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Substance use disorder appears to be on the rise as the number of fatal overdoses in the U.S. has reached a new one-year high. That means the demand for treatment is increasing, and with that, a need for healthcare leaders to navigate patient populations with more nuanced needs than they’ve experienced in the past.
Increasingly, part of the substance use disorder treatment conversation is the concept of a harm reduction philosophy. Public officials, legislators, mental healthcare leaders, academics, advocates and providers are publicly discussing the benefits, efficacy and necessity of harm reduction — particularly when it comes to opioid use disorder.
Dr. Ashley Peak, a Board-Certified Addiction Psychiatrist for innovaTel, said the landscape of acceptance for a harm reduction approach among her peers depends on several factors, including the quality of training they’ve received and when they received it, the geographic area where they practice and the overall philosophy of the organization where they work.
Despite the decades-long, prevailing philosophy of abstinence when it comes to substance use disorder, as is suggested by D.A.R.E and 12-step programs, a more effective approach appears to be one that involves harm reduction. And the numbers play that theory out.
When it comes to opioids, multiple studies have shown that the relapse rate from an abstinence-based treatment program could reach 95%. A harm reduction approach, however, generally results in about a 60% relapse rate.
“Opioid Use Disorder is more difficult to treat than other substance use disorders. Abstinence models do not effectively address higher relapse and overdose rates in Opioid Use Disorder,” Peak said. “Each substance of abuse should utilize evidence-based treatment plans based on the neurocircuitry involved and the patient’s individualized goals and needs.”
A harm reduction philosophy meets a patient where they are and generally involves the administration of FDA-approved medications such as methadone or buprenorphine as part of a medication-assisted treatment (MAT) program. As mental healthcare organizations utilize CCBHC expansion grants, more of these MAT programs are coming online, resulting in increased access to care for those in need of substance use disorder treatment.
And the need for treatment is tremendous, as the Centers for Disease Control (CDC) reported that 93,000 people died of drug overdoses in 2020, which represents a 30% increase as compared to 2019. The number of people who died of opioid overdoses alone outpaced the total number of drug overdose deaths for 2019.
When it comes to treatment, a significant ratio of those who need substance use disorder treatment also need care for a mental illness. With the increasing adoption of telehealth, which offers the availability of specialized, qualified remote providers, the introduction of a substance use disorder treatment program within an existing mental healthcare organization’s framework is within reach.
Our most recent whitepaper, “Integrating a Harm Reduction Philosophy,” explores the issue on a deeper level, offering more specifics on the challenges and potential treatment solutions.
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