Oregon Substance Use Disorder Research Committee releases recommendations

The Oregon Substance Use Disorder Research Committee (OrSUD) recently released a report on the impact of substance use disorders (SUDs) on Oregon and their recommendations for responding to the state’s SUD crisis. The report focuses on prioritizing prevention over treatment, improving access to treatment, revising physician practices, as well as the importance of treatment over incarceration.

According to the report, approximately 1-in-10 Oregonians suffer from SUD and only 11 percent of those people receive treatment. Last year, approximately 1,500 people died in Oregon from alcohol-related causes, and in 2015, 505 Oregonians died from drug overdoses. The financial cost of SUDs in Oregon is as much as $6 billion every year.

“Untreated SUDs increase health care and criminal justice spending; increase crime and violence; create more need for social services; reduce tax revenue by reducing employability; and devastate communities,” says the report.



To address this costly and destructive problem, in December 2016, the OrSUD came together with the goal of reducing the harm SUDs inflict on Oregonians and recommending policies to improve Oregon’s treatment and prevention programs. The committee reviewed social and medical literature and interviewed 29 witnesses from various fields in SUD research, treatment, and prevention to inform their recommendations.

 

OrSUD’s Key Recommendations:

One of the committee’s key findings is the idea that prevention of SUDs is a far better option than treatment. This notion is reflected in nearly all of their recommendations. According to the report, early childhood interventions are the most cost effective way to combat this crisis.

“Any prevention program that delays first-use of a substance decreases the likelihood of developing SUD. Intervening in the life of a child before development of an SUD, and especially before any exposure to addictive substances, is the most powerful tool to reduce the impact of subsequent SUD on Oregon’s residents and communities.”



Access to quality health care is also necessary. The committee recommends culturally appropriate SUD treatment (which should be covered by every insurance policy), geographically accessible health services, insurance-paid telemedicine options, and an “SUD Hotline” to provide immediate medical assistance. They also request Oregon put in place a dedicated funding pipeline to meet the needs of Oregon’s treatment services.

The OrSUD advised that physicians should be required to prescribe opioids based off of state and national guidelines and that Oregon  should enhance their Prescription Drug Monitoring Program and require all physicians to participate. They also ask for physician leadership from the Oregon Medical Board, Oregon Medical Association and other smaller associations to better train physicians in SUD detection and treatment.

Another recurring thread in the recommendations is that treatment is a better option that incarceration.

“SUD is a disease, not a crime. Incarcerating people with SUD is not an effective tool for prevention, treatment or reduction of social harm. Just as we do not jail people with other chronic diseases, we need a better approach to helping people who suffer from SUD that goes beyond incarceration.”

The committee asks law enforcement to use experimental programs that encourage people with SUD to enter treatment programs rather than the criminal justice system. Examples include the LEAD and “Treatment First” programs. They also ask for improved leadership from the Alcohol and Drug Policy commission as well as physician organizations to take the lead and increase their efforts in addressing SUD in Oregon.

The entire report as well as an op-ed on the report’s findings by Samuel Metz, MD can be found here.