Substance abuse is linked to several chronic illnesses, including heart disease, cancer, and in some cases, infectious diseases like HIV and AIDS. According to the National Center on Addiction and Substance Abuse (CASA), addiction-related illness is accountable for one-third of in-patient hospital costs.
Despite this startling statistic, only 3000 doctors out of the million practicing in the United States have taken training for addiction treatment— a disappointing prospect when you consider the origins of the opioid crisis.
Healthcare practitioners have a responsibility to push past biases and barriers to offer quality care to those experiencing substance abuse. Here are some practical tips for supporting patients facing addiction.
Treating patients with addictive tendencies doesn't necessitate directly treating their addiction. Rather, healthcare professionals should take the time to create a resource referral network for addiction treatment.
Research the local programs for alcohol and narcotic addiction treatment. Touch base with coordinators and get copies of literature to share with patients. Connect with local rehabilitation centers, AA meeting coordinators, MAT doctors, and other professionals in the treatment space.
One in five people facing addiction doesn’t know where to go for help. This should be a bare minimum for healthcare providers. Knowing where your patients should go if they need help is the first step in providing adequate medical care.
Many healthcare providers don't even know what to look for when it comes to addiction, beyond monitoring opioid consumption and doctor shopping. However, there are several signs that indicate when someone is struggling with substance abuse, whether related to alcohol, narcotics, or some combination of the two.
Some key identifiers include:
- significant behavior changes
- significant weight loss
- changes in appearance and hygiene
- frequent illness
- frequent injuries
In addition to looking for drug-seeking behaviors and significant health changes, medical professionals should also advocate for a centralized patient tracking system as well. While innovations have created incredible advances in patient and prescription tracking technology, enrolling in these programs is a choice. As such, many practices forgo the upfront expenses of changing systems leaving gaps in the quality and consistency of care.
Making time to review the latest research and journals on treating addiction can be incredibly informative. Furthermore, taking continued education on trauma-informed care and psychiatry can be invaluable when practicing in an area with elevated addiction rates.
In addition to formal education options, you can also explore additional experience through the referral network you put together. Ask to meet with different professionals in addiction treatment to ask questions and learn about their role in the recovery process. Ask what challenges they face when dealing with healthcare professionals and what recommendations they can provide for improvement.
If appropriate, consider scheduling a job shadowing day to gain some first-person experience in the world of addiction treatment. Confirm the feasibility with your network and local regulatory bodies.
It's also valuable to explore continuing education surrounding health inequities and challenges faced by marginalized groups. These learnings can lead to a better understanding and empathy when dealing with those facing addictions.
There's still a lot of bias surrounding addictions— especially in the medical world. Many healthcare providers feel jaded by negative experiences and struggle to unlearn their inherent biases. Yet, this is necessary for one of the most important skills when working with people facing addiction: compassionate care and active listening.
Ineffective communication is listed as one of the overarching causes of patient harm. Healthcare professionals can avoid unnecessary harm by practicing active listening skills to make patients feel heard and validated.
Some active listening skills include:
- Nodding and affirming as someone speaks to show you're paying attention and following.
- Using validating responses, like "that sounds frustrating" and "I'm sorry you're experiencing that."
- Repeating statements back to them to ensure understanding, such as, "It sounds like you're saying X. Do I have it right?"
- Asking open-ended and expansive questions to get a better understanding of the issues.
- Waiting until they're done speaking before responding.
Active listening and compassionate communication are lost skills for many healthcare practitioners in our fast-paced modern society. Many care providers have set time limits and quotas to meet, which puts the integrity of care at risk. These skills also lead to one of the most important aspects of addiction treatment: trust.
Establishing trust with a patient you believe is facing addiction is paramount for providing quality care. In addition to taking additional education and practicing empathy, you should also let them know the legalities surrounding what they disclose.
In most cases, a medical professional is bound to patient confidentiality. If someone discloses an addiction or illegal activity, that won't be reported unless someone is in immediate danger. Letting your patient know that it's a safe space to talk without fear of judgment or legal recourse is foundational for establishing trust.
It's not enough for the primary care physician in a practice to have addictions training; everyone who comes in contact with patients should have these skills.
Be the voice that advocates for addiction-related training in your practice, whether you're the lead physician or a patient coordinator. Bring forth the research and identify how it will help the practice and the overall patient experience.
As an advocate, you can also work to break the stigma and share information highlighting how addiction is tied to trauma and socioeconomic factors. Consider that when a patient is facing addiction, their family members are navigating it as well. This training will ensure quality care for all people impacted by substance abuse.
Finally, use your education, platform, voice, and privilege to push for policy changes supporting addiction treatment. Legislature like the Opioid Workforce Act promotes reimbursement for physician training in teaching hospitals. The 2019 version of the act proposed 1000 new positions, while the 2021 amendment strives to increase positions by 14,000 over seven years. Supporting these movements and pushing for improvements will help patients now and in the future.
Some of these changes will improve patient care overnight, while others will take years to employ. However, recognizing the gaps and making strides to improve them is a huge win for supporting patients facing addiction.
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