, and health care.
Given all the focus, shouldn’t we be better at helping people?
Unfortunately, the facts remain bleak:
- Over 20 million people have a substance use disorder, and the vast majority never get treatment
- We have a current shortage of behavioral health providers, and the problem is expected to get dramatically worse by 2030
- The relapse rate for SUD is estimated between 40 – 60%, similar to other chronic conditions such as hypertension and asthma.
Key to breaking the current downward spiral lies in connecting treatment across (and even after) the continuum of care. In the case of treating SUD, what should that mean?
- We must make it easier to refer patients to treatment. Currently, many healthcare providers struggle to appropriately screen for substance use and refer to treatment, especially if substance use is not something they see every day. The current system for SBIRT (Screening, Brief Intervention, and Referral to Treatment) might realistically only consist of checking a box in the EHR. Even the most thorough clinicians may not have the names of SUD or MAT providers at their fingertips, much less know if an inpatient bed is available.
- We must get dramatically better at integrating care with the patient at the center. Several states (notably, Washington and California) have developed programs to connect care between mental and physical health care providers. These initiatives are essential on a broad scale for impact. We simply have too many stories about our inability to coordinate care, even across conditions that are often co-occurring, such as SUD and mental health.
- We must extend federal program and health plan program coverage to additional types of providers, such as peer support specialists. Peer support services are effective in sustaining recovery over the long term and can be an important part of helping in-clinic providers be efficient with their face-to-face time with patients.
- We must make it OK to talk about substance use disorder. Mental health advocates have had a (well deserved) banner year. With famous athletes such as Simone Biles, Michael Phelps, and Naomi Osaka delivering the message that “it’s OK not to be OK,” there has been more open discussion about mental health concerns. SUD lags in this area – it’s simply still more stigmatized. Given the increasing number of individuals who are combatting substance use, we must normalize talking about SUD treatment and recovery. People who are working toward or in recovery should always have someone to connect with.
- We must surround individuals in recovery with a friend “safety net.” Studies show that having friends to talk to during recovery is important. That can be problematic, though, as many people in recovery – particularly in the early stages – have close friends who are still using substances. This means that we have to help individuals establish new, supportive connections that can relate to their recovery journey. Having common, shared experiences (even if they are difficult) is a powerful spark for connection.
- We must measure results and share successful (and unsuccessful) strategies broadly. SUD is complex, difficult to treat, and rife with risks for recovery. Solid, evidence-based approaches, such as results from randomized clinical trials on supportive technology, must be prioritized and shared widely. Given the decentralized nature of much of our healthcare system, if a program or approach does not work as intended, we should share that information too – so that others may learn and adapt their own approaches accordingly.
CHESS Health is uniquely positioned to help the public sector, payers, and healthcare providers combat the SUD crisis by connecting care across the continuum to achieve higher abstinence rates, reducing the risk of relapse, and lowering the total cost of care. As the leading provider of technology supporting the addiction management and recovery lifecycle, we offer evidence-based programs that offer meaningful connections on the life-long journey of recovery.
