A new project aims to stem the United States' quickly escalating heroin crisis by educating primary care physicians on how to better treat pain on the premise that even unintentional prescription painkiller abuse can lead to addiction. Medical experts say inconsistent, ill-informed treatment plans have fanned the flames of the burgeoning epidemic.
The Weitzman Quality Institute is partnering with New Mexico-based Project ECHO, which regularly connects doctors, often in poor or underserved areas, with specialized physicians from around the country. The specialists communicate with the general practitioners via video conferencing, to co-manage cases and provide mentoring and professional support. The doctors involved in this particular collaboration will consult specifically on how best to provide patients suffering from chronic and episodic pain with optimal care without putting them at risk of addiction.
As we have previously discussed on this blog, recent analysis in the journal JAMA Psychiatry revealed a substantial shift in the profile of the average heroin addict. Researchers found that the typical user is now a white, 20-something man or woman who lives in the suburbs and began using after developing a dependence on prescription painkillers. Lead researcher Theodore Cicero told The National Journal that when the prescription opioid supply decreased over time, the price rose. Those who were addicted to painkillers looked elsewhere for their high, often turning to heroin. He and his colleagues found that 75 percent of today's heroin abusers developed their habits after becoming addicted to prescription drugs. Compare that number to corresponding research from the 1960s, which found that at the time 80 percent of addicts had started their habit with heroin.
The new program is hoping to prevent more people from becoming addicted to opioid painkillers and, in turn, dependent on heroin. The physicians involved in the project say they welcome the opportunity to learn how to manage patients' pain, according to the Asbury Park Press (APP), a New Jersey media outlet. The director of the Weitzman Quality Institute, Dr. Daren Anderson, says that while medical professionals did not directly create the heroin addiction sweeping the nation, they did exacerbate it. He says that general care providers like himself received very little pain management training in medical residency, and have limited opportunities for continuing education once practicing.
A $400,000 grant from The Nicholson Foundation is powering the partnership. The foundation's director for healthcare integration, Raquel Mazon Jeffers, says one of her organization's goals is to help knock down the artificial boundary between physical and mental healthcare.
"A lot of chronic conditions, in order to be managed well, require behavior change," she told APP. "Behavior change is hand-to-hand combat, and you need educated professionals whose job it is to help people change their behavior."
Since Dr. M.K. (Khal) El-Yousef founded Fairwinds Treatment Center in 1989, he has strongly believed that physical health and mental wellbeing are inextricably linked. At the time, very few addiction treatment centers identified or addressed patients' underlying psychological issues. The behavioral changes to which Mazon Jeffers refers must be triggered by profound shifts in mental and emotional health, or they will not prove sustainable.
Fairwinds Treatment Center's dual diagnosis treatment plan is designed to help patients recover from alcoholism, drug addiction and eating disorders while also addressing any other underlying mental, emotional and psychological issues. Too often conditions that contribute to addiction, like depression, anxiety and bipolar disorder, go undiagnosed. Dual diagnosis treatment combines therapeutic counseling with clinical treatment plans, treating the patient as a whole, allowing for lasting recovery.