Since 2000, over 500,000 people in the United States have died from opioid overdoses (1). The opioid crisis has also impacted many countries with ~ 187,000 opioid overdose deaths per year (2). Consultation-liaison (C-L)psychiatrists commonly are tasked with managing the acute and maintenance management of substance use disorders in inpatient and outpatient C-L settings, as well as serve an important role with connecting patients with appropriate ancillary community SUD treatment. This oral paper will provide an overview of medication assisted treatments, harm reduction strategies including needle exchange programs, supervised injection facilities, and heroin assisted treatment), and policies (including decriminalization) that are being used in other countries to address the opioid epidemic. It will also review the arguments against expansion of opioid use disorder treatment and critically examine the evidence. To reduce morbidity and mortality from opioid use disorder, it is imperative that we advocate for effective policy changes and consider the risks and benefits of possible treatments and harm reduction strategies that may be adapted for use in the United States by the savvy C-L psychiatrist from lessons learned by our global colleagues.
1) Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths – United States, 2000-2014. MMWR Morb Mortal Wkly Rep. 2016; 64 (50-51): 1378-1382.
2) United Nations Office on Drugs and Crime, World Drug Report 2017 (ISBN: 978-92-1-148291-1, eISBN: 978-92-1-060623-3, United Nations publication, Sales No. E.17.XI.6).
Compare and contrast the benefits and risks to opioid treatment methods including medication assisted treatment, needle exchange programs, supervised injection facilities, and heroin assisted treatment), and policy changes including decriminalization.
Identify arguments against expansion of opioid use disorder treatment and critically examine the evidence.