Addiction is once again in the headlines this week. Overdose deaths are galvanizing the National Governors Association (NGA) into action. Representatives of the NGA met with President Obama on Monday following a weekend meeting where members decided on a set of bipartisan priorities for addressing the opioid crisis nationwide. A joint statement by the NGA and the American Medical Association focused on the need to “join together to take action” against the misuse of prescription drugs.
Community Catalyst applauds the NGA’s attention to this important issue. Moreover, we commend the efforts of Republican and Democratic governors to work with one another and with health care providers to address the misuse of prescription pain medications. We support some of the priorities identified by the NGA, including increased access to medication-assisted treatment and the need to address neonatal abstinence syndrome and maternal substance use.
However, these solutions represent only one piece of the complex puzzle of addiction. It is equally important to focus on the needs of consumers through leveraging evidence-based practices like screening and brief intervention, improving community supports so people in recovery from drug and alcohol use can get and stay well, and diverting people to health care and social services rather than jail or prison. These initiatives are central to the work of Community Catalyst’s Substance Use Disorders Project and our state advocate partners.
1. Screening and Prevention
The NGA priorities include provider education and training on pain management and safe opioid prescribing. We believe education is needed beyond these limited areas. Primary and specialty care providers who prescribe opiates should understand the complex nature of substance use disorders and receive training on how to talk with patients to assess risk for improper use. Many other trusted individuals who interact with youth and adults, including school personnel, community health workers and social workers, should also be trained in screening and early intervention.
2. Integrated Treatment
Difficulty accessing treatment is a contributing factor to the opioid crisis. Integrating care for substance use disorders with services for mental illness and other diseases is a more effective method of reducing barriers to treatment. Integrated care that serves the whole person has the potential to improve coordination, increase appropriate behavioral health referrals, and facilitate case management that is sensitive to the health needs of the many individuals with both physical and behavioral health problems.
3. Recovery Supports
Support for people in recovery to help them stay well is an important component of addressing the opioid epidemic. Recovery support services, including peer coaching, service coordination and supported education and employment, help people choose a healthy path. Insurance coverage for these services needs to be expanded
4. Diversion from the Criminal Justice System
A majority of individuals in the criminal justice system have a mental health or substance use disorder. Programs that link non-violent individuals with health and social services, such as housing supports, are a more productive use of resources than arrests and jail time. Diversion of these individuals from the criminal justice system can help save states money and help people return to productive lives in their communities. These programs need more support.
We’re heartened to see addiction remain at the forefront of the national health care conversation. Bipartisan proposals to address substance misuse continue to be introduced in Congress and state legislatures every day. We urge elected officials and health advocates to consider the four priorities above when crafting their own recommendations for a path toward a healthier life for those with substance use disorders.