Substance Misuse

Overkill: Unnecessary Care Is Low-Value Care

Solution lies in adhering to evidence that shows what works. Last month, Dr. Atul Gawande published a thought-provoking essay in The New Yorker about the millions of tests, drugs and surgeries that American people undergo every year, which won’t make them better, may cause harm, and costs billions. Sadly, this avalanche of unnecessary care is not confined solely to physical health care. Behavioral health and substance use disorder systems are also guilty of deploying what researchers call “low-value” care. This message is jarring, and the data indicating system failure is even more so. For example, only 25 percent of the 30 million Americans prescribed an antidepressant in a primary care setting every year show substantial clinical improvement. Given that common…

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Opioid Addiction Calls for a Chronic Disease Model of Care

Read Beacon Health Options’ white paper, “Confronting the Crisis of Opioid Addiction“ You’re unlikely to read or hear the news these days without learning more about the devastation of opioid addiction in our communities – large and small, rich and poor, urban and suburban – it’s everywhere, much the way the flu snakes its way through schools and workplaces. Indeed, there are a staggering 2 million Americans addicted to opioids; this fact should have the public standing at attention in a way it never has before. We have to do something – and quickly. While we’re hearing of it more than ever, addiction is not new. Where and when has the system failed? Deep-rooted challenges include addressing stigma and the “character…

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Don’t Bring Back the Asylum: Recovery, Not Re-institutionalization


Amid the current opioid crisis, high-profile events of mass violence and suicide, mental health parity implementation, and continued efforts to expand Medicaid for childless adults, never has behavioral health featured so prominently on policy agendas. Industry experts are scrambling for solutions, including a serious proposal to reintroduce the “asylum” as described in the Journal of the American Medical Association (JAMA) in January of this year. The JAMA article argued for the expansion of institutionalized settings for people with mental illness who cannot live alone, cannot care for themselves, or are a danger to themselves and others. Surely the solution to tackling the incredibly complex problem of mental illness and substance misuse has to involve a broader dialogue than whether or…

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