Breaking the Chain: Transforming Opioid Treatment, a Health Policy Proposal

Opioid use disorder (OUD) has remained a health issue among veterans. The challenges of warzones, including physical trauma or acute pain, make veterans one of the groups at risk of developing OUD. Although opioid prescription has been falling in the United States, in the last ten years, OUD has remained a serious problem in the veteran population (Dembek, Chekol, & Wu, 2020). OUD has negative implications for veterans’ health outcomes. Opioid misuse is significantly related to heroin initiation among military veterans and can lead to death following overdose. Moreover, the non-medical use of opioids in the veteran population can lead to addiction and opioid dependency (Dembek, Chekol, & Wu, 2020). Although the Veterans Health Administration has been actively addressing this issue, the high prevalence of OUD among military veterans indicates the need for the adoption of new initiatives to safeguard the health of this vulnerable population. The paper proposes a health policy and guidelines to help address OUD among veterans.

Proposed Policy

A policy that can help address the problem of veterans' opioid use disorder is the standardization of care provision within psychiatric and medical care settings, offering OUD treatment. One guideline to achieve standardized care in Veteran Affairs (VA) and non-VA treatment facilities is to develop quality metrics (Madras et al., 2020). Agencies that accredit or license substance abuse treatment centers can use these metrics to assess programs. Another guideline is to halt funding, licensing, and accrediting OUD treatment not founded on evidence. Reducing no-value or low-value care preserves scarce resources for services that effectively improve patients' health outcomes (Madras et al., 2020). Lastly, the proposed policy involves incentivization of facilities to follow up with veterans after discharge.

Advocacy for the Need of the Proposed Policy

The need to improve access to high-quality healthcare to combat the opioid crisis is now more relevant than ever. According to Madras et al. (2020), 70 % of individuals with OUD do not receive substance abuse treatment. For people who access specialty care, under 30% receive buprenorphine or methadone treatment (Madras et al., 2020). On the other hand, the share of people in treatment who receive evidence-based medication treatment of OUD (MOUD) using agents such as naltrexone has been rising but remains low. Between 2007 and 2016, the percentage of treatment facilities offering MOUD rose from 20 to 36% (Madras et al., 2020). Although this is commendable, the low adoption of evidence-based practices by specialty treatment centers is concerning. Besides, most primary care facilities in rural areas have not integrated substance use treatment and screening in their system. In rural areas that lack specialty addiction healthcare services, primary care professionals such as nurses are crucial in caring for individuals with OUD. An insufficient number of primary healthcare providers are screening for substance abuse use disorders in these settings.

Interprofessional Approach to Implementing the Proposed Policy

Implementation of the proposed policy requires collaborative efforts of individuals from various professions. Firstly, officials from accreditation organizations such as the Joint Commission should be involved in the implementation team. Such officials will create quality metrics to evaluate whether substance use treatment centers provide evidence-based care (Madras et al., 2020). Second, primary care providers and therapists must be trained in providing evidence-based care to patients with OUD. A significant focus should be given to the skills needed when providing care to veterans with substance abuse disorders. Telemedicine can be used to prescribe buprenorphine for veterans in rural areas (Brunet et al., 2020). Lastly, state legislators have a critical role in the implementation of this policy proposal. Collaboration among these professionals during the implementation of the proposed policy will reduce inefficiencies, lower healthcare costs, and improve veteran care and health outcomes.

In conclusion, the paper proposes the standardization of care in psychiatric and medical settings that offer OUD specialty care. In these settings, there is a lack of evidence-based care practices. Also, the number of primary care facilities screening for OUD in rural areas is substantially low. Interprofessional collaboration is critical in implementing the proposed policy.