29 Jun Early Intervention Leads to Better Outcomes in the Treatment of Substance Use Disorder
Treating Substance Use Disorder (SUD) is much like managing any other chronic illness–the goal is to reduce problematic symptoms and improve the overall health and well-being of the patient. SUD is a treatable condition, and recovery is attainable with continuous, comprehensive care. Early intervention for addressing mild disorders helps prevent more severe problems later in life. However, if SUD is left untreated, symptoms will likely worsen. Fortunately, there are evidence-based strategies for early intervention, such as community outreach, brief interventions, and telemedicine.
Several factors impact a person’s likelihood of misusing drugs or alcohol. Some individuals are genetically predisposed to addiction and substance misuse. Genomic testing, such as Genetic Addiction Risk Score (GARS) can predict the likelihood of developing substance dependency. Psychological elements, such as stress, depression and anxiety also increase the risk of SUD. Further influences include environmental circumstances such as trauma, use among peers, and access to drugs and alcohol.
Specific populations are at higher risk of developing SUD. For example, the use of alcohol, drugs, or nicotine at an early age signals potential future abuse. While symptoms may emerge during adolescence, only 4 percent of people aged 12 to 17 have the disorder. However, the percentage of young adults most likely to misuse drugs increases to almost 15% for young adults aged 18 to 25.
No single factor determines whether someone will develop a dependency. Practitioners should focus early intervention efforts on at-risk populations who engage in high-risk behaviors such as binge drinking, driving while intoxicated, and using substances while pregnant. Adolescents who engage in binge drinking are also at particular risk for future substance use disorders.
Community Outreach and Education
Early intervention goes hand-in-hand with outreach and education. According to the National Survey on Drug Use and Health, only 11 percent of individuals with SUD receive treatment. The vast majority don’t seek treatment because they don’t think they need it. Some realize they need help but aren’t ready to stop their behavior, while others lack coverage or adequate funds required to afford services. Identifying the underlying cause of SUD is the first step in lowering barriers to treatment.
An educated populace is more likely to seek treatment when it’s needed, and support others who need help. Outreach and education efforts in schools, shelters, and other community-based programs seek to educate active substance users about the necessity of treatment and the range of available services. Targeted educational campaigns also provide information regarding the hazards associated with substance misuse, sharing needles, and drug overdose. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsors National Recovery Month every September to increase awareness and understanding of mental health and substance use disorders.
Other community-based efforts include needle exchange and syringe services programs (SSPs). Injection-route drugs such as heroin and cocaine are a significant source of infectious disease transmission. SSPs reduce the spread of blood-borne pathogens and increase entry into drug treatment programs.
Screening and Brief Intervention
Early intervention is the bridge between prevention and treatment. While severe addiction requires specialty services, most patients don’t start out at a dedicated SUD facility. Early interventions can take place in a number of settings—schools, psychiatric clinics, or primary care offices. Providers often initiate services when the client presents for some other condition.
Practitioners can identify signs of addiction through dialogue, observations, medical tests, and screening tools. Patients who have substance use disorder may receive brief interventions from a primary care provider. Using this evidence-based approach, the primary care provider uses dialogue to provide information and advice regarding risks, safe levels of use, and strategies to reduce high-risk behaviors. Another intervention technique is Motivational Interviewing, which focuses on the client’s ambivalence to change. Through a conversational approach, the counselor directs the client to help them discover their interest in altering their behavior. Studies link Motivation Interviewing with improved adherence to treatment plans, leading to better patient outcomes.
Teletherapy and Early Interventions
A major hurdle in early interventions is getting people to treatment. Teletherapy helps facilitate communication through a variety of media, including smartphone and web-based systems. Some people are unable to travel for treatment. Teletherapy lowers these barriers for vulnerable and underserved populations, such as people in rural and remote areas that lack sufficient health care services, including behavioral health care. It can also be an effective step-down measure for SUD treatment. Studies show that telehealth outcomes are often similar compared to in-person options.
The adoption of tools such as Electronic Health Records (EHRs) and teletherapy could improve access and close treatment gaps. More and more, practitioners are using emerging treatment technologies to support assessment, early interventions, and continued contact of individuals with SUD. Through EHRs, clients and providers can easily access and share treatment records, which improves coordination and delivery of care. Technology-assisted screening, assessment, and brief interventions make it possible for more individuals to access care.
The most effective way to help a person with an addiction is to intervene early. We cast a wider net through community outreach, brief interventions, and electronic screening. With a spectrum of practical strategies and services, providers can reach more people. EHRs assist with coordinating referrals, documenting outcomes, and offering alternatives for care via telehealth as clients move through the continuum of care. When SUD is detected and treated quickly, it means better outcomes for the client and society.