Hospitals and healthcare providers are reconstructing the approaches they have taken towards the treatment of addiction and pain when it comes to the opioid crisis. These players in the healthcare sector are implementing new guidelines for prescriptions, creating personalized care systems, and addressing addiction not as a moral failing but as an illness.
According to the inpatient pain services director at the pain medicine division of Mayo Clinic, Dr. Halena Gazelka, this had to be started at almost the same time. Dr. Halena said this during a discussion of a panel in the role of hospitals in addressing the opioid epidemic. The discussion was held during the Healthcare of Tomorrow conference that is held every year.
With the number of people searching ‘does insurance cover rehab’ is increasing, everybody is getting concerned about the current opioid crisis. And, this concern came at almost the same time for the players in the healthcare sector. Thus, there was no specific pattern and no game plan in place for the players to take. Nevertheless, they have all had to come up with one moving forward.
Joining Forces
Gazelka works in Minnesota and was joined by Dr. Alicia Jacobs on this panel. Dr. Alicia is a family medicine physician and clinical operations vice chair at the University of Vermont Medical Center. Christopher Freer, the chairman of the emergency department at Saint Barnabas Medical Center in New Jersey also joined them. On the panel was also Jay Bhatt. This is the chief medical officer and vice president of the American Hospital Association.
These experts came together to address the opioid crisis that has partly been blamed on healthcare providers. Some healthcare providers give patients opioid prescriptions intending to reduce pain following major surgeries or injuries. Some people get opioid prescriptions when dealing with severe pain or chronic pain.
Generally, opioids are considered safe when used to relieve pain. But, they should be taken according to the prescription of a healthcare provider and on for a short period. Unfortunately, some people end up misusing opioids. Prescription opioid misuse has significantly been linked to the current opioid crisis in the U.S. It’s partly the reason why treating dependencies it’s too hard today.
The Approaches
The University of Vermont Medical Center started by changing the mindsets of the physicians as an approach to confronting the opioid crisis. According to Jacob, the bottom line is that this is not easy to do. Experts had to realize that opioid addiction is a relapsing, remitting, chronic disease. And if this is already understood, it can be confronted. For somebody that does not understand it, the condition can be perceived as diabetes that has chronic relapsing. That’s what should be applied to the population too.
To align with the hub-and-spoke system by Vermont for opioid addiction, the providers with an affiliation to the medical center integrated treatment for drug use into different practices. For instance, patient-centered medical homes provide a team approach when it comes to addressing the health issues of a patient and promoting a healthy lifestyle. As such, care is normalized and integrated into the things a person does every day.
To bend the patient’s cost curve answer the question “how to pay for addiction treatment” should be provided and the chronic disease addressed by developing a model that makes leveraging the primary care possible. Essentially, the patient should go to see a specialist with ease.
At the moment, physicians are impressed by the model. They see it as meaningful care that they provide to their clients. Physicians have learned into something they were previously uncomfortable with. They are currently serving communities they underserved completely. And, they can now see some changes. That’s why they consider it meaningful care.
In the meantime, Freer notes that RWJ Barnabas Health facilities like Saint Barnabas Medical Center have integrated programs for a peer recovery specialist. These are now part of the emergency departments of these facilities. Their role is to assist patients that are struggling with addiction or substance use disorders.
The Outcomes
It was observed that patients and staffs were receptive to these specialists that are in long-term recovery from addiction and providing support as well as intervention. According to Freer, this prompted them to spread the services to drug rehab insurance plan too.
Free add that they had a predisposition already when walking in as the providers. That meant saying I don’t have anything for you and I don’t want to be part of this problem, and simply providing a prescription. That’s a negative interaction.
A peer recovery specialist, on the other hand, will listen to a patient talk. They will hear what the patient is going through how he or she compensates expenses in case of chemical addiction and watch them closely beside their bed. This has become a contagious habit for the staff. Thus, it’s become a cultural shift in their rehab centers with rehabilitation insurance plan.
When it comes to the reconstruction of the prescription habits of hospitals, Gazelka noted that Mayo Clinic uses its recommendation for chronic and acute pain prescriptions. These are based on the Centers for Disease Control and Prevention guidelines. However, hurdles still exist because states have different laws that make attempting to treat different types of pain confusing or difficult.
The CDC guidelines for the prescription of opioids for treating chronic pain were aimed to inform care providers about the best ways to monitor their patients while providing opioid therapy. When used properly they are reasonable.
But, the problem comes in when everybody tries something and legislations are passed in different states requiring care providers to prescribe opioids for three days only.
Meanwhile, Bhatt from the American Hospital Association notes that support for individuals with opioid addiction should not stop after a patient has left the hospital and even help them to understand how to compensate chemical dependency treatment.
Final Thoughts
Bhatt notes that the conversation that has been held around social determinants, social needs, stigma, and health equity is not separate from the opioid addiction issues. And, opioid misuse and addiction is an issue that requires combined efforts to tackle. To win the war on opioid addiction, people from different quotas should play a role.
