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Most of us know the facts. In 2014, 1.9 million people had a substance use disorder linked to prescription pain medications and 586,000 had a substance use disorder involving heroin. In 2014, the Opioid Abuse epidemic deaths in the US jumped to 18,893. The problem continues to worsen. Contributing to the problem, opioid prescriptions have tripled over the last 20 years leading to excessive abuse and addiction. Heroin (an abused opioid related to this epidemic) is now very cheap and a very popular drug and many of all socioeconomic statuses are addicted.
Integrating medical care, mental health, addictions, wellness, mindfulness practices, parent education, child care, reducing violence in homes, criminal justice, and education can be a powerful solution to address the opioid addiction epidemic. An example of an addicted teen might include the fact that the teen has 1) gastrointestinal problems, 2) poor school performance, 3) peers that are also substance abusing, 4) trouble with the law, 5) a substance abusing parent, 6) violence in the home and 7) depression. Going to his pediatrician for his gastro-intestinal problems will not solve any of the other issues, primarily because the youth is unlikely to bring them up with his physician. In many cases, the youth is involved, or about to be involved with other youth serving systems. The healthcare, education, juvenile justice and social services communities often operate without communicating with each other. However, the substance abuse affects all parts of the youth’s life and other factors may be contributing to sustaining the substance abuse. One system must be able to communicate with other systems so that collectively they can all support the youth’s recovery.
SAMHSA states that for a person to experience recovery from opioid and other addictions, he/she must be well in their health, home, community, and purpose. A person needs health in mind, body and soul. He needs a safe and healthy home to live in. He/she must be safe and healthy in their various communities such as neighborhoods, jobs and schools and everyone needs a purpose or reason for living. All of these areas need support for optimal wellness to interrupt a life of addiction. The involvement and support of multiple people and systems in a person’s life are needed to make recovery from addictions work. For example, it is very difficult for a youth to recover if his parents are still addicted and/or neglectful or abusive.
In every area of a person’s life, his community should be able to recognize when he/she needs assistance and support all aspects of behavioral health prevention or recovery. For example, if an employee has 1) poor work performance, 2) excessive lateness and absences, 3) irritability and mood instability, 4) emotional outbursts, and/or 5) odd behavior or appearance, perhaps he/she has a substance abuse or mental health problem. Progressive disciplinary action is not going to solve the more severe problems at work or at school. One must first determine if the problem one that can be solved by progressive counseling measures or is it something more serious. If it is a more serious problem, professional intervention is needed and can be required if there are school or work rule violations.
One might say, “What business is that of mine.” It is your business if the person comes back to your place of business or school with intent to do harm. It is your business if the person is going to cost your business money due to poor performance. If the setting is a school, it your business because you are in charge of the well-being of the children in your care and disciplinary action does not always solve the problem, especially if it is a mental health or substance abuse problem or both. It is your business if your child also goes to that school and the child in question disrupts your child’s learning or safety.
Action Steps:
1. Nothing in HIPAA is intended to interfere with case coordination for optimal care
2. Communication due to danger to self or others is not intended to be blocked by HIPAA.
3. Medical, mental health, and addictions providers can set up systems of communication with other agencies by having signed releases that meet HIPAA requirements
4. Physicians and nurses, juvenile justice programs, and faith communities can ask those they serve about drugs, alcohol, mental health, and family violence as a routine screening. Have a routine referral network to make referrals easily and routinely
5. School personnel can ask questions about substance abuse, mental health, and family violence and make referrals to professional services routine practice.
6. Once referrals are made, treatment plans should include multiple agencies so that all providers can support the person’s recovery.
7. Parents can talk to their schools to make sure that such a system is in place and their children about substance abuse.
8. Communication between agencies can be done electronically and through HIPAA compliant apps to reduce the amount of time needed for coordination and increase the effectiveness of their services.
