Currently in the United States of America, treatment capacity in alcohol treatment and drug treatment is not keeping up with the growing number of people who need alcohol and drug treatment. There are not enough doctors to treat all the patients that are struggling with the opioid epidemic (Heroin, Fentanyl, Painkillers), alcohol, and other drugs of abuse. This problem has been ongoing, but severely negatively affected by the Covid-19 pandemic. Alcohol and drug addiction, or substance use disorder, has become much harder to treat during Covid-19 because medical attention and group therapy are both part of the usual process of recovery from alcohol and drug use disorders, and both normally involve close human contact. Depression and anxiety have both been far more prevalent during Covid-19 than before the pandemic, and are risk factors for alcohol and drug abuse and addiction, meaning they can cause and coincide with alcohol and drug addiction.
A Study on Nurse-led Addiction Care
An innovative and cost-effective approach is being experimented with successfully in Sydney, Australia, led by Melise Ammit and Nick Miles, two addiction specialists in the Northern Sydney Local Health District in Australia. They believe that nurse-led alcohol treatment is working. I would like to see the wider implementation of all types of medically supervised addiction treatment, including continuing current programs without the need for a doctor to be on hand every day. In their research for this study, they found literature and existing work on this subject was non-existent, but their idea makes perfect sense to me. Nurses and Nurse Practitioners are treating patients with substance use disorder in emergency rooms every day, and many nurses and nurse practitioners already specialize in alcohol and drug addiction treatment. Looking at the success of an addiction program in a suburb of Sydney goes a long way towards showing that something similar might work for both alcohol treatment and the treatment of drug addiction in other places, in my opinion. As just one example, alcohol treatment in Florida and the treatment capacity and open beds necessary for it, are both lacking right now as we try to deal with Covid-19 in the health system, so opening more access could help us solve that pressing matter.
The Failure in Treatment Capacity
In Florida and other states in the USA, people with drug and alcohol use disorders are being turned away from recovery programs because of staffing problems and other problems directly linked to Covid-19. Anything that can help with these problems immediately should be a welcome idea here in the United States. The aims of the authors of the North Sydney study, in their own words, were to “reduce harms from alcohol use” and “minimize barriers in accessing alcohol withdrawal treatment.” In many American health systems and hospital networks, the need to have a doctor on hand at all times has strained access to care and the number of patients that can be treated daily for drug and alcohol withdrawal. Doctors are always needed for other serious health ailments, even without a Covid-19 pandemic happening, so increasing access to addiction and substance abuse care by using nurses and nurse practitioners slightly differently and taking the pressure off doctors will help health systems and hospitals for various reasons moving forward.
The Fentanyl Effect and the Pandemic Effect
Until more urgency and attention are focused on addiction, recovery, and alcohol and drug withdrawal treatment, this will become more of a burden and ruin more lives. Fentanyl is much cheaper to produce than Heroin, and it is stronger, more addictive, and more deadly. The new Covid-19 pandemic of the last few years, and the depression and anxiety that have come with it, have pushed people to drink more, use more drugs, and need more doctors. One problem that health providers are currently dealing with is the street-level replacement of heroin with fentanyl and its derivatives. If we do not make changes necessary to help get people off street drugs, we will face a whole new set of problems that are caused by the switch from widespread heroin use to widespread fentanyl use, even though users themselves may still think they are buying heroin.
Health systems around the world are being pushed to the breaking point, and drug and alcohol treatment is something that does not go away when left untreated. It has already been demonstrated by multiple scientific studies that drug and alcohol use disorders have gotten more prevalent in 2020 and 2021 compared to prior years. It might be an appropriate time to look at solving ongoing capacity issues in our drug and alcohol withdrawal treatment system in Florida and the wider American health system. Here is one other big way the North Sydney District Health Study could help us here in the US now: According to the authors “Patients are able to self-refer to the clinic – a GP referral is not required – and the nurse who answers the initial phone call can advise on appropriate treatment options and make referrals”, this would help eliminate barriers to care, many people go to their doctor when they need health services, but others might be able to pick up a phone and find drug and alcohol treatment more easily. They are saying this model helps in both ways. Doctors and people who work in large health organizations should take special note of that referral difference, it is not the same in the United States, but we use a similar referral model.
The place that I work, Florida Springs Wellness and Recovery Center in Panama City, Florida uses medically-based detox, which is effective for many people as the first step towards sobriety, but we cannot currently find beds for all the people who need alcohol treatment in Florida. During Covid-19, traditional alcohol treatment, and traditional drug use disorder treatments have gotten extremely complicated, as close human contact has been limited as much as possible. We would have liked to be able to help more patients before Covid-19, and now it is getting harder each day to safely treat each patient individually. That’s where Nurse-led approaches in alcohol and drug treatment can help right away. There are many more nurses in this country right now than doctors, and many have already had experience treating patients with alcohol and drug abuse disorders because people with alcohol problems or drug use problems are much more likely to have repeated trips to the hospital from the side effects of alcohol and drugs, and the terrible sickness that comes from withdrawal from both alcohol and many other drugs, especially Opioids like heroin or pain pills. I will have another story about this study tomorrow, because this could be a breakthrough for some major problems in our health system if the right people hear about this.
If you or a family member needs alcohol treatment in Florida or the surrounding area We Can Help, or if you need treatment for drug addiction in Florida or anywhere near the panhandle region We Can Help, please call us today to speak with a counselor.
by T.A. Cannon (Contact me at TACannonWriting@gmail.com)
“Nurse-led alcohol clinic: Increasing access to drug & alcohol treatment” by Melise Ammit and Nick Miles