The opioid crisis is a severe public health issue. In 2015, over 12 million people in the United States misused prescription opioids and young adults; aged 18-25 are at the highest risk for drug abuse of prescriptions [1].
In October 2017, President Trump announced a new action to address the opioid crisis. This declaration confirms the role of the Department of Health and Human Services (HHS) and the Substance Abuse and Mental health Services Administration (SAMHSA) as leaders in problem-solving this issues.
Dr. Elinore F. McCance-Katz was appointed by President Trump as the first Assistant Secretary for Mental Health and Substance use [2]. The HHS announced strategies for guidance for SAMHSA’s response through the President’s five-point initiative.
These are to improve access to treatment and recovery in hopes for long-term recovery. It also targets the availability and distribution of opiates in hopes to reduce the accessibility of it.
Other areas of this five-point plan include increased research in reporting and collection of information to have more real-time education and response to epidemics nationwide.
The initiatives also hope to support more cutting-edge research to further understand addiction and pain, as well as the development of new treatments.
HHS hopes for advancement in pain management to enable quality evidence-based pain care which can, in turn, reduce the use of opioids.
Five Initiatives of SAMHSA
This five-point initiative is to support and increase the efforts that SAMHSA has implemented within the past year.
One program is the Opioid State Targeted Response grant created by the 21st-Century Cures Act which goal is to increase accesses to evidence-based treatment, reducing opioid overdoses through prevention and education as well as recovery services.
In May of this year, SAMHSA was also awarded $485 million to all 50 states.
An initiative to increase access to Medication-Assisted Treatment (MAT) for opioid use disorders. They are providing training for professionals both online and in-person for MAT. Over 46,000 have participated in this program to-date [2].
In September of this year, SAMHSA was also awarded $4.6 million over the next three years for the Building Communities of Recovery grant and $9.8 million for the new State Pilot Pregnant and Postpartum Women grant.
There are regulatory work and guidance through SAMHSA for nurse practitioners and physician assistants to obtain waivers to prescribe buprenorphine.
As of October this year, 3, 106 nurse practitioners and 806 physician assistants have received the waiver [2].
Grants are also being provided to Prevent Opioid-Related Deaths to train first responders to purchase and distribute naloxone for when responding to opioid overdoses.
Mission of SAMHSA
SAMHSA’s mission to be a leader in public health awareness, reduction of use and resources for those abusing that are evidence-practice treatment.
On the SAMHSA website, they have various resources for professionals, medical providers, and legislation initiatives [3]. There are also resources such as articles, how to apply for prescription limits with patients, and training.
For prescribing physicians, there is an online and toll-free number to access for those who have prescribed over 100 prescriptions in one year to increase to 275.
Health and Human Services Role
Within the Health and Human Services (HHS) for the fiscal year 2017 has invested close to $900 million in opioid-specific funding [4]. This includes not only support to states and local governments but also support for treatment and recovery services.
The HHS has also supported the efforts of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.
In President Trump’s address in October, he also addressed the concern for information sharing with this epidemic.
The HHS Civil Rights office released new guidance on how and when medical providers can share medical information with family, friends, other professionals when a person is in crisis and incapacitated.
HIPAA
Currently, HIPAA, the law that allows your healthcare information to be protected, enables providers to share information about a patient if there is an emergency to self or others, to include homicidal behavior or threat [4].
HIPAA and misunderstanding or miscommunication can create barriers to family and loved ones finding out information that is crucial for care, such as in an opioid overdose.
It can be a critical move for healthcare providers to be able to share this information without violating the HIPAA Privacy Rule.
HHS has also found that research in prescribing of opioid pain medication is a critical factor in the increase of opiate use, abuse, overdose, and death [5].
Activities that are addressing the five-point initiative is to advance national pain care policy, provide clinicians and patients with education and tools to improve pain care, and supporting cutting-edge research to pain.
The National Pain Strategy includes six action areas that are research, prevention, looking at gaps in treatment, service delivery, professional continuing education, and public education.
A pain Management Best Practice Inter-Agency Task Force was created in August 2017 that will identify gaps in pain management, best practices, and offer updates and recommendation to address the opioid crisis [5].
Other initiatives have been for Hospital Consumer Assessment of Healthcare Providers and Systems (SCAHPS) that is tied to hospital reimbursement and potentially aiding in inappropriate opioids.
Medicare and Medicaid in response to this are no longer linked to the HCAHPS pain management scores, producing a positive step forward in clinical practice.
In summary, SAMHSA and HHS are working to address the opioid crisis within the United States through initiatives, grants, and activities that are being rolled-out progressively.
As these initiatives begin to take place, hopefully, we will see a reduction in the amount of opioid overdose and deaths, as well as an increase in access to evidence-based practices.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.
References:
[1] Secretary, H. O., & Assistant Secretary for Public Affairs (ASPA). (2017, October 31). About the Epidemic. Retrieved November 18, 2017, from https://www.hhs.gov/opioids/about-the-epidemic/index.html
[2] B. (2017, October 26). SAMHSA Reaffirms Efforts to Address the Public Health Emergency on the Opioid Crisis. Retrieved November 18, 2017, from https://www.samhsa.gov/newsroom/press-announcements/201710260100
[3] C. (2016, November 22). Medication-Assisted Treatment (MAT). Retrieved November 18, 2017, from https://www.samhsa.gov/medication-assisted-treatment
[4] Secretary, H. O., & Assistant Secretary for Public Affairs (ASPA). (2017, October 30). HHS Opioid News Updates. Retrieved November 18, 2017, from https://www.hhs.gov/about/news/opioid-news/index.html
[5] Singh, V. M., & Jones, C. M. (2017, November 01). Advancing the Practice of Pain Management HHS Opioid Strategy. Retrieved November 18, 2017, from https://www.hhs.gov/blog/2017/11/01/advancing-the-practice-of-pain-management-under-the-hhs-opioid-strategy.html
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
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Published on January 6, 2018
Published on AddictionHope.com