Opioid addiction can be one of the hardest and most dangerous addictions to overcome. According to the Center of Disease Control there were 70,237 drug overdose deaths in the United States in 2017. Compare this to the 88,000 people that die from alcohol related causes in 2017 and you really get the picture. Even more compelling is that in 2018 out of the estimated 2 million Americans who were addicted to opioids only 400,000 received drug treatment.
To compound matters, people interested in treatment may have to wait a while to get in. One study found that people seeking drug treatment and looking to be assessed, less then 33% of participants got in within 24 hours, 40% got in between 3 to 7 days and 12% waited longer than a week.
So, what does this all mean?
Getting people into substance abuse treatment quickly is the key. In many areas across the United States someone struggling with a heroin or prescription opioid addiction will call for a substance use assessment and then have to wait days or weeks to get in as the local nonprofit agencies don’t have enough counselors to serve the opioid addicted population. This is unfortunate as waiting several days and weeks after the first call for help can increase the odds of a person fatally overdosing on opioids/heroin or spinning them back into an opioid use cycle that may last weeks, months or even years. Opioid treatment research has shown that the shorter the lag time between the first call and first appointment, the better the chance of a positive outcome.
Agencies sometimes are overwhelmed with clients and have waitlists due to not having enough counselors to serve the opioid addiction population need in their area. These agencies might be struggling with attracting therapists dually credentialed in addiction and mental health and may be constantly short staffed. These agencies will sometimes be in the dreaded turn over pattern of having existing counselors take on additional caseload stress due to counselors quitting and then they themselves quit a few months later from the stress, leaving the agency short staffed and with a high turnover rate. In addition, agency hiring problems can be due to salary limitations, location in an undesirable area (rural, low income urban areas), leadership/management issues or lack of efficient agency structure around intake, assessment and treatment.
5 Potential Solutions
Here are the 5 most effective solutions I have seen used in real time over the past 3 years to solve the wait list problem as a health care consultant. My hope is that agencies might consider some of these or even expand the list. Some of the solutions demand out of the box thinking, so brace yourself.
- Potentially share counselors across agencies to do intakes or lead addiction and mental health groups to help people struggling with opioid addiction get started quickly.
- Create a short-term holding group in which someone has a short intake/assessment and can begin group treatment immediately. These individuals could get short term stabilization with the group and eventually get referred into their appropriate ASAM level of care/group. Agencies might even involve their crisis units/staff to do daily or weekly check ins with clients while they are awaiting more intensive services.
- Build bridges in the community with potential medication assisted treatment providers to get people started as quickly as possible on MAT treatment as we know this improves opioid treatment outcomes significantly.
- Help current mental health counselors at the agency get certified/licensed as addiction counselors through training programs to increase the number of counselors available to treat the opioid addiction population at that agency. The agency is then investing in their existing staff who already understand the agency’s infrastructure and work flows, rather than investing more money in trying to attract applicants for vacant positions and having to train everyone from the ground up.
- Collaborate with other agencies in your area to brainstorm new ways to creatively work together to assist each other in being more successful in treating opioid addiction. Creating collaboration is a key and being in the same room with your collaborators while having an open mind and willingness to work together is even more important.
As directors, supervisors, therapists and administrators we all have vital and key roles to make a difference in the fight against opioid addiction. I truly feel we can form an unstoppable team of collaborators that can make a real difference in this fight. Having just seen the movie, “Ford V Ferrari,” I want to leave you with a famous Henry Ford quote.
“Coming together is the beginning
Staying together is progress
And working together is success”
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