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Stigma and Inaccessibility are Limiting Opioid Treatment Effectiveness

— April 4, 2019

Experts say stigma regarding treatment options and limited access to resources is hindering opioid recovery.

The Centers for Disease Control and Prevention (CDC) reported that between 1999 and 2016, more than 350,000 people died from an overdose involving an opioid.  The CDC reports 47,600 opioid overdose deaths for 2017 (a new record) and heroin was involved in 15,500.  The United States began to see an increase in prescription opioid use beginning in the ‘90s with pain medications such as morphine, codeine, hydrocodone and oxycodone taking center stage.  Now, there is a significant need for effective opioid treatment options.

Opioids are powerful pain killers because they attach to pain receptors in the brain and throughout the body, eliminating the discomfort associated with moderate-to-severe pain that might be experienced after surgery or an injury.  Some are so powerful, they have only been approved by the Federal Drug Administration (FDA) for cancer relief.  Unfortunately, the medications are also highly addictive, especially with long-term use.

Experts say that there is reason to be hopeful about the progress being made to curtail the crisis.  A recent Blue Cross Blue Shield Association (BCBSA) report published in July of 2018 found that the total number of opioid prescriptions filled by those it insures decreased 29% since 2013.  Taking the total opioid prescriptions filled in 2017, researchers found 45% were within the CDC’s recommended guidelines for the dose and duration least likely to contribute to misuse, up from 39% in 2013.

Stigma and Inaccessibility are Limiting Opioid Treatment Effectiveness
Photo by GoaShape on Unsplash

An ongoing roadblock to curtailing the opioid epidemic is stigma. “Unlike other chronic diseases, such as diabetes or heart disease, substance abuse is often considered a personal weakness,” said Lorina Marshall-Blake, president of the Independence Blue Cross Foundation. “We hear again and again how drug abuse is a self-inflicted problem, and that people who use drugs are flawed.”

In Pennsylvania, the Independence Blue Cross Foundation has started a campaign called “Someone You Know” which is largely advertised in billboards, videos, and print.  The campaigning is raising awareness that addiction is a disease and needs to be treated like one.

“We want to let those who are struggling know that recovery is possible; there are others fighting the same battle and you can too,” Marshall-Blake said. “They are parents and grandparents, artists, veterans, community leaders and advocates for recovery. In short, they are someone you know.”

The medical community has also made significant changes to how it approaches opioid treatment and substance abuse treatment in general.  Anthem Blue Cross Blue Shield (BCBS) of Connecticut, New Hampshire, and Maine is tackling addiction recovery through a partnership with Aware Recovery Care.  The agency offers an alternative to traditional treatment options, reaching more BCBS members and their families through programs designed to allow those addicted to remain in their homes.

“The partnership with Aware maximizes our opportunities for innovation,” says Stephen Friedhoff, MD, chief clinical officer and senior vice president at Anthem. “There are circumstances where a multiple week residential or inpatient intervention is necessary, but studies show only about 10-30% of people show sustained recovery after leaving inpatient and residential treatment.”

Throughout the year-long Aware Recovery Care program, a multidisciplinary team works with a member in the individual’s home, using a combination of drug therapy and counseling to develop an individualized treatment program. The model makes treatment more accessible.

“It’s not always realistic that someone can leave their job or their family for weeks,” he says. “This is a wonderful opportunity not only for people in that position, but also for people who may have tried an inpatient program in the past.”

By reducing stigma and creating more accessible treatment options, experts says the crisis can be successfully adverted.  It’s all about getting everyone on the same page.


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