Surgeon general's report.
The recently released Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs and Health lhttps://addiction.surgeongeneral. gov/) marks an important milestone. It is the firstever Surgeon General's report on this topic and marks a turning point in our nation's understanding of and response to substance misuse.
The report was not issued simply because of the prevalence of substance misuse or even the related devastating harms and costs, but also to help inform policymakers, health care professionals, and the general public about effective, practical, and sustainable strategies to address these problems. These strategies have the potential to substantially reduce substance misuse and related problems, promote early intervention for substance misuse and substance use disorders, and improve the availability of high-quality treatment and recovery support services for persons with substance use disorders.
While prior Surgeon General's reports have discussed substance use disorders in certain contexts, The Surgeon General's Report on Alcohol, Drugs, and Health is the first report to address these disorders and the wider range of health problems and consequences related to alcohol and drug misuse in the United States. Its aim is to galvanize the public, policymakers, and health care systems to make the most of these new opportunities so that the individual and public health consequences associated with alcohol and drug misuse can be addressed effectively. Only by doing so can individuals, their loved ones, and their communities be restored to full health and well-being.
* One of the report's major calls to action is for increased integration of primary care and substance use disorder services. Substance use disorders are strongly intertwined with other medical conditions, making an integrated approach to care essential. Challenges to such integration include insufficient training of health care professionals on how to identify and treat substance use disorders. The data cited in the report speaks volumes: Over 47,055 Americans died from drug overdose in 2014, more than in any previous year on record. Analysis of the 2006-2010 period shows an annual average of 88,000 alcohol attributable deaths in the United States.
* The chapter on prevention in the report highlights extensive scientific research that identifies the issues contributing to substance use risk factors as well as protective factors that encourage reduction of risk. All of us can play a role in preventing substance misuse before it starts and intervening before it leads to tragedy.
* Substance use disorders are one of the nation's most pressing health concerns. One in seven Americans experience an addiction in their lifetime, and even more will misuse substances. Addiction is a chronic disease that puts a person at risk for other illnesses including HIV, cancer, and heart disease. Addiction costs our nation $442 billion annually in health care costs, lost productivity, and criminal justice costs.
The report recommends adopting an evidence-based public health approach, America has the opportunity to take genuinely effective steps to prevent and treat substance-related issues. Such an approach can prevent substance initiation or escalation from use to a disorder, and thus reduce the number of people suffering with addiction; it can shorten the duration of illness for sufferers; and it can reduce the number of substance-related deaths. A public health approach will also reduce collateral damage created by substance misuse, such as infectious disease transmission and motor vehicle crashes. Promoting much wider adoption of appropriate evidence-based prevention, treatment, and recovery strategies needs to be a top public health priority.
HHS takes additional steps to expand access to opioid treatment--November 17, 2016
The U.S. Department of Health and Human Services (HHS) is taking additional steps to address the national opioid epidemic by further expanding access to medication-assisted treatment (MAT) for opioid use disorders.
Administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), today's announcement enables nurse practitioners (NPs) and physician assistants (PAs) to immediately begin taking the 24 hours of required training to prescribe the opioid use disorder treatment, buprenorphine.
NPs and PAs who complete the required training and seek to prescribe buprenorphine for up to 30 patients will be able to apply to do so beginning in early 2017. Previously, only physicians could prescribe buprenorphine. Once NPs and PAs receive their waiver they can begin prescribing buprenorphine immediately.
"Today's action will provide even more access to medication-assisted treatment," said SAMHSA Principal Deputy Administrator Enomoto. "Allowing nurse practitioners and physician assistants to prescribe buprenorphine will greatly expand access to quality, evidence-based treatment methods for those most in need of assistance."
HHS also is announcing its intent to initiate rulemaking to allow NPs and PAs who have prescribed at the 30 patient limit for one year, to apply for a waiver to prescribe buprenorphine for up to 100 patients. HHS hosted a public meeting on October 1, 2016 on the training requirements associated with recent legislative action to expand eligible buprenorphine providers.
All training will be available either at no cost through the SAMHSA-funded Provider's Clinical Support System--Medication Assisted Treatment program or through training programs that may be offered by the American Society of Addiction Medicine, American Academy of Addiction Psychiatry, American Medical Association, American Osteopathic Association, American Nurses Credentialing Center, American Psychiatric Association, American Association of Nurse Practitioners, and American Academy of Physician Assistants.
SAMHSA is working quickly with training providers to help them adapt curricula and obtain continuing education credits for this important training. Updates on training information and the waiver application will be available at http://www. samhsa.gov/medication-assisted-treatment.
SAMHSA finalized a rule in July that expanded access to MAT by allowing practitioners who had a waiver to prescribe buprenorphine for up to 100 patients for a year or more, to now obtain a waiver to treat up to 275 patients. Practitioners are eligible to obtain the waiver if they have additional credentialing in addiction medicine or addiction psychiatry from a specialty medical board and/ or professional society, or practice in a qualified setting as described in the rule. Since the rule was finalized, 2,477 practitioners have applied for and been granted a waiver to prescribe buprenorphine at the increased limit.
The HHS Opioid Initiative is focused on improving opioid prescribing practices; expanding access to medication-assisted treatment (MAT) for opioid use disorder; and increasing the use of naloxone to reverse opioid overdoses. The initiative concentrates on evidence-based strategies that can have the most significant impact on the crisis. But additional funding is necessary to ensure that every American who wants to get treatment for opioid use disorder will have access. Under the President's FY 2017 Budget proposal, states would be eligible for up to $920 million over two years to expand access to treatment. At this time, Congress has not fully funded the budget proposal. Visit https://www.whitehouse.gov/factsheetsprescription-opioid-abuse-and-heroin-use for a state by state breakdown of the President's budget and, if fully funded, the impact it would have on states' ability to further expand access to treatment.
U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.
U.S. Department of Human Services. (n.d.). HHS takes additional steps to expand access to opioid treatment [Press release]. Retrieved December 28, 2016, from https://www.hhs.gov/about/news/2016/11/16/ additional-steps-expand-opioid-treatment.html
* Office of the Surgeon General: https://addiction.surgeongeneral.gov/
* SAMHSA: Medication Assisted Treatment: http://www.samhsa.gov/medicationassisted-treatment
* The SAMHSA-HRSA Center for Integrated Health Solutions Contact: Integration@TheNationalCouncil.org
* The National Council for Behavioral Health: https://www.thenationalcouncil.org
* White House Fact Sheets: https://www.whitehouse.gov/factsheetsprescription-opioid-abuse-and-heroin-use
This column is provided by Peer Assistance Services, Inc. (PAS) with offices in Denver and Grand Junction. PAS provides the Nurses Peer Health Assistance Program through a contract with the Colorado Department of Regulatory Agencies.
For information please call:
Katherine Garcia, MA, MAC, LAC Client Services Manager, Peer Health Assistance Programs Peer Assistance Services, Inc. (303) 369-0039 or email@example.com www.PeerAssistanceServices.org firstname.lastname@example.org
Elizabeth Pace, Peer Assistance CEO
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