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Addiction Health Experts Say More Research And Better Treatment Integration Will Improve Outcomes

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Allegheny General, the flagship hospital of Allegheny Health Network. The medical system's Center for Inclusion Health aims to integrate marginalized patients into the general care settings.

Addiction treatment needs to be integrated with other aspects of patients’ lives, according to presenters at the Pittsburgh-based Institute for Research, Education and Training in Addictions. Those aspects include stable housing and employment, adequate social support and other chronic health issues.

Presenters spoke at a Wednesday night panel on barriers to quality substance use treatment.

“So, someone can get the best treatment in the world and do really well… and then when they leave, if the conditions of their life aren’t pro-health, it’s not going to stick,” explained Brooke Feldman, of the CleanSlate Centers, which works to improve the quality of people’s lives who have opioid or alcohol addictions.

Stuart Fisk, of Allegheny Health Network’s Center for Inclusion Health, said that historically drug users have been siloed into separate health care systems, including jails and prisons. This, he argues, has failed patients and made health systems weaker.

“If you bring the most complicated … patient in, and figure out how to take care of them, then everybody else in the care system is going to get better care,” said Fisk. “Cause if you can figure out how to take care of a homeless, schizophrenic, cocaine-addicted, transgender woman, you can take care of anybody.”

Another issue is a lack of clinical research on addiction treatment compared to other areas of medicine.

“If I were a cardiologist or an oncologist, I could get down to the finest detail of a decision and find good science to support that, and that just does not exist in addiction medicine,” said Dr. Margaret Jarvis, chief of addiction medicine for Geisinger Health System.

Jarvis said because there isn’t enough “good” science, people who seek help for substance use disorders often end up getting substandard care.

“People are really doing some, at best, really unfortunate things and calling it treatment,” said Jarvis.

For example, many treatment agencies continue to only offer 12-step programs. That’s even though research has shown other therapies and medication-assisted treatment are more effective for many people. 

Fraud is also a problem with an addiction treatment. Recent national reportinghas found that a lack of licensing allows facilities to market themselves as residential rehabs, when in reality they provide little or no treatment services.

WESA receives funding from Allegheny Health Network.

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.