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1. Reduce overdose deaths by providing easy access to naloxone. Naloxone, now available as a nasal spray, immediately blocks the deadly respiratory suppression caused by heroin, methadone and narcotic pain pills (like OxyContin, Percodan and Vicodin), and it should be made easily available to first responders, families and those dependent on narcotics and their friends. In 2014, overdose deaths from prescription pain pills reached nearly 19,000, a more than threefold increase from 2001. Over 47,000 people total overdosed that same year.

2. Identify and crack down on prescribers who are providing large quantities of narcotics in so-called pill mills. Use state prescription databases to identify these prescirbers, and distinguish them from doctors legitimately practicing with populations of pain and cancer patients.

3. Employ TV, radio and social media to educate families about drug-abuse prevention. This has been repeatedly shown to reduce the non-medical use of narcotic pain pills.

4. Establish and implement medical guidelines for the treatment of chronic pain. This can be done through quality improvement techniques and performance improvement strategies.

5. Make problem drug and alcohol use screening a standard of care. Screening for this abuse should be a universal practice, used with adult patients seen in primary care settings to identify and intervene early before addiction sets in and overtakes an individual. Screening, brief intervention and referral for treatment, or SBIRT, is a proven intervention that is generally covered by insurers, including Medicaid and Medicare. This intervention has also been adapted for teenage detection and intervention of drug and alcohol problems.

6. Increase the availability, affordability and access to drug treatment programs. An estimated 80 to 90 percent of individuals who could benefit from treatment are not getting it. Celebrities who can pay vast sums for private treatment programs should not be the only ones able to enter them. The Affordable Care Act requires as an essential service element coverage and parity for mental health and substance use disorders, meaning that insurance benefits for addiction must be equivalent to any other covered general medical condition. The opportunity for proper reimbursement for substance disorder treatment has never been better.

7. Educate doctors, patients and families about what good addiction treatment must include. Medical providers, not just addiction specialists, need to appreciate the underlying neuroscience of addiction and fashion their treatment accordingly. Patients and families need to be far more informed consumers in order to advocate for effective treatments.

8. Expose treatment centers not providing comprehensive treatment for substance abuse as falling below standards of quality of care. 12-Step recovery programs (like Alcoholics Anonymous and Narcotics Anonymous) are important as a part of a comprehensive treatment program, but have low rates of effectiveness alone. Treatment options must include motivational enhancement, cognitive-behavioral treatments, relapse prevention, family education and support, wellness efforts and medication to help prevent relapse and maintain sobriety.

9. Promote and pay for the use of medication-assisted treatment. This means that recovery efforts can include medication. The use of medication should not be exhorted as a violation of sobriety. A number of medications now exist for drug and alcohol addiction (tobacco too) that improve rates of abstinence – or reduce use, called harm reduction. These include buprenorphine (Suboxone), methadone, naltrexone (including the 28-day injectable Vivitrol) and naloxone. Let's give people in recovery as good a chance as possible not be drawn into puritanical and outdated notions of recovery.

DMU Timestamp: February 03, 2020 23:30





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