By STEVE SMITHERMAN
Guest Columnist
Substance use and substance use disorder (SUD) have been a growing public health concern over the past decade, both nationally and in Indiana. Data from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics indicates there were an estimated 100,306 overdose fatalities in the U.S. during a 12-month period ending in April 2021, an increase of 28.5 percent from the same period in 2020.
The COVID-19 pandemic played a large role in these increasing rates, as the Indiana Department of Health (IDOH) tells us that from January to December 2020, there was a 41 percent increase in drug overdose deaths compared to the same time period in 2019 in Indiana. Additionally, naloxone, or Narcan, an opioid antagonist designed to reverse an overdose, administrations across the state were 66 percent higher in 2020 compared to the same period in 2019.
September is National Recovery Month, an annual observance to promote and support new evidence-based treatment and recovery practices for substance use. Launched by the Substance Abuse and Mental Health Services Administration (SAMHSA), the month aims to increase public awareness surrounding mental health and addiction recovery.
CareSource, a national nonprofit health plan, recognizes that the process of accessing and completing proper treatment and care for SUD was hindered during the pandemic. Simultaneously, the number of vulnerable Hoosiers within these populations greatly increased as well as the barriers standing in their way of receiving assistance. Because of this, we have partnered with several organizations to better support those facing SUD and are focusing on the steps that should be taken to work towards recovery.
- Educate yourself.
Take the time to educate yourself on the facts surrounding drug use and SUD. Know that addiction is a long-term chronic disease. Seek the best resources available and use those to determine where you can access treatment. Helpful resources include the SAMHSA website, which contains information about substance use, treatment types, treatment locators and more, as well the National Institute on Drug Abuse (NIDA), which leads the nation in offering research on the health aspects of drug use and addiction. We also direct many of our providers to “Know the O Facts,” a guide provided by the state of Indiana and Next Level Recovery that contains important resources, including the addiction hotline and treatment providers in the state.
Additionally, it’s important to educate yourself on the major causes of overdose deaths, like fentanyl, a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. Fentanyl is prevalent in multiple substances and is often added to other drugs because of its extreme potency, making drugs less expensive, more powerful, more addictive and more dangerous, per the CDC.
- Recognize that treatment works, and that Medication Assisted Treatment remains the gold standard treatment for opioids.
One of the most important items we stress at CareSource is that treatment does work. There needs to be active treatment, supportive treatment and recovery management during the course of someone’s treatment plan in order for it to be effective. It also needs to be recognized that detox is important, but detox by itself is not treatment. If you detox without treatment, you risk overdose, as an individual’s tolerance decreases rapidly.
Medication Assisted Treatment (MAT) is the top treatment option for opioid use disorder (OUD) and is considered the gold standard in addiction care. MAT combines behavioral therapy and counseling with medication approved by the Food and Drug Administration (FDA) that provides a holistic or whole-patient approach to dependency. The treatment, regulated by a doctor, allows those with SUD to reduce their cravings and dependency quickly to begin their recovery.
- Focus on the full rehabilitation process.
Good treatment is not only focused on substance use. Rather, a good treatment plan focuses on someone’s mental and physical health as well. We recently partnered with Wayspring, a provider of high-touch care coordination and treatment services for those with SUD, to create a SUD Home program, the first of its kind in Indiana.
The program aims to reduce the burdens and barriers on members throughout the full rehabilitation process by supporting care navigation, establishing people with a primary care provider to detect and manage any current or underlying medical conditions, prioritizing the management of high-risk individuals through in-person behavioral health, primary care and addiction medicine services, and utilizing CareSource’s case management team to ensure the development of an individualized care plan and that members receive assistance with social needs crucial to the rehab process, such as transportation, appointment scheduling and housing. A strong combination of care coordination and focusing on a person’s specific social determinants of health is critical to recovery.
- Obtain a Narcan kit and an emergency preparedness plan.
When an overdose occurs, breathing stops. That’s where the FDA approved medication, naloxone (Narcan), can help. A statewide study of emergency Narcan doses in Massachusetts found that when given the medication, 93 percent of people survived their overdose.
We work with Overdose Lifeline Inc. to provide Indiana schools with emergency medication boxes and emergency preparedness training in the event of an opioid emergency and to connect schools to evidence-based prevention programs. Indiana school districts are permitted to stock Narcan as an emergency medication, but few do. It’s essential to have school staff trained in how to recognize and respond to an overdose emergency. Our goal with the three-year grant with Overdose Lifeline Inc. is to increase the number of Indiana schools who have implemented an Opioid Overdose Emergency Preparedness and Response program by 275 schools by targeting 75 schools in the first year and having 250 school staff members attend the training programs.
- Find a support system in recovery.
To help with your recovery, it’s important to recognize who your support system is, maintain proper nutrition, and work to find a meaningful and fulfilling activity. Keep in mind that substance use disorders are like all chronic conditions and often require repeated episodes of treatment and ongoing maintenance. While it is a long-term process, recovery from SUD is possible.
If you know someone struggling with addiction during this time, CareSource offers care management for members struggling with addiction, which can be accessed at 1-855-475-3163, as well as support through our 24-hour addiction hotline. Call 1-833-674-6437 to reach a care advocate. And finally, consider attending support groups close to home, like Al-Anon, Nar-Anon, the National Alliance on Mental Illness, or Parents of Addicted Loved Ones (PAL) and referring to resources like bewellindiana.com and in.gov/recovery/know-the-facts.
Steve Smitherman serves as the President of CareSource Indiana.