RECOVERY

When you asked me thirty one years ago: “What do I want to achieve in sobriety?”…..I replied “I want to be free…. from obsessively overthinking everything….”

On the 12th October I celebrated 31 years of continuing addiction recovery.

I am free.

Acceptance of what is….non-judgement, compassion and loads of now too just be present….for daily walks and talks in the local park with my husband, and our gorgeous son whenever he visits, drinking my greens, present moment pranayama, all the while consciously living consciously.

My service commitment to the global recovery movement is to continue to maintain the momentum of person-centred addiction healthcare clinics within A&E -NHS settings.

Addiction clinics where clinicians and lived experience volunteers work together to save lives. Addiction is a public health emergency.

Initially I leaned about the American Society of Addiction Medicine in 1989 from my then psychotherapist, it was their addiction criteria and addiction medicine research that change the course of my recovery….I no longer felt as though addiction was a socially stigmatised “sickness” instead it was a brain disorder…which made perfect sense based upon my generational knowledge of addiction….

This prompted me to introduce into Scotland in 2019, the ASAM “Fundamentals of Addiction Medicine Trainings” so that frontline healthcare professionals, and first responders, know how best to manage people in active addiction.

Safe prescribing is essential…as is can confidently prescribing and supervise medically assisted detox programmes, inpatient addiction primary care programmes, intensive outpatient programmes all the while knowing their individual process is fully supported.

Recovery is an individual process that can be sustained by the support of the global recovery movement.

You are not alone.

Ask for help.

RECOVERY & SERVICE WITHIN THE RECOVERY COMMUNITY

Service

“Red flags that warn that a bottom or relapse is coming involve: dropping out of meetings and isolating; being argumentative or unreasonable; gossiping; losing focus and returning to one of the family roles of hero, lost child, or mascot; general non-commitment to recovery; avoiding the Steps and intellectualizing; failing to give service to ACE; binging on sex, drugs, food, or other compulsive behaviors; and acting with perfectionism and failing to talk about feelings and critical inner messages.”

ACOA – Adverse Childhood Experiences: characterises deep attitudes and behaviours that sometimes are difficult to stay conscious of. The blaring ones are easy to recognize and to admit into our consciousness. But others lie beneath multiple layers of self-deception or socially-celebrated attributes. When we miss meetings on a consistent basis.

it may seem like a way of avoiding unwanted pain and disappointment. But it also provides the opportunity for our critical parent to distract us from our healing journey. This false self is masterful at finding ways to avoid doing the work that gives us a lifeline of hope.

In ACA, one way that keeps us coming back is to give service from a space of love. This is a sure-fire way of keeping ourselves tuned into our True Selves and our inner loving parent, which leads to taking care of our Inner Child.

By having consistent check-ins with ourselves, we can stay focused on what is right with our program and how to best help fellow ACAs begin their recovery process. On this day I will give service to my ACA group as a way of staying conscious and focused on my recovery process.

INC., ACA WSO. Strengthening My Recovery: Meditations for Adult Children of Alcoholics/Dysfunctional Families . ACA WSO INC.. Kindle Edition.

DR. L. DUPONT. RECOVERY. CONNECTION. COMMUNITY. ORGANISATION & LEADERSHIP

“Recovery leadership rules with heart. ” William White

As the second White House “Drug Czar” and the first Director of the National Institute on Drug Abuse (NIDA), Dr. DuPont was in the midst of a concerted effort by President Nixon and Congress to address the rising heroin and marijuana epidemics of the 1960s and 70s.

He was recently asked by the Nixon Foundation to discuss his unique perspective on the 50th anniversary of the July 14th, 1969 Special Message to the Congress on Control of Narcotics and Dangerous Drugs, in which Nixon insisted that “A national awareness of the gravity of the situation is needed; a new urgency and concerted national policy are needed at the Federal level to begin to cope with this growing menace to the general welfare of the United States.”

Looking back, Dr. DuPont sees Nixon’s Message as a “remarkable document” that anticipated and drove the development of many aspects and institutions of research, law enforcement, treatment, and international cooperation that still form the core of US drug policy to this day.

In particular, Dr. DuPont observes that Nixon’s Message broke new ground in two areas that were key in Dr. DuPont’s own career: the recognition that law enforcement and treatment are synergistic rather than competing components of effective drug policy, and the promotion of medically-assisted treatment (MAT), which Dr. DuPont helped pioneer in 1969 with the first large-scale MAT program in Washington, DC.

The interview concludes with Dr. DuPont offering his perspective on today’s drug policy landscape, including the marked shift from “cultivated” drugs to “synthetic” drugs, the drug legalization movement, and the new threat of what he calls “commercialized recreational pharmacology”, with businesses now a key driver of developing and marketing stronger, more addictive drugs and new delivery systems such as vaping and edibles.

As he succinctly observed in a 2018 interview with Opiod Watch, “drug users are able to buy more drugs, at higher potency, and lower prices, with more convenient delivery, than ever before.”

https://soundcloud.com/nixonfoundation/robert-dupont-on-the-50th-anniversary-of-president-nixons-message-dangerous-drugs

Current deaths in America involving synthetic opioids, such as fentanyl, increased from roughly 3,000 in 2013 to more than 30,000 in 2018. This analysis provides decisionmakers, researchers, media outlets, and the public with insights intended to improve their understanding of the synthetic opioid problem and how to respond to it. Limiting policy responses to existing approaches will likely be insufficient and may condemn many people to early deaths.

The Future of Fentanyl and Other Synthetic Opioids (RAND), consider examining a text edited by David F. Musto, One Hundred Years of Heroin (Auburn House 2002).

Cited in several national conference presentations in the past year, it is a compilation of 14 articles dovetailed to form a coherent history of the archetypal opioid of misuse.

The book provides multiple perspectives ranging from neurophysiology to the political response to the endemic, and featuring authors of such diversity as Bill White, Herb Kleber, Bob DuPont, and Daniel Patrick Moynihan.

…Why the plug? Because of the serialized hype surrounding synthetic opioids of misuse, of which only the most recent are fentanyl and sufentanil (sic).

As misuse of historical accounts and abuse of citations have returned to vogue among too many politicians, it is more important to make use of an informed, deep examination of the oldest player in the opioid addiction world.I recommend exploring a new groundbreaking book

“The Future of Fentanyl and Other Synthetic Opioids’ Paperback – 15 Oct 2019
by Bryce Pardo (Author) to learn about the past 100 years of heroin up until todays global opioid epidemic.

Fascinating read!

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

Dr Gabor Maté is a leading addiction medicine, healthcare, educator in treating addiction. His trauma informed approach in the treatment and healing of addiction is profoundly transformative.

“In the final analysis, it’s not the activity or object itself that defines an addiction but our relationship to whatever is the external focus of our attention or behaviour. Just as it’s possible to drink alcohol without being addicted to it, so one can engage in any activity without addiction.

On the other hand, no matter how valuable or worthy an activity may be, one can relate to it in an addicted way. Let’s recall here our definition of addiction: any repeated behaviour, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on his life and the lives of others.”

The distinguishing features of any addiction are: compulsion, preoccupation, impaired control, persistence, relapse and craving. Although the form and focus of addictions may vary, the same set of dynamics is at the root of them all.

Dr. Aviel Goodman writes, “All addictive disorders, whatever types of behaviors that characterize them, share the underlying psychobiological process, which I call the addictive process.”

It’s just as Dr. Goodman suggests: addictions are not a collection of distinct disorders but the manifestations of an underlying process that can be expressed in many ways. The addictive process—I will refer to it as the addiction process—governs all addictions and involves the same neurological and psychological malfunctions. The differences are only a matter of degree. There is plenty of evidence for such a unitary view.

Substance addictions are often linked to one another, and chronic substance users are highly likely to have more than one drug habit: for example, the majority of cocaine addicts also have, or have had, active alcohol addiction.

In turn, about 70 per cent of alcoholics are heavy smokers, compared with only 10 per cent of the general population.3 I don’t believe I’ve ever seen an injection drug user at the Portland Clinic who wasn’t also addicted to nicotine.

Often nicotine was their “entry drug,” the first mood-altering chemical they’d become hooked on as adolescents. In research surveys more than half of opiate addicts have been found to be alcoholics, as have the vast majority of cocaine and amphetamine addicts, and many cannabis addicts as well.

Dr Gabor Maté . “In the Realm of Hungry Ghosts: Close Encounters with Addiction.” Knopf Canada. Kindle Edition.

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

“To be a more successful country we need to see an overall improvement in our population health, and we need to close the gap between the health of our wealthiest communities and the health of our poorest. Only through an effective partnership, can we make the best use of our collective resources and work together to tackle our most difficult challenges – making a real difference to the prosperity and wellbeing of our communities.”
Rt Hon Nicola Sturgeon MSP
First Minister of Scotland

In order to positively impact the financial and emotional burden upon the A&E-NHS of vulnerable people seeking help with mental and addiction healthcare issues it is time to actualise expanded acute care clinics that can be implemented into the public health sectors.

I am a person in longterm recovery – 31 years of lived experience that began with an encounter in A&E following a failed suicide attempt.

I failed not because I am alive today, I was fortunate to not have the courage to kill myself… flipping this into having the courage to live, is primarily because of an intervention by a psychiatrist in recovery who offered me choice: return to 12step meetings. OR be admitted, and medicated but not be treated for substance mis-use (cocaine) alcohol dependency (straight vodka), and prescription pill abuse (valium).

I returned to 12step meetings, which takes courage to admit defeat, and humility to ask for help…which I did as I spoke about the past 24 hours, walking through Central Park looking for someone to murder me…and that familiar feeling of desperation….something shifted… and I knew I needed to get help…I left Central Park and caught a cab to Payne Whitney, a psychiatric hospital where the intervention took place…

From that moment on I have never been alone in my recovery. I ask for help. At different stages in my recovery it has been of great value to work though the 12steps with my A.A. sponsor.

The befits of recovery are numerous…one is that I am kinder, compassionate, happier and available to do service in the recovery community: starting step and topic meetings in remote rural Indian Villages and Chelsea, London.

When I lived in NYC I went along with a few people in recovery to learn how to take meetings into hospitals and prisons. It is challenging to see, hear and and witness incarcerated people whose entire existence is absent from love, care and community, they are so isolated yet the ones who want help seek us out…even if their “recovery world may be unconfined space…their recovery world is huge–millions of people are in recovery and available online to talk about how to not relapse and shift the focus from self sabotage to one of self care….

In my longterm recovery experience, I will have 31 years on the 12th October, 2019…and my trainings in the fundamentals of addiction, coaching, counselling, psychotherapy, life is incredibly fulfilling.

Despite people in need of recovery resisting engaging in treatment….I know from experience that if that person sitting opposite them is in recovery they will have better chance of surrendering… as a clinician that people suffering who are within the spectrum of addiction: sex addiction, sugar, fat salt addiction, illicit drugs, prescription drugs, alcohol, and or workaholism…. whatever their drug of choice is, they can recover…there is hope…to break the cycles of deep suffering.

Addiction is complex…and can be exacerbated by trauma from the past being triggered in the present…creating a cascade of obsessive thinking, (cravings) irrational behaviours (compulsivity) anxiety, depression and suicidal ideation.

My therapeutic biopsychosocial approach is compassionate, mindful and is about empowering people, meeting them where they are….when they in need of help with addiction.

Vulnerable, at risk people have a right to be treated, not dismissed, and discharged. However, due to cutbacks, long waiting times and lack of experienced in addiction trainings first responders, doctors, nurses and associated healthcare workers, people are being turned away away instead of receiving treatment.

We are experiencing a health emergency. A radical restructuring of mental and addiction healthcare needs to actualise how people in need access and receive healthcare.

It is not good enough to say universal addiction will cost millions, actually addiction is costing people their lives…. addiction and mental healthcare is already costing billions globally: loss of income, loss of family, loss of life….

Changes in how vulnerable people access treatment is what I am suggesting for them to have a choice: a medically supervised impatient detox, impatient primary treatment plan with aftercare upon discharge to support the varying stages of addiction recovery or be discharged with appropriate medicine.

The NHS Health Scotland “Burden of Disease” study highlights that alcohol and drug dependence are major contributors to absolute inequalities and recommends that alongside other measures we must tackle conditions that are more prevalent within higher levels of deprivation.

Like many international cities, Glasgow has been ravaged by the opioid epidemic. Since 2000, annual overdose deaths involving opioids have increased tenfold, with a dramatic spike over the past few years driven by the spread of the highly lethal opioid fentanyl. In a recent survey, more than 1 in 4 Glaswegians reported knowing someone who had died from an opioid overdose.

The 2018-19 death toll 1,127, is even more tragic in light of the many effective treatments for opioid use disorder that exist. Overdose-reversal drugs, naloxone and -approved medications for opioid use disorder — buprenorphine, methadone, and naltrexone — have all been shown to reduce overdose deaths, but they aren’t consistently getting into the hands of the individuals or the communities that need them most.

What motivates me to continue to do service in the wider recovery community, to raise addiction awareness, and strive for essential changes in the dismissive, negative, judgemental language and perceptions that defines addiction? In my daily commitment to recovery I know I ned to reach out to my recovery tribe. It is my connecting with other recovering people that I feel “at home” accepted, seen and heard.

It is by overcoming prejudice, and stigma, (which stopped me initially from getting help when I most needed it) and making accessible inpatient and outpatient primary care, inpatient and outpatient addiction medicine treatment programmes that will save lives, NOW that is needed.

Let’s stop talking about what to do about addiction recovery ….we know what to do, and we know why people are dying from opioid overdoses…

I am currently engaged in forming strategic partnerships with Scottish recovery organisations to strengthen the focus on a full spectrum of addiction care: prevention, treatment, remission, aftercare, and re-generation of relationship with family, workplace and recovery communities.

The plan includes: patients and their families and will highlight the personal experience of addiction in much closer view aimed at leading scientific and medical progression in the field. It also exemplifies a firm recommitment to providing continued education for all treatment providers.

Renewed and redesigned goals amass to form a robust foundation and profound course of action in the spirit of the recovery from active addiction.

With a strategic plan in place, the opportunity to set standards, pioneer research, educate healthcare professionals and the public, challenge stigma, endeavours to enhance the goal of holistically treatments from medically supervised detoxes, to save lives, and reduce the financial burden upon the person in need of recovery, their family and community..
This strategic plan provides to guide and prioritize that way forward.

• Positive changes are seen as starting points for the recovery process: reduced harm, safer use, reduced use, moderation and potential abstinence.

• A comprehensive initial assessment will determine an initial personalized treatment plan based on substance use severity, the psychobiosocial factors, multiple meanings and functions of the behaviour, motivation to change, and insight.

• Effective treatment has a primary focus on engagement and therapeutic alliance throughout the assessment process that “starts where the person is” with empathy, respect and acceptance, because creating safety and support are seen as essential to the therapeutic outcomes.

• Teaching self-management skills to address urges and difficult emotions is often essential. An ongoing assessment throughout treatment deepens both client and therapist awareness of the addiction severity and its meaning and functions.

• Exploring the client’s resistance about change reveals the issues that need new solutions. As these issues are clarified, positive change goals around the substance use and these issues can be established.

• And, finally, a personalized plan for pursuing these positive changes can be developed collaboratively between client and therapist. The plan may include a variety of therapeutic modalities, lifestyle changes, health practices and medications depending on the client’s needs.

It is time for sustainable addiction healthcare programmes, that are accessible 24/7.

Elizabeth Hearn, HP/NCH. SMAPPH
ELIZABETHHEARN.COM
+447894084788

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

“Addiction is a global health emergency. Policy makers, and mental health ministers can work with third sector recovery communities in changing the addiction healthcare narrative from “what to do?” …to actualising implementing addiction healthcare clinics: 24/7 A&E-NHS hospitals settings within the United Kingdom” Elizabeth Hearn. Addiction Clinician. Therapist. Educator. Addiction Healthcare Influencer.

I founded Universal Addiction Healthcare in response to the consistently increasing number of drug and alcohol related deaths in the UK but particularly in Scotland.

The aim is to provide comprehensive addiction training for all healthcare medical professionals, so that they can work along side third sector, recoverists , to provide a compassionate and holistic treatment in response to people in need of mental and addiction healthcare, in crisis at Accident and Emergency Departments.

Addiction is not a criminal justice issue but a public health issue which requires specialist training and insight into the medical and psychosocial nature of the illness.

I believe in the benefits of accessible and available addiction healthcare and of an individual’s right to expect effective, inclusive and compassionate treatment from NHS Services without fear of judgement or negative consequences

I am an addiction clinician and therapist, with 28 years of addiction healthcare treatment programmes experience, and 30 years of longterm addiction recovery to support fulfilling my professional and personal recovery obligation: continuing to provide addiction and mental healthcare to individuals and families in need of help.

In January 2019 I initiated a partnership with the American Society Addiction Medicine to provide evidence-based/fundamentals in addiction trainings and resources to augment healthcare providers in the United Kingdom of the skills and knowledge they need to treat addicted patients.

I am proposing implementing 24/7 addiction emergency treatment clinics within A&E-NHS settings. facilitated by trained in the ASAM “Fundamentals of Addiction” medicine healthcare professionals, in addition to the Scottish Recovery Consortium lived experience – third sector support volunteers for people in need to access 24/7 addiction and mental health primary care integrated treatment programmes. Easy access to the most effective approach for supporting person-centred addiction and mental healthcare.

The following links reveal the backbone of the American Society of Addiction Medicine’s evidence-based research and teachings:

The ASAM definition of addiction:
http:// https://www.asam.org/resources/definition-of-addiction

“We know it’s possible to make inroads and see real progress in preventing addiction and advancing its treatment,” concluded Dr. Earley. “And while the cost of addressing every facet of the addiction crisis is substantial, the cost of doing less than what is absolutely necessary is far more.

We need the political will of lawmakers to pursue bold, systemic solutions. There is no time left for incremental policy changes – we need to come together as a nation to both implement and fund the programs that will comprehensively address the complex, chronic disease of addiction.”

ASAM advocates urged Congress to support the following legislation to address America’s addiction crisis.

The Comprehensive Addiction Resources Emergency (CARE) Act (H.R. 2569/S.1365). This legislation will provide critical funding and resources now and over the next decade to strengthen our nation’s addiction prevention and treatment infrastructure and expand access to evidence-based care.

The bill allocates billions of dollars in funding to train health professionals in the diagnosis, treatment, and prevention of substance use disorder (SUD) and helps standardize addiction treatment by directing the Department of Health and Human Services, in consultation with the American Society of Addiction Medicine (ASAM), to develop model standards for the regulation of SUD treatment services based on Levels of Care standards set forth by ASAM in 2013 or an equally strong set of standards.

It also allocates funding to states, local governments, and other institutions to support SUD treatment programs and expanded access to evidence-based prevention, treatment, and recovery support services.

The Opioid Workforce Act of 2019 (H.R. 3431). This legislation will increase the number of residency positions eligible for graduate medical education payments under Medicare for hospitals that have, or are in the process of establishing, approved residency programs in addiction psychiatry, addiction medicine or pain medicine, with an aggregate increase of 1,000 positions over a five-year period.

The Medication Access and Training Expansion (MATE) Act is legislation designed to ensure all DEA controlled substance prescribers have a baseline knowledge of how to prevent, identify, treat, and manage patients with SUD. The MATE Act will require that all DEA controlled substance prescribers receive one-time training on treating and managing patients with SUD, unless such a prescriber is otherwise qualified.

It will also allow accredited medical schools and residency programs, physician assistant schools, and schools of advanced practice nursing to fulfill the training requirement through a comprehensive curriculum that meets the standards laid out in statute, without having to coordinate the development of such education with an outside medical society or state licensing body. Importantly, the legislation’s required education also satisfies the DATA 2000 X-waiver training requirement to prescribe certain medications for addiction treatment, as long as a separate DATA 2000 X-waiver is required by law.

This legislation is expected to be filed soon.
The Humane Correctional Health Care Act (H.R. 4141 / S. 2305). This legislation will allow states to use federal Medicaid matching funds to cover healthcare services provided to inmates of public institutions under Medicaid.

The Community Re-entry through Addiction Treatment to Enhance (CREATE) Opportunities Act (H.R. 3496 / S. 1983). This legislation will create a new grant program within the Department of Justice for state and local governments to cover and provide evidence-based opioid use disorder (OUD) treatments, including medications for addiction treatment, in their correctional facilities and connect individuals to continued OUD treatment upon release into the community.

Additionally, ASAM advocates are asking Congress to make strategic investments to incentivize and train clinicians to specialize in the prevention and treatment of SUD by fully funding previously authorized programs. This includes allocating $25 million in the fiscal year 2020 Labor, Health and Human Services, Education, and Related Agencies appropriations bill for the Substance Use Disorder (SUD) Treatment Workforce Loan Repayment Program and $10 million for the Mental and Substance Use Disorders Workforce Training Demonstration Program.

About ASAM

The American Society of Addiction Medicine (ASAM), founded in 1954, is a professional medical society representing over 6,000 physicians, clinicians and associated professionals in the field of addiction medicine.

ASAM is dedicated to increasing access and improving the quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addiction. For more information, visit:

http://www.ASAM.org.

ADDICTION RECOVERY RESOURCES.

Google is launching a new website it’s calling “Recover Together” that collates resources for addiction recovery in the United States. The site includes Google Maps-based search for resources like recovery support meetings and pharmacies that offer Naloxone without a prescription — it’s a drug that can be used to counteract opioid overdoses. The new site will be linked under the search bar on Google’s most valuable real estate: its home page.

The company says that it’s partnering with the Recovery Resource Hub to fill out its maps. Vetted sources are especially important in rehab, where scams can run rampant. Google itself ran afoul of those problems in 2017, when we reported on how rampant scams were in Google’s own search results. Google cracked down, banning many rehab ads, though it allowed vetted ones back onto the Google homepage beginning in April 2018.

The new page Google is launching today won’t feature ads, instead offering basic information on recovery, treatment, and prevention — with links to trusted resources.

Click on the link to find out more:

https://www.theverge.com/2019/9/12/20861764/google-addiction-recovery-website-resources-naxolone

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

For 28 years I have worked as an Addiction Professional in all three sectors within the UK, Australia, India and America.

I am committed to changing how people in need of addiction and mental healthcare access treatment. Addiction treatment has varying stages to engage the person seeking recovery from active addiction: I recommend that a person-centred addiction treatment programme begin with a psychosocial assessment, treatment evaluation process to determine the appropriateness of an inpatient medically supervised detox.

Often I will post updates via the interdisciplinary approach being implemented @ Boston Medical because we do not have the standard of services here within the uk. We desperately need to be adapting addiction medicine protocols within A&E-NHS Hospitals.

UNIVERSAL TRAINING EXPANDS ACCESS TO TREATMENT

Medication for Addiction Treatment (MAT) has proven to be highly effective in addressing substance use disorder, yet only a fraction of those who could benefit from it are receiving it. One hurdle is that health care professionals must be authorized by the Drug Enforcement Administration (DEA) to prescribe addiction medications like buprenorphine. Under DEA regulations, providers must be “waivered” to prescribe MAT.

The Grayken Center launched an initiative that makes Boston Medical Center a leader among hospitals nationwide by implementing universal waiver training for physicians and other medical professionals across all of its primary care departments. The importance of the waiver training goes beyond prescribing MAT, and establishes BMC’s commitment to reducing the stigma around treatment of SUD and creating an environment where there can be an open dialogue between patients and all providers, leading to better care.

“The urgency of the opioid crisis means we have to accelerate everything and provide access to evidence-based medications when and where our patients show up.” said Colleen Labelle, Director of Office Based Addiction Training and Technical Assistance and of the Opioid Addiction Treatment ECHO at BMC. “Part of that effort involves making sure we train all providers, giving them the knowledge to have conversations with patients about substance use and facilitate seamless access to treatment. It’s also an important part of ensuring that providing addiction care isn’t optional but becomes a standard part of medical practice.”

BMC has already completed Phase 1 of this effort, which involved training all general internal medicine residents. Family medicine providers have also been trained. Trainings are underway for residency instructors and emergency department clinicians and next up are OB/GYN physicians and nurse practitioners, family medicine residents and general internal medicine physicians.

ABOUT ADDICTION
Addiction is the most pressing public health crisis of our time. It is a chronic, medical condition that can impair health and function and is characterized by repeated use of a substance despite harmful consequences. Prolonged substance use can cause changes to the brain, making it important to get someone with unhealthy alcohol or drug use into treatment as quickly as possible. People with substance use disorders often have other chronic health conditions, and they can be made more difficult to treat because of substance use. There is effective treatment available for substance use disorders and most people with substance use disorders do recover.

ADDICTION CAN OCCUR FROM:
Genetic predisposition
Psychological factors (i.e., stress, depression, anxiety, eating disorders, personality and other psychiatric disorders)
Environmental influences (i.e., exposure to physical, sexual, or emotional abuse or trauma, substance use either in the family or among peers, references within popular culture)
Starting use of alcohol, nicotine or other drugs at an early age
More than 20 million people in the United States now live with an addiction, costing more than $400 billion in health-related costs each year. At BMC, we care for thousands of individuals with addiction each year. In fact, 34% of individuals transported by Boston EMS for drug-related illnesses are brought to BMC for care.

WHO IS AFFECTED?
Everyone is affected by addiction. It is not a disease of the underserved, of those who encountered a rough patch in life, or the uneducated. It is affecting every socioeconomic bracket of our country, every neighborhood, and every ethnicity. Consider the following:

21.7 million people aged 12 or older needed substance use treatment. 2.3 million (10.8) received treatment at a specialty facility in the past year.

PERSON CENTERED: ADDICTION HEALTHCARE & RECOVERY

Medication for Addiction Treatment (MAT) has proven to be highly effective in addressing substance use disorder, yet only a fraction of those who could benefit from it are receiving it. One hurdle is that health care professionals must be authorized by the Drug Enforcement Administration (DEA) to prescribe addiction medications like buprenorphine. Under DEA regulations, providers must be “waivered” to prescribe MAT.

The Grayken Center launched an initiative that makes Boston Medical Center a leader among hospitals nationwide by implementing universal waiver training for physicians and other medical professionals across all of its primary care departments. The importance of the waiver training goes beyond prescribing MAT, and establishes BMC’s commitment to reducing the stigma around treatment of SUD and creating an environment where there can be an open dialogue between patients and all providers, leading to better care.

“The urgency of the opioid crisis means we have to accelerate everything and provide access to evidence-based medications when and where our patients show up.” said Colleen Labelle, Director of Office Based Addiction Training and Technical Assistance and of the Opioid Addiction Treatment ECHO at BMC. “Part of that effort involves making sure we train all providers, giving them the knowledge to have conversations with patients about substance use and facilitate seamless access to treatment. It’s also an important part of ensuring that providing addiction care isn’t optional but becomes a standard part of medical practice.”

BMC has already completed Phase 1 of this effort, which involved training all general internal medicine residents. Family medicine providers have also been trained. Trainings are underway for residency instructors and emergency department clinicians and next up are OB/GYN physicians and nurse practitioners, family medicine residents and general internal medicine physicians.