A congressional hearing emphasizes the need to rethink addiction treatment
Despite the fact that a variety of pharmacotherapy and behavioral treatments are effective in treating service members and veterans with substance use disorders, psychologists who spoke at a congressional forum on addiction said that they are less likely to be used than more intensive and expensive options, such as intensive inpatient rehabilitation.
"Very often, less expensive treatments are as beneficial as or more effective" than extensive inpatient interventions, according to Yale University's Kathleen M. Carroll, PhD.
While medications for alcohol, opioid misuse, smoking, and co-morbid psychiatric problems have been tested in veterans and found to be effective, it's important to remember that they're like "Hamburger Helper" in that they're more effective when combined with effective evidence-based behavioral therapies, according to Carroll. The gathering on Capitol Hill in July was supported by a bipartisan group of a dozen senators and members of Congress. Many are co-sponsors of the Comprehensive Addiction and Recovery Act (CARA), which is currently being debated in both chambers of Congress at the time of publication of the Monitor. It calls for up to $80 million in grants to help with prevention and treatment in areas dealing with substance use disorders, a scenario described as a "devastating public health concern and an epidemic across the country" by Sen. Kelly Ayotte (R-NH), who started the conference.
Prescription opioids, according to several speakers, are frequently used as a gateway drug for misusing other substances, particularly among veterans and service members who get them for combat-related ailments. Sen. Sheldon Whitehouse (D-RI), another CARA co-sponsor, stated, "Our veterans return with physical agony." "They return with the stress of multiple deployments. They return to a world where new opioids are widely administered but poorly understood in terms of how they can lead to addiction. When you combine those factors, you get a population that is particularly exposed to the danger of addiction."
More study is needed, according to Daniel Kivlahan, PhD, national mental health program director for addictive disorders at the Veterans Health Administration (VHA), so clinical practice guideline recommendations are founded on strong evidence. Furthermore, he stated that researchers require improved access to existing clinical data on Medicare and Medicaid patients with substance use disorders.
The Veterans Health Administration is boosting up efforts to educate veterans about opioid overdose while also increasing the distribution of naloxone, a medication that can reverse the effects of an accidental opioid overdose. "Nothing is more helpful than veterans assisting veterans engage in change," Kivlahan added, emphasizing the importance of social support in overcoming the stigma of seeking treatment. To that end, the agency is launching a social media campaign to combat substance abuse.