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Focusing On The Family To Confront The Opioid Crisis, Substance Use Disorders

posted by Alicia Caramenico

on October 25, 2018

“I think my son’s opioid addiction is going to kill me before it kills him.”
–  father of a son who recently overdosed and nearly died but engaged in treatment and recovery

“Grief has no expiration date, it hurts all the time.”
– mother commenting on the loss of her son to a drug overdose over five years ago

Not a day goes by without news of the opioid epidemic and its devastating impact in terms of addiction, fatal overdoses, crime, lost productivity, and family pain. One of the greatest adverse consequences is the effect of opioid addiction and other substance use disorders (SUD) on the families and children of those with addiction.

Pain, hurt, anguish, confusion, anxiety, depression, and hopelessness are far too common among adults and children in families with a SUD. These families experience “collateral damage” that is not sufficiently addressed in the nation’s approach to the opioid epidemic.

Interventions focus on the patient, but often overlook the family. To help address this problem, a family-focused approach to addiction is needed among all stakeholders—practitioners, educators, researchers, politicians, policymakers, and others.

It’s a fact that people with SUDs are more likely to enter treatment with encouragement and support from family members. Moreover, family involvement in treatment can help all family members better understand the disease of addiction, prospects of long-term recovery and treatment options, and the value of community mutual support programs. Treatment can also help family members deal with the challenges they face living with an addicted parent, sibling, or child. And, treatment can encourage family members to engage in their own recovery to reduce their emotional burden and learn more coping skills to deal with their loved one and their own behaviors.

“The focus today of many organizations, publications, and education programs is often on the drug—opioid, fentanyl—the illness, or the impact of addiction on the affected person—and less on the family,” says Dr. Dennis C. Daley, UPMC Health Plan’s Senior Clinical Director in the Substance Use Services Behavioral Health Integration Division and Professor of Psychiatry at the University of Pittsburgh School of Medicine. “The voice of the family is seldom sufficiently acknowledged by academics, researchers, opioid workgroups, addiction and medical treatment systems, and others involved in addressing the opioid epidemic.”

So, UPMC Health Plan includes the family experience in many of its efforts to confront the opioid crisis and other SUDs among health plan members and their families, treatment providers, and other community stakeholders. As part of its growing commitment to addiction-affected families and children, the health insurance provider:

  • Advocates on behalf of members, patients, families, and children
  • Disseminates information, such as articles, blog posts, recovery guides, and videos
  • Educates members, families, providers, and the community
  • Facilitates screening, evaluation, education, programs, and services

The health insurance provider encourages and supports screening, evaluation, treatment, and referral (or SBIRT related-activities) throughout medical systems. Patient navigators, degreed individuals with substantial personal experience in recovery from a SUD, are embedded in many UPMC hospitals and ambulatory programs. More than 12,800 teens were screened for substance use and problems in a pediatric and adolescent medicine learning collaborative. And more than 7,000 books and recovery guides, other educational publications, and lists of resources for individuals and families affected by a SUD were provided to patients or families throughout the medical system and community.

Addiction-affected families and children also have benefited from family support groups like Bridge to Hope, Narcan education programs, My New Leaf Community Center activities, and community educational events like live telehealth townhalls on Facebook—where more than 24,000 people tuned in or viewed the archived videos to better understand addiction and seek solutions.

“We include family representation in many of our workgroups, conferences, educational programs, and recovery events.”

For example, its recent Pain and Addiction conference included workshops developed and offered by family members. A new UPMC system-wide addiction and recovery grand rounds program will address collateral damage to families, with families in recovery discussing what helped them deal with the chaos of having an addicted family member. In addition, the health insurance provider initiated a family learning collaborative involving local treatment providers, UPMC and UPMC Health Plan staff, and family members, to explore ways to increase the focus on the needs of families and children affected by SUDs.

Collaboration with its provider partners at UMPC Medical Center and in the community also plays a key role in getting families and children the support and resources they need to recover as individuals and as a family unit. A newsletter that reaches over 13,000 providers a month dedicates articles to the physical, emotional, and financial health of families coping with addiction. The medical school also included family-oriented addiction treatment as part its special program on the opioid epidemic for first-year students. These efforts are helping to improve what Dr. Daley calls addiction illiteracy.

While the health care industry has a long way to go in battling the opioid epidemic and other SUDs, it’s moving in the right direction. To build on progress to date, policy, prevention, treatment, recovery, and research all need to focus on the family and children, who represent the innocent victims of addiction.