Maintaining that substance use disorder is a treatable chronic medical condition, the American College of Physicians (ACP), the nation’s largest medical specialty organization, this week published a series of recommendations to facilitate effective treatment and prevention of SUDs involving illicit and prescription drugs.
Recommendations were provided for both physicians, such as encouraging patient education and proper prescribing practices, as well as for policymakers, with recommendations that cover harm reduction strategies, and incarceration and diversion programs.
In its paper, published in the Annals of Internal Medicine, the ACP states:
- Managing substance use disorder as a chronic medical condition should include an expansion of evidence-based public and individual health initiatives, as well as medical research on substance use disorders, including causes and treatment.
- Treatment-focused programs should be implemented as an alternative to incarceration for persons with substance use disorders found guilty of the sale or possession of illicit substances.
- Stakeholders should assess the risks and benefits of removing/reducing criminal penalties for nonviolent illicit drug offenses.
- Stakeholders should cooperate to: implement evidence-based guidelines for pain management; expand access to Naloxone for opioid users, law enforcement and emergency medical personnel; expand access to medication-assisted treatment for opioid use disorders; establish a national prescription drug monitoring program; and improve existing monitoring programs.
- Health insurance should be required to cover mental health conditions, including evidence-based substance use disorder treatment, and abide by parity rules.
- The substance use disorder treatment workforce should be increased through loan forgiveness programs, mentoring initiatives and increased payment.
- Substance use disorder screening and treatment training should be embedded throughout the continuum of medical education.
- Public initiatives such as syringe exchanges and safe injection sites should be further explored and tested.
The ACP paper was drafted by the organization’s Health and Public Policy Committee, which addresses issues that affect public healthcare in the U.S. and the practice of internal medicine and its subspecialties.