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 flaw” often associated with drug addiction. A seismic shift is required to make these adjustments in attitude.
Redefining and Right-Treating Addiction
However, action is not only dependent upon the vagaries of social change. First and foremost, the health care delivery system must recognize addiction for what it is – a chronic brain disease – and needs to treat it accordingly, much as we do asthma and diabetes. Extensive research has shown that opioid exposure creates permanent brain changes in genetically susceptible individuals. These changes occur in the very parts of the brain that affect responsible decision-making, impulsivity and the ability to feel pleasure or satisfaction. In other words, traditional detox programs fall short; bodies become drug-free, but brains are permanently rewired in a way that makes affected individuals continue to seek drugs to avoid the tremendous dysphoria and pain they feel without them. In brief, without follow-up care in community settings, people living with opioid addiction will resort to old behavior. Therefore, like other chronic diseases, addiction requires ongoing management measured in years rather than days.
Currently, substance misuse is not routinely treated as a chronic condition. In the chronic disease model of care, six fundamental elements enable high-quality, chronic disease care:
- Community resources and policies
- Health care organization
- Self-management support
- Delivery system design
- Decision support
- Clinical information systems
This framework is more than a clinical program, per se; the model incorporates the necessary societal, systemic and legislative overhaul to promote real and continuous improvements in care. By following through on these six tenets, the health care delivery system can start to construct an evidence-based, rational, hands-on solution to a problem that cannot wait for society to embrace addiction for what it is: a chronic disease and not a moral failing or lack of self-control.
Change is never easy; real transformation requires innovation from all fronts. However, the logical framework of the chronic disease model of care is an excellent place to start.
Beacon is currently working with consumers, health plans, Medicaid agencies, policy makers, providers and our medical leadership to implement the key elements of the chronic disease model in each of our markets. To understand the evidence supporting Beacon’s recommendations, and be a part of putting a stop to this pervasive issue and bring about lasting, positive change, we invite you to read our white paper, “Confronting the Crisis of Opioid Addiction.” Download, read, share, respond – let’s help fix this!
Click here to view an overview of our white paper: Confronting the Crisis of Opioid Addiction – An Overview of Beacon’s White Paper.
Listen to Beacon leaders discuss the white paper and learn how we can right-treat addiction through the chronic disease model of care.