The Treatment Plan approach to addressing the pain opioid epidemic is a comprehensive, multi-stakeholder, and multi-phase roadmap for citizen involvement in their political ecosystem. Our goal is to provide a framework, a platform of sorts, to tackle an epidemic that has claimed many lives, emotional and financial toll, and has assaulted our civil liberties.
The challenge of pain and related opioid use requires a well-formulated, coordinated effort that addresses the complexity of the pain opioid ecosystem* as well as to leverage our understanding of the institutional challenges that must be identified and overcome. We are motivated by and are testing the belief that given the right tools and framework, citizens, patients, consumers, healthcare professionals, public servants, and politicians, working together can achieve great results addressing the pain opioid epidemic and related challenges facing our nation. The treatment plan offers a modular approach that can be easily used to address particular aspects of the pain opioid epidemic. The activist agenda that addresses the identified challenges and powerful barriers that have stymied prior efforts at addressing the medical and social challenges of pain and addiction. The particular items are linked to an action plan for citizen engagement.
The Pain Opioid Epidemic Case Presentation
Treatment Plan
Vision
Establish a vision for the individual, community, nation and the international community
Humanizing the pain- opioid epidemic
Focusing on the individual suffering with pain and addiction, challenge the stigma associated with pain and addiction
Opioid Supply Reduction
Preventing the initiation of inappropriate opioid substance use
Harm Reduction
Preventing and reducing harm associated with opioid use
Eliminating overdose mortality and morbidity.
Social Determinants of the Opioid Epidemic
Pain Management
Appropriate management of pain and the evidence based use of opioids
The War on Drugs
Targeting the challenges associated with the law enforcement-legal approach to the pain-opioid epidemic.
Vision
Establish a vision for optimal pain management and Opioid Use Disorder care for the individual, community and the nation
Goal:
The vision for the pain opioid ecosystem is one where every individual is able to receive the appropriate care they need to manage their pain, where opioid use is treated with compassion and evidence-based practices, where the opioid epidemic is seen as a public health issue rather than a criminal one, and where the community is actively engaged and empowered to be part of the solution.
Our vision:
By September 2023, there is a comprehensive and coordinated system in place that addresses all aspects of the pain opioid ecosystem, including pain management, opioid use disorders, opioid overdoses, public policy, law enforcement, criminal justice, and related challenges.
By September 2023, the healthcare system is designed to prioritize the needs and preferences of patients and their families, rather than the financial interests of pharmaceutical companies, insurance providers, and other stakeholders.
By September 2023, all healthcare professionals are equipped with the knowledge, skills, and resources necessary to provide high-quality, evidence-based care for pain and opioid use conditions.
By September 2023, there is a culture of transparency and accountability in place that holds all stakeholders accountable for their actions and promotes the responsible use of opioids.
By September 2023, the community is engaged and empowered to play an active role in addressing the pain opioid epidemic, including access to information and resources, opportunities for education and training, and opportunities for participation in decision-making.
Humanizing the epidemic
The individual suffering with pain and opioid use disorder
Vision:
By September 2022 the prevailing approach to care reflects the individuality and the humanity of all the people involved in the pain opioid ecosystem.
Goal:
To ensure that patients in pain and those suffering with opioid use disorder are not stigmatized and are treated respectfully as individuals and patients.
Background:
One of the most challenging aspects of the Pain- Opioid Epidemic is the ongoing demonization of people embroiled in the challenge of experiencing acute and chronic physical and emotional pain and individuals dependent on opioids. These are individuals biologically altered by pain/ addiction. It is clear that patients in pain deserve compassionate care just like any other patient physicians treat, and stigmatizing patients who require opioid therapy is often a barrier to optimal treatment.
Opioid Supply Reduction
Preventing the initiation of inappropriate opioid substance use
Vision:
By September 2022 the official approach to opioid use, dependence and addiction is informed by the principles and spirit of public health instead of a criminal justice approach.
Goal:
Primary and secondary prevention of Opioid Use Disorders*: Reducing the supply of non medical opioids and preventing the initiation and misuse of nonmedical opioids.
The Challenge:
How to limit the number of individuals who have access to non medically acquired opioids/ heroin. There are many people who start using opioids in their teens after being introduced to opioids by others as part of “lifestyle” activity. The opioids have been noted to come from friends, families and other sources of legitimate sources. Individuals starting on heroin pose a different challenge. It has been suggested that a sense of hopelessness, alienation and feeling of worthlessness provides a fertile group for initiating and maintaining opioid and other substances.
Preventing and reducing harm associated with opioid use, including eliminating overdose mortality and morbidity associated with opioid use
Vision:
By September 2022 there are no reported deaths due unintentional opioid overdose or recorded cases of disease transmission associated with IV heroin use reported in the US.
Goal:
Provide strategies to eliminate the unintended consequences of opioid use/ abuse in general and preventing and reducing opioid overdose mortality and morbidity
Background:
Opioid overdose and the problems associated with IV drug use continue to be a major public health problem in the United States. It has contributed significantly to accidental deaths among those who use, misuse or abuse illicit and prescription opioids. Overdose now kills more Americans every year than car accidents. This wave of death impacts us all as our communities grieve over the loss of our family members and friends.
Vision:
By September 2022 individuals suffering with Opioid Use Disorders are properly diagnosed at the earliest stage and have access to affordable, evidence based treatment.
Goal:
To provide information, tools and resources to achieve the appropriate diagnosis for individuals suffering with opioid use disorder and to provide an approach to the care journey of the person with opioid dependence that is frictionless, behaviorally informed, simple and appropriate.
Background:
Currently, nearly 2 million people suffer with opioid use disorder, this includes individuals who are dependent on prescription opioids and more than half a million abuse or are dependent on heroin.
Addressing the needs of this population in of great need as they are at greater risk for relapse. Additionally, they can be involved in public awareness initiatives and may be more motivated to take part in efforts to address the substance use epidemic.
Opioid Use Disorder
Best evidence for the effective diagnosis and treatment for individuals suffering with Opioid Use Disorders
Pain Management
Appropriate management of pain and the evidence based use of opioids
Vision:
By September 2022, every individual who experiences pain has access to and is able to receive evidence based, best practice informed treatment that improves their well-being in outcomes that matter for them.
Goal:
The right medication/ treatment for the right patient at the right time, for the right length of time, and the right dose and amount, right monitoring.
The Challenge:
Appropriate pain management and medical use of opioids that alleviates pain and related suffering when indicated: Clinicians are striving for a finer balance that meets the patient’s need for pain relief while minimizing chances for abuse.
Achieve balance between the benefits and risks of the various treatments.
The War on Drugs
Law enforcement-legal aspects of the war on drugs
Vision:
By September 2022 “The War on Drugs” will be officially over globally, nationally, and locally.
Goal:
A criminal justice system that reflects scientific understanding of opioid use and targets criminal elements associated with the pain-opioid epidemic.
Background:
The War on Drugs is an American term commonly applied to a campaign of prohibition of drugs, military aid, and military intervention, with the stated aim being to reduce the illegal drug trade. This initiative includes a set of drug policies that are intended to discourage the production, distribution, and consumption of psychoactive drugs that the participating governments and the UN have made illegal.
Social Determinants of the Opioid Epidemic
The social factors that contribute to the opioid epidemic
Vision:
By September 2026 social, economic, educational, health care disperaties will be addressed.
Goal:
The key to a successful battle against opioid addiction will be prioritizing interventions aimed squarely at environmental risk factors in order to address true impacts that social determinants have on opioid dependent populations, while also continuing efforts begun to address prevention and treatment aimed at the supply side and continuum of care.
Background:
Social determinants such as poor housing conditions are often accompanied by neighborhood-level conditions that limit access to health care, risk-reduction information, and treatment alternatives, which are protective resources and can disrupt behaviors that ultimately lead to opioid addiction.