Many options open to address addiction

Fairbanks Medical Director Dr. Darrin Mangiacarne, DO, MPH, CPE, recently co-wrote a column with Stephen C. McCaffrey, president and CEO of Mental Health America of Indiana about the available options to address substance abuse and addiction for The Journal Gazette in Fort Wayne, Ind. Here is the column in its entirety:

Indiana is in the midst of an opioid epidemic, an unparalleled public health crisis that stands to negatively affect communities for generations. The numbers are staggering, from the state’s rising overdose rate to the national $25 billion price tag to deliver services to those who need them most.

Indiana’s response is bringing together some of the best minds in public health, private industry, government, academia, mental health, and the medical community to prevent and treat those affected by this epidemic. These efforts are supported by significant financial resources that are spread throughout the state. This unprecedented level of cooperation is one of the few bright spots in this otherwise-challenging climate.

Treating individuals addicted to opioids is highly personalized. A one-size-fits-all approach will not stem the tide of this epidemic. Health care providers need an array of tools to individualize treatment. These tools include medication-assisted treatment, which combines behavioral therapy and medications to treat substance-use disorders.

The use of medication-assisted treatments, such as buprenorphine, methadone and naltrexone, means the right treatment gets to the right patient at the right time. Each medication has its unique attributes, and the Food and Drug Administration is on board with this strategy. Last fall, FDA Commissioner Dr. Scott Gottleib, in a statement, shared: “The more widespread adoption of MAT, coupled with relevant social, medical and psychological services, has the highest probability of being the most effective of all available treatments for opioid addiction.” Based on other evidence, the Substance Abuse and Mental Health Services Administration reports that patients receiving medication-assisted treatments cut their risk of death from all causes in half.

Medication-assisted treatments can be administered in a clinical setting, reducing the likelihood of diversion, abuse and accidental exposure. Health care professionals can administer medication-assisted treatments, allowing the patient to receive this critical treatment in their community, eliminating barriers to access.

A treatment plan that incorporates medication-assisted treatments also is cost effective. The Journal of Substance Abuse Treatment reported in 2015 that individuals treated with medication result in $153 to $223 less in health care spending per month than people treated without medication.

Importantly, medication-assisted treatments are more than just another tool in the toolbox to address opioid addiction. Medication-assisted treatments are an essential lifeline to a patient when they need it most. Just as a patient would take medication for diabetes, asthma or high blood pressure, medication for opioid addiction is a critical piece for a patient to gain control of and, ultimately, manage their health care.

Treating addiction – and its root causes – is not a simple task. Yet, ensuring patients have access to a host of options means patients and their providers can utilize an all-of-the-above approach to combating this epidemic. As Indiana continues to explore concrete opportunities to reduce opioid addiction, it is imperative we use every possible solution so our neighbors, our friends and our loved ones can achieve recovery.