Modern Recovery for a Modern Addiction

By Rich Jones 

CEO, FAVOR GREENVILLE

Governor McMaster’s recent announcement declaring the “opioid crisis” a state of emergency was an important step in addressing the overdose epidemic. Listening to the announcement and reading the press release, at first blush it sounds like the state drug and alcohol commission and state law enforcement will form a coalition to drive the emergency response strategy.

We don’t exactly know what this means in terms of “on the ground” impact. We don’t know how this emergency declaration will play out. FAVOR GREENVILLE, will monitor and weigh in on this from our position in South Carolina and from our position as a national leader in the Recovery Management Movement. We take our advocacy responsibilities seriously. We believe in the potential for this declaration to impact the crisis. We believe that recovering people are part of the solution. We are very grateful for the Governor’s attention in this matter and have every confidence this will result in lives saved.

All that said, we can’t help but offer some unsolicited advice. This crisis is ultimately a demand side issue not a supply side issue. We can not prosecute or arrest our way out of this epidemic. We can’t rely on depressing the supply of prescription narcotics. This will certainly help, however, in the big picture supply side approaches do not significantly improve outcomes.

Instead, we need to fund and focus on demand side interventions. Specifically, we need to push the envelope regarding multiple pathways to recovery. We need a new, innovative response to Opioid Use Disorders. The over-prescription of opioids is part of the problem, however, our antiquated response to opioid use disorders is just as much part of the problem. We cannot focus on limiting access without a plan of attack for those already dependent.

People with Opioid Use Disorders face some unique challenges. We know that this is one of the most intractable and difficult disorders to treat. Patients with opioid use disorder are more likely than the general population to have a host of other health conditions, including hepatitis C, post-traumatic stress disorder, and anxiety making the process more complex and recovery more challenging. Some studies indicate that relapse rates for those who do receive traditional treatment to be as high as 91% with 59% experiencing a recurrence within 1 week of discharge (Smyth, et al, 2010). We also know that 90% of those in need do not even receive treatment (NHSDUH, SAMHSA, 2016). Clearly our approach is not working.

Any discussion surrounding Opioid Use Disorder includes a difficult conversation around our professional response to the disease. We need change. For example, we know that Medication Assisted Treatment is a highly effective approach in terms of reducing mortality. And I hope we can all agree alive is better than dead. Reducing mortality rate is a good thing. “Various studies, including systematic reviews of the research, have found that medication-assisted treatment can cut the all-cause mortality rate among addiction patients by half or more” (Pierce, et al, Addiction, Society for Study of Addiction, 2015).

Why do we still have professional treatment and recovery providers who reject this concept? In today’s culture of overdose, it seems almost criminal for a professional treatment provider to not acknowledge and support this as a viable option in the treatment of Opioid Use Disorders. Perhaps Governor McMasters should use the bully-pulpit of this state emergency to issue an executive order mandating all licensed facilities in South Carolina fall into line with M.A.T. guidelines? M.A.T does not have to be the only option. However, it must be an option. It is a best practice. It is science based. It saves lives.

There is also a need to fund recovery support for these individuals on medication assisted treatment. “Doing recovery” on you own is difficult. It is sometimes hard for individuals on M.A.T. to fit in with traditional recovery groups due to the stigma within the stigma. We need to have people available who can help bridge the gap that exists.

As we approach the end of 2017, the data from 2016 is still not fully tabulated. Many believe the final number of deaths due to overdose could top 70,000. We must get over traditional philosophy surrounding sobriety and first focus on saving lives. This isn’t working.

At FAVOR Greenville we welcome you with open arms if you are on M.A.T. You are in recovery if you say you are in recovery. Please come check us out at 355 Woodruff Road.