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What's Next for Opioid Addiction and Recovery?

Analysis  |  By Debra Shute  
   December 01, 2016

Experts hope for continued expansion of coverage for substance-abuse treatment and broader acceptance of addiction as a brain disease requiring medical care.

The harrowing brutality of the opioid crisis is old news to addiction professionals.

"We could have told you that opioids were at epidemic levels years ago," says Clay Ciha, CEO of AMITA Health Behavioral Medicine, which includes Alexian Brothers Behavioral Health Hospital in Hoffman Estates, IL.

What's somewhat novel is that the brain disease of addiction has become a top priority for many people outside the medical field.

Just last week, U.S. Surgeon General Vivek Murthy, MD, issued his office's first report about alcohol, drugs, and health. Now treatment advocates are watchfully waiting to see whether the incoming Trump administration takes actions that make the problem better or worse.

For an insider's perspective on these developments, Ciha and his colleague, Gregory Teas, MD, chief medical officer of the behavioral medicine service line at AMITA Health, agreed to answer a few questions. The following transcript has been lightly edited.

HealthLeaders Media: How might Trump's election affect addiction treatment policies nationally, and AMITA in particular?

Ciha: I can't speak to that directly, but I do think Congress, the legislative branch is making some great strides in understanding the importance of addressing both behavioral health and substance use disorders, so I would hope that wouldn't backslide in any way.

I think there's some really good bipartisan support for almost all of these bills. I don't know that the role of the president is going to affect the cooperation that currently exists in Congress.

Teas: I agree. We've seen important legislative acts in the last five years to increase parity in coverage between general medical conditions and both mental illness and addictions that have allowed access for many more people to treatment, and I think that would be a hard policy to reverse, and hopefully is going to continue to expand coverage for those who are willing to seek treatment.

HLM: Also on election day, California, Massachusetts, and Nevada joined the ranks of states with some measure of legalized recreational marijuana. Does this trend make your jobs harder?

Ciha: I'll let the doctor answer that one.

Teas: It's a concern. According to insurance statistics, the number one drug that teenagers seek treatment for is marijuana. Now we're putting marijuana in a legalized form into households where it can lead to exposure to minors as so-called acceptable adult behavior.

One of the real problems we may see down the line through this exposure to youth is rising rates of cannabis use, a trend that's already noteworthy in high-school-age kids. That makes me nervous, particularly with the latest data about cannabis on the developing brain in that age group.

As States OK Medical Marijuana Laws, Doctors Struggle With Knowledge Gap

HLM: We've seen that language matters in reducing the stigma surrounding addiction. What terms should healthcare providers use or avoid when discussing addiction and recovery?

Teas: The federal government agencies, including the office of the Surgeon General, now refer to addiction as a brain disease, and that gives it the status of a medical problem rather than a moral problem.

Ciha: Simply put, it's wrong to say that these are people who need to pull themselves up by their bootstraps. This is a disease like any other disease, and if we treat it as such, I think you're going to see a lot more acceptance of people wanting to get treatment, as well as better social support from families.

We can also remove a lot of negativity from the conversation. People get better. Their lives get better. Their relationships grow and mature and exceed their wildest expectations. The good news here is that people do recover and people do get better—and we have the tools to make that happen.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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