Strategies to Overcome Barriers in Sud Treatment

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  • View profile for Aliya Jones, MD, MBA

    CEO at Clifton T Perkins Hospital Center | Championing Safety, Trust, & Clinical Excellence

    5,563 followers

    Medications in SUD Treatment: A Standard, Not a Last Resort The treatment of opioid and alcohol use disorders has long suffered from the underuse of FDA-approved medications like naltrexone and buprenorphine. Too often, these life-saving tools are reserved as "last-resort" options, prolonging suffering and increasing the likelihood of recurring substance use episodes. Substance use disorders (SUDs) are complex medical conditions, and while medication alone isn’t sufficient, it is a critical part of comprehensive treatment. Medications for SUDs are as vital as those used for chronic conditions like diabetes or asthma. Yet, they are rarely presented as the standard of care. A 2020 survey found that only 29% of residential treatment programs in the U.S. offered medication options—this underscores the need for systemic change. We've taken a proactive approach at Luminis Health Pathways, our residential drug treatment program. Since spring 2024, we've emphasized medications as a strong, evidence-based recommendation, not just an option. The results? There is a doubling of patients in our outpatient medication management program compared to a year ago. Patients are initiating and continuing medication at higher rates, leading to fewer full relapses and more successful long-term recoveries. We’ve also seen remarkable improvements in other areas of health. For many, achieving success in managing their SUD has positively impacted comorbid medical conditions that worsened during active substance use. Addressing Barriers While all residential programs must be able to address medical needs, many lack prescribing clinicians or nursing staff to administer medications. If so, programs should partner with local medical providers to ensure access. Most payors now cover these life-saving medications, with prior authorization often being the only hurdle. Program stigma against medications for substance use disorders (MSUD) is another barrier. This can be countered with: Education: Benefits and risks of medications (the latter being minimal compared to the risks of continued substance use). Clinical Experience: Familiarity gained by working with MSUD and seeing patients thrive. Collaboration: Learning from providers who prescribe MSUD as a large part of their practice. Learning from those with lived experience. While no treatment works for everyone, these medications profoundly impact the majority of patients, helping them achieve stability and abstinence. The Call to Action It’s time to mandate access to MAT in all residential treatment programs, especially those supported with public funding. Providers, policymakers, and insurers must work together to eliminate gaps in care. No patient should leave a treatment program without access to these essential tools for recovery. #OpioidCrisis #AlcoholUseDisorder #EvidenceBasedCare #PublicHealth https://lnkd.in/ebqKk9Bu

  • View profile for Timothy Harrington

    Founder, Family WellthCare™ Services | Strategic Family Systems Coach | Emotional Wealth Architect | Helping Families Build Resilience, Connection & Legacy

    16,776 followers

    The biggest need in the Substance Use Disorder (#SUD) treatment field right now that would most significantly improve #outcomes is a comprehensive, #holistic approach to treatment that emphasizes the integration of #mentalhealth services with #community support. This approach should address not only the physical aspects of addiction but also the emotional, social, and psychological factors that contribute to substance use disorders. 1. Emphasizing Connection: Often, substance use disorders stem from a lack of #connection and unresolved emotional pain. A treatment approach that fosters genuine human connections and rebuilds relationships (family) can provide the emotional safety needed for #recovery. 2. Trauma-Informed Care: Recognizing and treating the underlying #trauma that often accompanies addiction is crucial. A trauma-informed care approach would help patients understand and heal the root causes of their substance use, rather than just treating the symptoms. 3. Patient-Centered Care: Treatment plans that are tailored to the individual needs of each person, respecting their unique background, experiences, and recovery goals, can significantly improve outcomes. This includes offering choices in the types of #therapy and support available. 4. Community Integration: Programs that integrate #community resources, including #socialsupport networks, #employment assistance, and #housing, can help individuals in recovery build stable, supportive environments. 5. De-Stigmatization: Reducing the #stigma associated with addiction can encourage more individuals to seek help without fear of judgment. This involves public education and the promotion of a more compassionate, understanding approach to addiction. Implementing these improvements requires a shift in both public perception and #healthcare policy towards a more compassionate, holistic model of care that acknowledges addiction as a complex, multifaceted issue. #familypoweredchange

  • View profile for Alexandra Plante

    Behavioral Health Strategist | Substance Use Disorder and Mental Health - SUD Care Coordination | Senior Advisor @National Council

    18,729 followers

    David McRaney studied how people in conspiracy movements and cults came to let go of deeply held beliefs. Shifts didn’t happen because someone argued them into change with better facts. It happened when their environments physically changed, exposing them to new social cues and norms. So in the fractured systems of substance use disorder (SUD) care, we really don’t need more evidence. We need to change the environment! 1. Team-based care = clinical excellence, not administrative burden 2. Normalize coordinated care tasks (e.g., warm handoffs, relapse prevention plans) into expected daily workflows so they don't appear exceptional 3. Make coordination visible in performance dashboards and incentive structures 4. Use patient expections as cultural pressure Changing doesn’t start by convincing skeptics. It starts by finding the people who already know this is broken and are ready to fix it. Then building with them, fast.

  • View profile for Craig Joseph MD, FAAP, FAMIA

    Chief Medical Officer | Author | Podcast Host | Transforming Physician and Patient Experience with Design

    9,148 followers

    A recent cluster-randomized clinical trial published in 𝘑𝘈𝘔𝘈 𝘐𝘯𝘵𝘦𝘳𝘯𝘢𝘭 𝘔𝘦𝘥𝘪𝘤𝘪𝘯𝘦 explored how a clinical decision support system (CDSS) integrated into the #EHR could support primary care clinicians in treating opioid use disorder (OUD). Conducted across 92 clinics and over 10,000 patients, the study found that while the CDSS didn’t increase OUD diagnoses or long-term medication coverage, it significantly improved short-term access to treatment. Specifically, patients at intervention sites were more likely to receive naloxone and a prescription for medications for OUD (MOUD) or referral within 30 days. This study underscores a simple but powerful insight: equipping primary care teams with the right tools, not just the right intentions, can expand access to addiction treatment in frontline settings. With a national shortage of addiction specialists, scalable and pragmatic digital interventions like this CDSS may help close the treatment gap, especially among historically underserved populations. 💡 Action Items for Healthcare Executives and Physician Leaders: 🧠 𝗥𝗲𝘁𝗵𝗶𝗻𝗸 𝗱𝗲𝗰𝗶𝘀𝗶𝗼𝗻 𝘀𝘂𝗽𝗽𝗼𝗿𝘁: Align EHR nudges with your system’s biggest public health crises. 📈 𝗧𝗿𝗮𝗰𝗸 𝘁𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁 𝗿𝗲𝗳𝗲𝗿𝗿𝗮𝗹𝘀, 𝗻𝗼𝘁 𝗷𝘂𝘀𝘁 𝗱𝗶𝗮𝗴𝗻𝗼𝘀𝗲𝘀, to measure real impact. 👥 𝗜𝗻𝘃𝗲𝘀𝘁 𝗶𝗻 𝘁𝗼𝗼𝗹𝘀 𝘁𝗵𝗮𝘁 𝗹𝗼𝘄𝗲𝗿 𝘁𝗵𝗲 𝗯𝗮𝗿𝗿𝗶𝗲𝗿 𝗳𝗼𝗿 𝗣𝗖𝗣𝘀 𝘁𝗼 𝘁𝗿𝗲𝗮𝘁 𝗮𝗱𝗱𝗶𝗰𝘁𝗶𝗼𝗻, especially where specialists are scarce. 📊 𝗘𝘅𝗮𝗺𝗶𝗻𝗲 𝗱𝗶𝘀𝗽𝗮𝗿𝗶𝘁𝗶𝗲𝘀: this tool showed particularly strong effects for American Indian and Black patients. #ClinicalInformatics #OUD #HealthEquity

  • View profile for Matthew Hermenau, PharmD, CPT, NBC-HWC 🔱

    Husband | Co-founder (P)harmless Health® | Helping men combat obesity, and reclaim masculinity

    3,585 followers

    𝐏𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐰𝐡𝐨 𝐮𝐬𝐞 𝐝𝐫𝐮𝐠𝐬 𝐢𝐧𝐬𝐢𝐝𝐞 𝐭𝐡𝐞 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥 Top reasons: 1️⃣ Inadequate pain control due to high opioid tolerances 2️⃣ Unnoticed withdrawals, cravings, desire for use by the primary medical team 3️⃣ Fear of stigmatization/punishment if they admit to using in the hospital In-hospital substance use increases rates of patient-directed discharge, readmissions, and death! So what can YOU do to better IDENTIFY patients with SUD and HELP prevent in-hospital substance use in the hospital? 𝐈𝐝𝐞𝐧𝐭𝐢𝐟𝐲 ⤵️ 👉 Urine drug screens on admission (NOT to punish patients) ⇢ This helps identify patients with possible SUD right away ⇢ Do not assume any results without talking to patients first 👉 Data that highlights "high" opioid doses in the hospital ⇢ Ask patients who claim to have "high tolerance" why that maybe is? 👉 Be aware on rounds and ask open ended questions ⇢ If a patient with OUD is using minimal prescribed opioids or non-opioids and has no withdrawal... ask the patient why this may be? 𝐏𝐫𝐞𝐯𝐞𝐧𝐭 ⤵️ 👉 Adequate pain control ⇢ If a patient is admitted with an acute pain/trauma then you need to take into account this higher tolerance ⇢ Maximize non-opioids, consider interventional procedures, and be open to increasing opioids when clinically appropriate 👉 Evidence-based medications for the specific SUD ⇢ For OUD, this would be using either buprenorphine or methadone 👉 Other supportive services ⇢ Talk with these patients! ⇢ Consider activities that distract from use (magazines, journal, snacks) ⇢ Consult the addiction medicine service (if available in your hospital) Lastly, your hospital may want to revamp or create an in-hospital substance use policy that highlights who will be involved, drug discarding procedures, and appropriate escalations Have you ever been involved in the care for someone who has used a substance in the hospital? If so, what did you do? #InhospitalSubstanceUse #SubstanceUseDisorder #Identification #Prevention

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