Opioid addiction treatment: Challenges (and opportunities) for community practice Marc Fishman MD.

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Presentation transcript:

Opioid addiction treatment: Challenges (and opportunities) for community practice Marc Fishman MD

Relapse prevention medication as the standard of care Persuading patients Persuading families Persuading criminal justice system Persuading SUD providers, especially residential treatment Persuading payers Persuading the recovery community

Treatment matching options Choice of medications Methadone Buprenorphine Extended release naltrexone

Providing a full continuum of care Inpatient detoxification and stabilization Short term residential treatment Long term residential treatment Day treatment / partial hospitalization Assisted living support for outpatient treatment (IOP plus/ PHP plus) Recovery housing

Linking patients to medical care Embedding medical care in opioid specialty settings Providing opioid treatment for stable patients in general medical settings Medical home models

Linking patients to psychiatric care Embedding psychiatric care in opioid specialty settings Providing opioid treatment for stable patients in mental health settings Integrated care models (eg Integrated Dual Disorder Treatment -- IDDT)

Providing additional support for struggling patients Direct medication administration (in non-OTP) 7 day services: weekends and evenings Case management services Family services Vocational services Recreational/social services Assertive outreach for extended engagement

If only it were that easy

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