Q&A: Opioid epidemic: ‘We cannot arrest our way out of this’
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The American Association for the Treatment of Opioid Dependence held its annual conference in Baltimore, from Oct. 30, through Nov. 3.
The event featured more than 1,200 treatment providers who presented the latest news and research on a municipal, state, national and international level, focusing on both policy and clinical findings regarding the treatment of opioid use disorder (OUD).
Healio spoke to AATOD President Mark Parrino, MPA, to gain insight on the events of the conference as well as the major issues facing clinicians on the front lines of OUD treatment.
Healio: What are your thoughts on the milestone of 100,000 deaths in the U.S. attributed to accidental drug overdoses?
Parrino: Passing the milestone of 100,000 deaths has been tragic and frightening. Clearly, the driving force has been fentanyl, which accounts for over 60% of these deaths. It has certainly motivated the current administration and Congress to do what they can to bring these numbers down. Some of the proposals are good in expanding access to comprehensive treatment for opioid use disorder while others are a bit dangerous, including giving doctors outside of the scope of [Opioid Treatment Programs] the ability to prescribe methadone.
Healio: Coming into the conference, what did you see as the major issues facing researchers and clinicians regarding substance use disorders, and specifically opioid use disorder?
Parrino: In preparing for the conference, my associates wanted the clinicians, state officials and researchers to better understand how to treat the use of fentanyl as patients are admitted to treatment. Given the strength of the drug, it is more challenging to stabilize such patients using buprenorphine or methadone. In spite of the fact that methadone is more clinically effective when compared to buprenorphine in treating such patients, the conference presentations were designed to provide updated clinical guidance.
Healio: From which presentations did you come away with a feeling of positivity that those in the field can reverse the trend of OUD and deaths related to it?
The Wednesday plenary session featured a broad number of innovative policy approaches from the state of Maryland. Participants also reflected a sense of optimism in better understanding what our federal and state policies will provide.
Healio: Building on the theme of the conference, how do you think the “power of collaboration” can motivate all academics and professionals who deal with substance abuse issues?
Parrino: The conference made it clear that our treatment system will expand into underserved areas through the expansion of mobile vans connected to [Opioid Treatment Programs] and as we work more collaboratively with our associates in the justice system. Additionally, federal agencies are working more collaboratively in addition to aligning with state policymakers. This was demonstrated as SAMHSA officials met with State Opioid Treatment Authorities. As one of the law enforcement representatives indicated, “we cannot arrest our way out of this epidemic and we need to work with our associates in the treatment sector.”
Healio: What do you think are the hot topics or major issues that need more attention, in order to improve OUD outcomes?
Parrino: Moving forward, federal and state agencies need to provide increased funding to expand opioid treatment programs. There needs to be continued and consistent encouragement to increase access to treatment in the justice system through correctional settings and drug courts.
There also needs to be a national public education campaign to explain how our citizens better understand the dangers associated with opioid use. Part of this campaign needs to explain the vital part that medications play in treating this disorder including methadone, buprenorphine and naltrexone.