2021 in Addiction Recovery Medicine: Part 1

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“Things do not change; we change” (Henry D. Thoreau).

For the final article of this year, I want to start with a conclusion that many experts in the field of addiction agree upon, which is also pointed out in the conclusion of the research I used for today. “The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries.” With that knowledge, and understanding that Covid-19 has rocked our medical system and killed thousands, could there be a more appropriate moment to improve on things that we have been doing the same way for many years? I submit to my readers an expert look at 2020 and the challenges we will face in 2021 in addiction medicine. 

Some of the most important experts and researchers in the field of substance use disorder medicine have released a ground-breaking study on what the post-Covid-19 era will look like for the substance use disorder treatment field. They have laid out seven pillars of future success that the entire industry can measure itself by. All seven of these pillars are vital areas of need that we have talked about before on this website, but starting today we will look at these final reactions to 2020, and dig into the larger discussion about positive changes that need to take place in substance abuse treatment. The seven pillars that were chosen by the experts are as follows: (1) Telemedicine and digital solutions, (2) at-home hospitalization and care, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promoting paid work for people in treatment, after-care, and recovery, and finally (7) integration of addiction care.

One reason I am so excited about this article and the chance to discuss this study is that many of these pillars call to mind important discussions that we have had earlier in 2020. Just to bring up a few examples of this, telemedicine is number one on the list. The best drug rehabilitation and treatment center in Florida is Florida Springs Wellness and Recovery, and many times we have discussed our medical director Dr. Raymond Pomm and his history of advancing the cause of telemedicine. More recently, we discussed the issue of people in treatment being asked to work for little or no pay. If that practice goes away in 2021 that would be fabulous, but we can see that up and down this list of seven pillars we have pressing topics to discuss and changes that need to be made going forward. It has now been reported by NPR that 2020 was the deadliest year ever for people with substance use disorder, due to things like overdose and suicide. We can only change that horrible escalation in death and destruction by understanding the weaknesses in what we are doing and improving on the things we understand more fully today. I included the quote from Henry David Thoreau because I thought it was an important point for our purposes, but it was the authors of the study who first used it in the beginning of their studies’ background section, so all credit to them. Let us now discuss a few of the first pillars, and we can pick back up tomorrow wherever we leave off. 

Telemedicine has been a huge part of 2020, even though no one could have guessed that would be the case. In addiction medicine, however, there were signs that things should head in this direction. People often travel very far or devote a month or more of their time to inpatient drug and alcohol rehab. Many times, if people are taking off from work and family responsibilities, telemedicine is a useful option for continuing care. We also know that telemedicine can make things more affordable as well as more accessible, and accessibility will remain a challenge in substance use disorder treatment for the foreseeable future. Luckily, telemedicine is one area where the shift has begun during Covid-19, and we can imagine more people will be getting comfortable and acclimated to telemedicine in the future so that we can all benefit from this new status quo. There will be challenges that medical professionals face when treating patients from a distance, but the benefits should outweigh the difficulties in the long term. 

The next item on their list is at-home hospitalization. I had to do more research on this pillar compared to the others. I was not completely familiar with this idea and its relationship to substance abuse treatment. The authors state the following, 

“Active healthcare treatment in the patient’s home (home hospitalization) is an alternative to inpatient treatment that has shown a reduction in readmissions, improvement of patient’s satisfaction, and reduction of hospital length of stay, with little or no differences in mortality for many medical conditions.”

They go on to discuss that the research of this approach for addiction and mental health services is limited. With that being the case, we should commit our industry to some fact-finding initiatives on this topic. There are highly likely situations where at-home health care could make more sense, and I can imagine disabled people who get up every morning and go to a treatment center; those individuals and many others could benefit greatly from improved at-home options in the recovery industry. As always, if you or a loved one is suffering from substance use disorder in this difficult time, one of the best drug rehabs in Florida or anywhere else is our inpatient and outpatient facility in Panama City, Florida, and we await your call. I will continue with the other 5 pillars and more thoughts on what lies ahead for our industry tomorrow.

By T.A. Cannon (Contact me at TACannonWriting@gmail.com)

 

References

LÓPEZ-PELAYO, H. et al. “The post-COVID era”: challenges in the treatment of substance use disorder (SUD) after the pandemic. BMC medicine, [s. l.], v. 18, n. 1, p. 241, 2020. DOI 10.1186/s12916-020-01693-9. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=32731868&authtype=geo&geocustid=s8475741&site=ehost-live&scope=site. Acesso em: 30 dez. 2020.