We must treat opioids as a war without a truce

I am encouraged that this region will be serviced by one of the planned hubs for opioid care.

Referrals will be no problem, we will have plenty of them. The care issues challenging the coordinator will be the serious and varied. Finding and hiring of staff will need to be done carefully.

From what I have observed of the current situation, there is inadequate staffing of centers. There is a documented need to raise the salary level of those currently in the system. Further, that raise from the current levels should be advertised to the new hires for the hubs.

Any treatment plan should begin with the service coordinator doing a comprehensive evaluation of the client. Referral for clinical counseling and remediation should be based on documentation not a guess as to what the client needs. Family and community influences should be taken into account when making the individual’s plan.

No one can predict the specifics of each patient’s addiction. We can predict with some certainty what addiction counselors need. They need to be able to apply their skills in a variety of settings. They need to be open to new strategies in response to the changing needs of their clients. The hub should have access to accepted models of treatment. They should have a consulting relationship with a pharmacist who is aware of current drugs being distributed. The hub should be prepared to provide behavioral self-control training, psychotherapy and have a plan to address relapses. A clear-cut policy for communicating with state and federal agencies needs to be in place. HIPPA rules guiding ethical standards related to confidentiality must be understood by all staff.

Further, part of any plan must be continuing assessment. Techniques of outreach, follow-up and after-care must be in place. Engaging family and significant others should be a part of the ongoing recovery process.

In closing, we must treat this as a war without a truce. In other words, we must win. We have already tried accommodation and it hasn’t worked. The funding must respond to the continuing needs. It should start by being adequately funded and continuing the same way into the future. Need should guide the funding, not a committee.

That said, there should be a local willingness to comply with guidelines from on high. There should be credible research on alternative pain medication prescribing that can be shared with local physicians. For instance, a non-narcotic drug called Eparel may have some application in both prevention and cure programs.

I wish the hubs well. Let the work begin in earnest on this most odious problem affecting our communities.

Bill Dawson

Northfield