commentary
PATIENTS WITH A SUBSTANCE USE DISORDER NEED TREATMENT — NOT STIGMA
BY THE AMA TASK FORCE TO REDUCE OPI- OD ABUSE Junkie, stoner, crackhead
— We’ve all heard the terms used to describe those who struggle with drug addiction. These terms are dis- missive and disdainful; they reflect a moral judgment that is a relic of a bygone era. We need to change the national discussion. Put simply, those with substance use disorders are our patients who need treatment. May is Mental Health Month, a good time to remember this important fact and to ensure we carry the message through- out the year. Scientific progress has helped us
understand that addiction — also re- ferred to as substance use disorder
— is a chronic disease of the brain. It is a disease that can be treated suc- cessfully. No one chooses to develop this disease. Instead, a combination of genetic predisposition and environ- mental stimulus — analogous to other chronic diseases like diabetes and hypertension — can result in physi-
cal changes to the brain’s circuitry, which lead to tolerance, cravings, and the characteristic compulsive and de- structive behaviors of addiction that are such a large public health burden for our nation. Every day, 78 Americans die as
a result of prescription opioid and heroin overdose. The rate of heroin- related overdose deaths has increased dramatically; 10,574 lives were lost in 2014. The nation is seeing an increase in opioid-related pediatric exposures and poisonings. The rise in neonatal abstinence syndrome as a result of women being exposed to opioids dur- ing pregnancy is distressing. Misuse by older adults also has
become an increasing concern. The rate of opioid-related hospital admis- sions has increased significantly over the past two decades across all age categories. Because of higher rates of substance use disorders in the cur- rent baby boomer generation, illicit and nonmedical drug use among older
adults will likely increase in the future. The bottom line is, physicians must lead the nation in changing the tide of this epidemic. The Texas Medical Association and
the American Medical Association Task Force to Reduce Opioid Abuse encourage physicians and other pre- scribers of controlled substances to register for and use prescription drug monitoring programs (PDMPs) as one tool to identify patients in need of counseling and treatment for a sub- stance use disorder. The trend among policymakers has been to use PDMPs to identify “doctor shoppers.” This, by itself, is important, but the real work is to understand why a patient is seeking medication from multiple prescribers or dispensers and to offer a pathway for treatment and recovery. Information from PDMPs can play a helpful role in identifying patients in need of help. TMA and AMA want to see a larger
focus on prevention, which includes intervening early with teens who initi- ate the use of alcohol and/or marijua- na, as well as efforts to encourage safe storage and disposal of medications. Unused medications increase the risk of nonmedical use by adolescents who live in the home and can be ingested by curious young children. Implementing campaigns to edu-
Those with substance use disorders are our patients who need treatment.
May 2016 TEXAS MEDICINE 13
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76