Deaths from drugs, alcohol and suicide are skyrocketing — what can we do to respond?

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The rise in deaths from drugs, alcohol, and suicide are now reaching numbers that threaten to desensitize us to their magnitude. In one year alone we saw 142,000 die — which equates to one every four minutes. These numbers are staggering and preventable; however, like many problems our country will face for health care, we have a choice as to how we respond

If we fail to respond, these numbers will likely rise precipitously to as many as 2 million deaths over the coming decade.

{mosads}In a recent report released by the U.S. Centers for Disease Control and Prevention (CDC), emergency departments saw a 30 percent increase in visits for opioid overdose from July 2016 through September 2017.

 

In specific parts of the country, some of these emergency departments saw up to a 70 percent increase in visits. And, in larger cities, opioid overdoses increased by 54 percent across 16 states.  

We need real policy solutions to support those who help people with overdoses. For instance, we must put in place better protocols in the emergency department so doctors and nurses are connecting overdose patients with the appropriate care outside of the hospital so they don’t end up back in an ambulance being rushed to the emergency department.

However, our most powerful intervention from the emergency department cannot be a referral for someone else outside the hospital to follow up. We need better training for providers to ensure they know how to link people directly to the social programs that can help them. But this isn’t enough.

In reality, our immediate response to a crisis is often to do something about the setting or place we see the biggest issue — in this case, the emergency department. But, like too many problems we face in healthcare, our immediate reaction is often a temporary stop gap.

While it is vital that we support programs that help emergency departments deal with overdoses, that’s not enough. That’s a tourniquet after a wound. We need to prevent the wound from ever occurring. To do so, we need a truly integrated healthcare and public health system that can catch these patients before they fall.

The nation needs a National Resilience Strategy that takes a systemic and comprehensive approach by focusing on prevention, early identification of issues and effective treatment.

Specifically, this includes:

1. Improving surveillance to track problems faster and inform and target response activities

This includes drug use patterns, such as identifying trends in prescription drug misuse, heroin, fentanyl and carfentanil increases in communities and related harms such as hepatitis C and HIV.

2. Bolstering the behavioral workforce

We can do this by Incentivizing workforce development initiatives and expanded training and use of community health workers and peer counselor support — and models such as tele-health in many communities and other service delivery model.

3. Better support for evidence-based community prevention programs

These can be scaled and expanded to benefit local areas throughout the country and which support best-practice, multi-sector partnerships that leverage the leadership, expertise and resources within a community to support a comprehensive strategy.

4. Using treatment as prevention

This works by expanding the availability and quality of substance misuse services available that meet recommended, modern standards of care.

5. Developing diversion strategies

This will  provide support and treatment to individuals with substance use disorders that focus on treating addiction as a health and not a criminal issue.

6. Increased focus on early identification of issues and connections to care

There are numerous models and tools for screening for trauma, adverse childhood and family experiences, risk for mental illness, risk for and misuse of drugs and alcohol and risk of suicide.

Quite simply, we should support better integration and coordination across our communities and health-care systems, including public health departments, behavioral health and social services.

Since many factors influence health, systems must support connections to services and case management to ensure people receive the support that is needed and available.

The United States has a major problem. And like many problems, the solution will not be found in one program or one approach, but in a much more thoughtful and systemic solution.

While it might be intricate and winding, there is a path forward.

The resources and expertise needed to prevent more deaths should be provided as soon as possible — and the nation must come together to support a National Resilience Strategy. One person every four minutes. We do not need more data to justify our decision to act — it’s past time.

Benjamin F. Miller, Psy.D. is the chief strategy officer at Well Being Trust. He worked at the Department of Family Medicine at the University of Colorado School of Medicine, where Miller was the founding director of the Eugene S. Farley, Jr. Health Policy Center and currently remains a senior advisor. 

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