When it comes to treating opioid addiction, conventional health care, even in a large system, just doesn't cut it. Specialized treatment can mean the difference between life and death.
That's according to a Forbes article on the state of the opioid epidemic, and the disturbing findings of a study published in the Journal of Addiction Medicine: If opioid addicts are treated like they are conventional patients in a general health care setting, they're actually 10 times more likely to die in four years than are other types of patients.
With the epidemic far outstripping the capacity of available addiction treatment systems, many opioid addicts end up being treated in conventional facilities such as regular hospitals and clinics, by non-specialists in the area such as primary care physicians. And that isn't working.
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"The high rates of death among patients with opioid use disorder in a general health care system reported in this study suggest we need strategies to improve detection and treatment of this disorder in primary care settings," says lead study author Yih-Ing Hser, professor of psychiatry and behavioral sciences at the David Geffen School of Medicine at UCLA, in the report.
The high mortality rate is due in part to a higher rate of disease infection. Opioid addicts, in particular those who have been so for longer periods of time, are subject with greater frequency to such ailments as hepatitis C and other liver diseases; cardiovascular disease; and even some cancers. They are also particularly susceptible to serious health issues from abuse of other substances, including alcohol, tobacco and cocaine.
The study points out that traditionally, opioid abuse has been treated "in specialty addiction treatment clinics such as methadone treatment programs, isolated from the primary health care system or general medical settings."
However, in the wake of the passage of the Federal Mental Health Parity and Addiction Equity Act and Affordable Care Act, it's been possible to expand treatment into primary care. Given the study's results, however, that has not proved effective.
The study also says that "studies have shown that most primary care physicians feel they do not have the education, training, resources or time to diagnose and treat patients with SUDs [substance use disorders]." In addition, the study adds, "many physicians do not fully appreciate the mortality risks to their patients."
In a statement, Hser said, "The findings were surprising because one would potentially expect better healthcare outcomes for patients being served by a large health care system," adding, "Late identification of opioid use disorder and lack of addiction treatment could contribute to these high rates of serious health conditions and death."
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