Reducing overdoses

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A new leader in the Open Society Institute shares a sensible perspective on reducing overdoses:

Looking ahead, reducing drug overdoses will require major shifts in how we approach substance use.

First, and possibly most importantly, Maryland needs to connect individuals struggling with addiction to high-quality addiction treatment that is integrated with their primary care. Primary care providers should be monitoring the long-term health and progress of those struggling with addiction, ensuring that the substance use treatment they are receiving dovetails with an overall health strategy.

Next, we need better monitoring of how often pain medication is prescribed. Research indicates there is an increase in the prescription of opioids that is not driven by clinical necessity. Many public health officials have identified the rise in prescriptions of opioids as a significant factor driving pharmaceutical overdose deaths, which quadrupled between 1999 and 2010, and as a gateway to other substances such as heroin.

Additionally, we need to educate patients that prescription drugs are, in fact, highly addictive and should be used with caution. A strategic and hard-hitting public awareness campaign would help people better understand the slippery slope from prescription drugs to street drugs.

And finally, we must undo the stigma that paralyzes individuals struggling with addiction that deters them from seeking help. This will require a shift in public policy — beginning at the highest levels — from criminalization to a focus on the medical and public health implications of addiction.

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One response to “Reducing overdoses

  1. I agree with all you stated. However it is absolutely imperative that Primary care providers are ‘truly’ educated on addiction. At the present time this is marginalized during the four years of medical school. Ask any PCP how many hours they had of education and clinical exposure in medical school on mental health/addiction issues. I feel confident their answer will shock you.

    This is not meant as a an attack on them, rather an indictment of a system that over the years has downplayed this area of health. (Psych is the red-headed step-child of Medicine, and Addiction is the red-headed step-child of Psych). Having been a preceptor for a medical school here in the Boston area on ‘substance abuse and co-occurring disorders’ I have seen first-hand the need for greater training; both academically and what I feel more important, ‘clinical.’

    Pain management I believe should be a distinct area of specialization; not open to intervention by primary care physicians. In the near future I will write a whole article on this based on my clinical observations over the past twenty-five years in the field.