Submitted on Mon, 2015-09-21
By SMART Health Claims

Public Health Strategies to Combat Our National Opioid Epidemic

Heroin deaths have nearly quadrupled over the last decade. Opioid use has become a national epidemic, infiltrating every neighborhood across America. In August, the White House took action with the announcement of a new Heroin Response Program, signifying a fundamental transformation in strategy. The goal of this program is to shift the focus from the punishment of victims to the training and empowerment of those who work to help them.

Wiping Out a Generation

The opioid epidemic affects more than 2 million Americans and continues to ravage the nation. In areas like Bell County, Kentucky, nearly every resident knows someone who has become addicted or died from opioid abuse. The 2013 Bell County opioid death rate was double of any other Kentucky county at 93.2 per 100,000 people. The rise is addiction can be partially attributed to injured miners who are prescribed opioids for pain. The result is that two-thirds of Bell County adults are unable to hold jobs or contribute to society.

Every day, more and more Americans are discovering the extent of this national public health crisis, yet most feel powerless to solve it.

The Path to an Effective Strategy

Policy experts, government authorities and public health professionals are thoughtfully devising new strategies that will halt the epidemic and deal with the fallout. These new strategies range from addressing the source of the issue at medical schools, to the ongoing treatment of the addicts at public health clinics. It is the hope of these leaders that new strategies will reduce the potential of substance abuse wiping out a significant portion of this generation.

The new White House strategy is a treatment-based pilot program for 5 states in the Northeast that aims to build a bridge between public health and public safety professionals. The Office of National Drug Control Policy plans to spend $2.5 million to increase the collaboration between public safety and public health coordinators, helping them to share knowledge and best practices.
 

“The new Heroin Response Strategy demonstrates a strong commitment to address the heroin and prescription opioid epidemic as both a public health and a public safety issue. This Administration will continue to expand community-based efforts to prevent drug use, pursue ‘smart on crime’ approaches to drug enforcement, increase access to treatment, work to reduce overdose deaths, and support the millions of Americans in recovery.” The White House

Strategies for Presidential Candidates

On the campaign trail, presidential hopefuls are following the lead of the White House by raising awareness and revealing their plans to stand up to substance abuse, if elected. Every presidential candidate must now have a platform to address how they will deal with this crisis.
 

“The heroin epidemic is the sleeper issue of the 2016 campaign in a way I have never seen an issue emerge in the New Hampshire primary,” said New England College professor Wayne Lesperance. Boston Globe

Hillary Clinton announced a $10 billion plan to help contain opioid-related abuse, highlighting that drug and alcohol is “a disease, not a moral failing - and we must treat it as such.”

Governor Chris Christie implemented legislation in February to address heroin treatment in New Jersey, a state that has been dramatically affected by the epidemic. The legislation requires that substance abuse centers submit performance reports and extends immunity to emergency responders and employees who administer safe needles and the anti-opioid drug Narcan. It also mandates that state agencies provide mental health and substance abuse services to inmates in state prison. During a recent stop in New Hampshire, presidential candidates learned that the opioid crisis is the second largest issue facing the state.

Governor Jeb Bush and former Hewlett-Packard chief executive Carly Fiorina were moved to make personal admissions about how addiction has affected their own lives as parents, as they listened and responded to heartbreaking testimonials from New Hampshire residents.

Strategies Aimed at the Source

A July 2015 study conducted by the Mayo Clinic found that prescription practices play a role in opioid addiction. The study found that 1 in 4 patients who were prescribed a short-term prescription for opiates went on to use opioid painkillers for more than 90 days. A quarter of this subset engaged in so-called long-term use, defined as receiving at least 120 days' worth of pills or more than 10 separate prescriptions.

In Massachusetts, Governor Charlie Baker made a first-in-the-nation effort to educate medical students and staff on safe opioid prescribing methods when he met with the Massachusetts Medical Society and the Deans from four medical schools. The effort reveals a move by national leaders to understand the source of the crisis as a possible starting point to finding a solution.

Strategies for Public Health Agencies

The National Alliance of State and Territorial AIDS Directors (NASTAD) released a plan to directly serve as a helpful resource for Local Health Departments (LHDs).In the plan,NASTAD leaders emphasize thatthe opioid epidemic should be addressed as a public health emergencyand outline a coordinated national response for LHD workers - those who serve on the front lines of the crisis.

The following highlights from the comprehensive NASTAD plan may be helpful for Local Health Departments to review against their existing substance abuse plans:

  • Substance Abuse Prevention and Treatment: At-risk individuals must have increased access to prevention and treatment.

  • Mental Health Treatment: Substance abuse is often linked to mental health disorders. At-risk individuals must have increased access to mental health treatment.

  • HIV and HCV Prevention: At-risk individuals must be allowed access to sterile needles and syringes to support prevention of deadly diseases.

  • HIV and HCV Treatment: Those affected by these diseases should have unrestricted access to infection treatment.

  • Overdose Prevention:  At-risk individuals should be exposed to education about risk of an overdose and the importance of emergency assistance, as well as have increased access to naloxone (recovery) treatment.

  • Provider Education, Capacity and Expertise: This includes various approaches to chronic pain management and increased access to “high quality, culturally competent and client centered services” to help serve substance abuse patients.

  • Sustained Support for People in Recovery: Recovering addicts should participate in formal after-care support, including 12-step programs or more informal family and friend support can aid the lifelong recovery process.

  • Active Engagement of People with Substance Use Disorders: Policy and program decisions should include the experts about substance abuse - the individuals that struggle with addiction themselves.

  • Strong Public and Private Insurance Protections: While the Affordable Care Act has increased access to Medicaid and private insurance, it must begin to recognize mental health and substance abuse disorders.

 

For Local Health Departments, a plan to effectively address the opioid epidemic must include a plan for funding. An essential way to bring in funding to support the rise in substance abuse on the local level is to maximize existing revenue, as well as generate new ways to achieve it.

Learn more about our comprehensive, step-by-step plan to increase revenue in your LHD by downloading a preview of our Revenue Cycle Playbook. To review the playbook in its entirety, schedule a meeting with one of our public health billing experts.