From AIDS to Opioids — How to Combat an Epidemic

Abstract

n engl j med 375;9 nejm.org September 1, 2016 support to assist with ongoing medical treatment would be can-didates for innovative transitional care programs aimed at support-ing remission of OUD, avoiding reinfection, and reducing costs. The unfortunate case of Mr. M. highlights the fact that the cur-rent approach to hospitalized pa-tients with OUD and infections is far from optimal. Hospitals will have to be part of any com-prehensive plan to address the opioid epidemic. Currently, we are not routinely assessing the sever-ity or treatment needs of the un-derlying OUD, initiating evidence-based treatments, and supporting risk reduction. Though OUD is a complex medical illness amena-ble to treatment, stigma and con-flict unfortunately continue to influence care, frustrate providers, and marginalize patients. The Affordable Care Act man-dates parity between treatment of substance-use disorders and that of other medical illnesses, and the American Board of Medical Spe-cialties now recognizes addiction medicine as a medical subspecial-ty. Since there are not enough trained addiction medicine physi-cians to curb the opioid epidem-ic, we believe education about evidence-based OUD treatment should be expanded to all mem-bers of the care team and inte-grated into standard hospital care. Education coupled with expanded treatment resources can improve patients' experience, increase ad-herence to treatment recommen-dations, and improve health out-comes. It is time to put parity into practice. Disclosure forms provided by the authors are available at NEJM.org.