Research tests benefits of matching addiction patients to treatment options

When it comes to gender, alcohol and drug abuse are not equal-opportunity afflictions. Men are more likely than women to use almost all types of illegal drugs, and they are more likely to end up in emergency rooms or dying as a result of overdose, according to the National Institute on Drug Abuse.

Men also have higher rates of use or dependence on alcohol than do women and men are three times as likely as women to die as a consequence of alcohol abuse, according to the National Center for Drug Abuse Statistics. That makes this a crucial topic when it comes to men’s health.

Addiction and drug abuse cost the U.S. economy more than $700 billion a year in health care costs, lost productivity and crime, according to the NIDA.

But the more profound costs, realized in ravaged lives and destroyed families, can’t be measured. Excessive alcohol use is responsible for more than 95,000 deaths in the United States annually, according to the U.S. Centers for Disease Control and Prevention. For the 12 months ending in May 2020, more than 81,000 people died from a drug overdose, the highest number ever recorded in a 12-month period, according to the CDC.

Addiction results in job loss, domestic abuse, family breakups and homelessness. It also plays a role in the spread of infectious diseases such as hepatitis and HIV/AIDS. Research that improves treatment outcomes holds the promise of reducing this suffering.

While it may begin with a voluntary act of consumption, addiction develops into a chronic brain disease that causes an individual to crave and use a drug or drugs despite devastating life consequences. Research suggests that at least half of a person’s susceptibility to alcohol or drug addiction can be linked to genetics, according NIDA. Environmental conditions, mental illness or trauma also play a role.

Addiction is a disease that can be treated, but treatment is not simple or widely accessed. Among people aged 12 and older, 21.6 million people needed substance use treatment in 2019, but only 4.2 million received treatment of any kind, according to figures from the 2019 National Survey on Drug Use and Health.  About one-third of patients who begin treatment don’t complete it.

Treatment options for people suffering from addiction include behavioral counseling, medication, and treatment of related mental health issues such as anxiety or depression. Long-term follow up to prevent relapse is important. A tailored treatment program and follow-up are crucial to success, according to the NIDA.

Because different treatments work more effectively for some patients than others, the American Society of Addiction Medicine, or ASAM, created criteria for matching patients to treatment based on their specific needs. The criteria include substance use, physical and mental health, readiness to change behaviors, chance for relapse, and recovery setting. Patients are asked questions about each of these topics.

Funded by a grant from Patient-Centered Outcomes Research Institute, RTI International, a nonprofit organization headquartered in the Research Triangle Park in North Carolina, is studying how use of the ASAM criteria affects communication between patient and provider, retention in treatment and treatment success after one year.  Because addiction treatment programs have shifted from in-person care to telehealth during the COVID-19 pandemic, the study has been enhanced to assess the effect of telehealth on treatment.

The study is designed to track patients who are Medicaid recipients in California, where some counties require clinicians who treat addiction to use the ASAM criteria to match patients to treatment and other counties do not.

When the study is complete in 2022, it will provide policy makers, healthcare administrators, insurers and clinicians with more insight about how to best help patients with substance abuse get the treatment that works best for them.

Addiction robs it’s victims of their health, their relationships, their livelihoods, virtually everything of value. Treatment offers sufferers hope for a better life. This and other research that helps health care providers figure out how to make treatment more available and more targeted is critical to achieving healthier individuals and communities.

Photo by Volodymyr Hryshchenko on Unsplash

Joy Franklin

View posts by Joy Franklin
Joy Franklin is a freelance writer and former newspaper reporter and editor. She is the author of "La Capilla de Santa Maria: A Spiritual Tapestry."

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