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.