Jan. 23, 2020
The National Academies of Science. Engineering .Medicine
WASHINGTON — The opioid epidemic in the U.S. is driving a simultaneous epidemic of infectious diseases — including HIV, hepatitis C virus (HCV) and bacterial infections, and sexually transmitted infections — but workforce shortages, stigma, and financial and policy barriers are preventing the integration of opioid use disorder (OUD) and infectious disease services, says a new report from the National Academies of Sciences, Engineering, and Medicine. The report recommends state and federal policy actions, including removing insurance requirements on prescribing medications for OUD (i.e., buprenorphine), expanding access to medications in criminal justice settings, and lifting state bans on syringe service programs.
The rise of infectious diseases related to OUD is attributed to sharing needles, having unprotected sex, and lacking access to medical care, says Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic. Over the past few years, four states hardest hit by the opioid epidemic — Tennessee, Kentucky, Ohio, and West Virginia — have seen a 364 percent increase in acute HCV infections. In rural areas in particular, there is a shortage of providers — including physicians, social workers, therapists, and counselors — available to care for patients in an integrated way.
Methadone clinics, primary care clinics, and jails and prisons see thousands of patients with concurrent OUD and infectious diseases annually, and should be leveraged as integrated care sites, the report says. However, some organizations are unable to provide integrated services because of restrictions on the types of services they can provide. For example, some state Medicaid laws do not allow billing for medical care and behavioral health services on the same day. Other states ban syringe service programs, despite evidence that these programs can link patients to more intensive treatment for OUD and infectious disease as well as prevent new cases of infectious disease.
“Substance and opioid use disorder treatment is already segregated from traditional medical care. Treating OUD and infectious diseases as separate epidemics only reinforces stigma,” said Carlos del Rio, professor of medicine at Emory University School of Medicine and professor of global health at the Rollins School of Public Health of Emory University, and chair of the committee that wrote the report. “The better we integrate services, the sooner we can connect people to diagnosis, treatment, and prevention and achieve successful health outcomes.”
TO CONTINUE READING:http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25626
The National Academies of Science. Engineering .Medicine
WASHINGTON — The opioid epidemic in the U.S. is driving a simultaneous epidemic of infectious diseases — including HIV, hepatitis C virus (HCV) and bacterial infections, and sexually transmitted infections — but workforce shortages, stigma, and financial and policy barriers are preventing the integration of opioid use disorder (OUD) and infectious disease services, says a new report from the National Academies of Sciences, Engineering, and Medicine. The report recommends state and federal policy actions, including removing insurance requirements on prescribing medications for OUD (i.e., buprenorphine), expanding access to medications in criminal justice settings, and lifting state bans on syringe service programs.
The rise of infectious diseases related to OUD is attributed to sharing needles, having unprotected sex, and lacking access to medical care, says Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic. Over the past few years, four states hardest hit by the opioid epidemic — Tennessee, Kentucky, Ohio, and West Virginia — have seen a 364 percent increase in acute HCV infections. In rural areas in particular, there is a shortage of providers — including physicians, social workers, therapists, and counselors — available to care for patients in an integrated way.
Methadone clinics, primary care clinics, and jails and prisons see thousands of patients with concurrent OUD and infectious diseases annually, and should be leveraged as integrated care sites, the report says. However, some organizations are unable to provide integrated services because of restrictions on the types of services they can provide. For example, some state Medicaid laws do not allow billing for medical care and behavioral health services on the same day. Other states ban syringe service programs, despite evidence that these programs can link patients to more intensive treatment for OUD and infectious disease as well as prevent new cases of infectious disease.
“Substance and opioid use disorder treatment is already segregated from traditional medical care. Treating OUD and infectious diseases as separate epidemics only reinforces stigma,” said Carlos del Rio, professor of medicine at Emory University School of Medicine and professor of global health at the Rollins School of Public Health of Emory University, and chair of the committee that wrote the report. “The better we integrate services, the sooner we can connect people to diagnosis, treatment, and prevention and achieve successful health outcomes.”
TO CONTINUE READING:http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25626
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