This toolkit is meant to assist state legislators (and others) concerned with addressing the opioid epidemic within the U.S. The toolkit was collectively developed by HealthyWomen and the Authorized Motion Middle and is partially primarily based upon a presentation we made at a Girls in Authorities Convention in June 2018.
The opioid epidemic has many elements and causes. To deal with it requires a number of approaches and collaborations. Every area, state and neighborhood should take into account its personal state of affairs in creating and implementing plans and actions. This instrument equipment is meant to help these efforts; the instrument equipment is organized into the next sections:
Dispelling Stigma
Access to Treatment
Affordability
Data to Focus Efforts
Collaborations
Ensuring Adequate Pain Management
Resources
For views on the opioid epidemic from HealthyWomen and the Authorized Motion Middle, these hyperlinks supply a broad vary of data:
HealthyWomen’s Policy Center page about Opioids Use Disorder & Treatment
For extra info or so as to add sources, contact us: [email protected]
Dispelling Stigma
Dispelling the stigma of opioid use dysfunction (OUD) is a major motion for confronting a neighborhood’s issues arising from the opioid epidemic. Understanding and speaking that OUD is a medical situation, like diabetes or melancholy, is a primary step in the direction of complete and built-in options that embrace medical, social and authorized elements. Such built-in approaches can result in actual progress for people, households and communities. Like most ailments, OUD impacts all populations and communities. Its vast impression should even be acknowledged as a part of the method of dispelling the stigma and misconceptions about OUD.
Confront the stigma and misconceptions of OUD:
- Check with OUD as a medical situation or illness quite than casting it as any sort of private or ethical failing or weak spot. (Telling tales about completely different people and the way they skilled OUD may also help make that time.)
- Keep away from the phrases “addict” or “dependancy.”
- Evaluate OUD to different ailments comparable to diabetes, melancholy or arthritis – all of that are organic circumstances that may be handled medically, as can OUD.
Assets to assist dispel the stigma of OUD:
- Legal Action Center: Myths & Facts about MAT
- Seven myths about Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD) – National Behavioral Council
- “Drugs, Brains, and Behavior: The Science of Addiction” National Institute of Drug Abuse [Editorial Note: The terms addiction and abuse are no longer favored, rather the term opioid abuse disorder is the preferred phrase.]
- “Confronting the Stigma of Opioid Use Disorder—and Its Treatment,” JAMA, April 9, 2014.
- “The Burden of Opioid-Related Mortality in the United States,” JAMA, June 1, 2018.
- “Where have all the workers gone? An inquiry into the decline of the U.S. labor force participation rate,” Brookings, September 7, 2017.
Entry to Remedy
Entry to Remedy for OUD is a serious barrier in lots of communities. Lack of entry to remedy for OUD leaves individuals and communities with fewer alternatives for stopping or overcoming the impression of OUD, comparable to:
- An infection with ailments comparable to HIV or hepatitis C and demise
- Workforce and financial issues as a result of individuals who can’t get handled for OUD could not have the ability to discover or maintain jobs
- Strains on native legislation enforcement, first responders, and emergency medical companies.
Increasing entry to remedy usually is a major purpose for a lot of communities. Doing so requires recognizing that there are profitable remedy choices for OUD that permits individuals to work and reside regular lives whereas managing their OUD.
Growing entry to OUD remedy embrace:
- Working to scale back obstacles for clinicians to offer remedy assisted remedy (MAT) by eradicating laws that restrict the variety of sufferers they serve, selling care coordination fashions comparable to “hub and spoke” and different actions that make it simpler for sufferers to see certified clinicians and for these clinicians to deal with extra sufferers.
- Growing reimbursement for clinicians to offer remedy for OUD.
- Increasing funding for public well being entry factors for MAT.
- Implementing present legal guidelines and laws that require remedy parity between psychological well being and substance use problems and different power diseases.
- Selling coordination throughout authorities and personal sector teams concerned in well being care, public well being, first responders and the judicial system Remedy for OUD is simpler and cheaper than incarceration, e.g., $4,000 versus $23,000 per yr in response to a 2011 examine.
Assets to assist clarify the worth of remedy for OUD and find out how to enhance entry:
Affordability
Affordability can be a serious OUD remedy barrier for sufferers. As with different critical medical issues like diabetes and melancholy, excessive co-payments or deductibles can create monetary hurdles stopping individuals from getting remedy for his or her OUD, which suggests they’re basically denied remedy.
Addressing affordability obstacles for individuals with OUD consists of:
- Making certain the state’s Medicaid program and the medical health insurance for state workers covers OUD therapies with minimal cost-sharing.
- Implementing state legal guidelines that require all insurance coverage – together with short-term well being plans – to cowl therapies for OUD, and for that insurance coverage to have parity in protection and affordability with therapies for different circumstances.
- Confronting the stigma of OUD to help people to hunt remedy and encourage employers to rent individuals with OUD who’re in remedy.
- Selling cooperation and programmatic alignment amongst corrections and dependancy remedy suppliers to enhance well being outcomes and cut back prices.
Assets to enhance affordability of remedy for OUD:
Knowledge
to Focus Efforts
Knowledge to Focus Efforts is Important. Knowledge helps focus and information the deployment of sources for remedy packages, public well being and first responders – notably associated to outbreaks of latest and probably lethal types of opioids comparable to unlawful fentanyl. Knowledge can be necessary for figuring out if remedy packages and different initiatives are efficient and producing the specified outcomes.
Addressing find out how to enhance the supply and use of information consists of:
- Extra strong use of Prescription Drug Monitoring Programs (PDMPs). (The precise actions will rely on present state legal guidelines and laws associated to PDMPs)
- Legislators ought to use knowledge on opioid misuse and overdoses to tell funding priorities and different choice making.
- Constant knowledge reporting ought to be inspired by health workers, hospitals, and first responders. Knowledge ought to be quickly collected and analyzed to allow public well being and others to reply appropriately to the opioid epidemic in every neighborhood.
Assets for creating and utilizing knowledge to deal with opioid issues in a neighborhood:
Collaborations
Collaborations amongst authorities companies and personal organizations is necessary for complete neighborhood and regional responses to the opioid epidemic.
Areas for enhancing collaboration and coordination associated to OUD embrace:
- Coordinate PDMPs
- State legislators can work with their governors and Federal colleagues to help efforts to cease the inflow of unlawful opioids. The inflow of unlawful opioids into the U.S. from different nations is exacerbating our opioid epidemic, with the disaster now being pushed in lots of locations by heroin, fentanyl and different opioids manufactured in different nations and shipped into the U.S. These unlawful opioids will be made into tablets that appears like respectable prescription medicines however could also be way more potent and thus extra harmful.
- Legislators can also work with their colleagues in adjoining states or their area to coordinate and help their knowledge assortment and evaluation efforts by linking to PDMPs. Coordination or linking of PDMPs allows physicians and pharmacists to examine if a affected person has just lately acquired an opioid prescription from one other doctor or pharmacy. States may evaluate or revise the necessities for the way clinicians and pharmacies use PDMPs earlier than writing a prescription for an opioid or allotting the medication to the affected person.
Assets about collaborating on enhancing entry to remedy, affordability, knowledge and different avenues for coordinating packages to help higher remedy for OUD and responses to the opioid epidemic:
Making certain
Sufficient Ache Administration
Making certain enough ache administration for sufferers (for people with and with out OUD), wants thought of, since well-intentioned approaches to the opioid epidemic could limit entry to prescription opioids. These unintended restrictions might depart individuals with terminal diseases (comparable to most cancers), and people with power ache circumstances, with out correct ache administration. A part of the answer for these people is selling higher built-in and multi-modal ache administration approaches that each makes use of opioid medicines (when applicable). Therapies which have been proven to achieve success, comparable to cognitive behavioral remedy (CBT), bodily remedy, acupuncture and different non-pharmacological remedy, should even be thought of.
Exploring how to make sure entry to enough ache therapies is past the scope of this toolkit, however hyperlinks to some sources are offered beneath, and neighborhood leaders ought to seek the advice of with their native specialists as they develop plans and implement initiatives to deal with the opioid epidemic.
Assets about guaranteeing enough ache therapies embrace:
Further Assets
Further sources and background info for neighborhood and legislative leaders to fight the opioid epidemic and enhance remedy for OUD embrace:
