In the United States, opioid use disorder (OUD) is an epidemic. According to the Centers for Disease Control and Prevention, every day 91 Americans lose their lives to opioid overdose.1
Many of us know someone who has a substance use disorder. Yet stigma and lack of understanding thwart efforts to deal with the crisis on a broad scale. Our society often treats addiction as a moral failing or character flaw.
Too frequently, addiction is addressed by the criminal justice system rather than the medical community. As we’ve seen, this leads to a cycle of jail, unemployment and homelessness rather than to recovery and improved quality of life.
But OUD is a chronic medical condition. In a landmark report last year, the Surgeon General identified OUD as a chronic brain disease.2 Understanding that OUD is a chronic medical condition has changed the approach to how it should be treated.
One of the most effective approaches to managing OUD is medication-assisted treatment (MAT). MAT pairs counseling or cognitive behavior therapy with FDA-approved medications to treat substance use disorders and prevent opioid overdose.
Unfortunately, only a portion of those living with OUD are treated with MAT. Stigma plays a role. As with many behavioral health conditions, many people are reluctant to ask for their physician — or anyone— for help.
And then much depends on the physician’s expertise. The treatment community has not fully adapted to using evidence-based treatment. Those who oppose MAT say it’s just replacing one drug with another, a characterization many doctors and scientists disagree with.3
Some in the treatment community still offer an old, abstinence-based approach. Not only is this less effective than MAT, it doesn’t engage the person in treatment. MAT provides individualized care that’s focused on long-term recovery.
The medication addresses how patients can deal with their cravings, one of the leading causes of relapse. Also, when a person withdraws from opiates they lose their tolerance to the drug. This puts them at risk of accidental overdose. But MAT blocks cravings, decreasing the risk of death.
Taking on the opioid crisis isn’t easy, and no single solution exists. We have to work together to advance proven treatment methods. Our goal is to bring dignity to those who suffer from the chronic medical condition that is OUD.
To help address the challenge, Optum is working to expand access to life-saving MAT, adding thousands of providers and locations to the network. New payment models and partnerships boost availability and access.
To learn more about how OUD became an epidemic —and what we can do to stop it — read Opioid use disorder: Supporting recovery with a medication-assisted treatment approach.
About the author:
Martin Rosenzweig, MD, is regional medical director for behavioral solutions at Optum, and the head of the substance use disorder treatment initiative across the behavioral health business. He received his medical degree from the University of the Witwatersrand and has been in practice for 30 years.
1. Centers for Disease Control and Prevention. Opioid basics: Understanding the epidemic. cdc.gov/drugoverdose/epidemic/index.html.
2. Office of the Surgeon General. Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. November 2016. addiction.surgeongeneral.gov
3. Treating opioid addiction with a drug raises hope and controversy. May 17, 2016. npr.org/sections/health-shots/2016/05/17/478387232/treating-opioid-addiction-with-a-drug-raises-hope-and-controversy