BullhornORIGINAL CONTENT
Date: January 23, 2023     |     Author:  Karen Hadley

Category:
CSDAP Original Content, Medical Model, Policy Makers, Service Providers, Suboxone (Buprenorphine),

Abstract

Government agencies like the Substance Abuse and Mental Health Services Administration, the Department of Health and Human Services (HHS) and the National Institute on Drug Abuse (NIDA) are continuously involved in setting the standards for treatment of addiction. They publish guidelines for both drug rehab facilities and those seeking rehab. Therefore, the exact wording of their guidelines is of utmost importance. A subtle shift could result in unintended and undesirable changes in treatment.

The headquarters of Health and Human Services and the National Institute of Drug Abuse

Government agencies like the Substance Abuse and Mental Health Services Administration, the Department of Health and Human Services (HHS) and the National Institute on Drug Abuse (NIDA) are continuously involved in setting the standards for treatment of addiction. They publish guidelines for both drug rehab facilities and those seeking rehab. Their virtual voices carry weight in this field. Rehab staff, medical practitioners and others working in addiction recovery will follow the lead of these three (and other) agencies.

Therefore, the wording of their instructions, treatment tips and guidelines becomes critically important. Any shift in wording could influence the success of efforts following these guidelines.

A comparison of recent guidelines from NIDA and HHS reveals a subtle change that may not be so subtle when it is implemented. You be the judge of the effects this change could bring about.

First, the wording of a NIDA manual called Principles of Drug Addiction Treatment.

On page three of this guide, NIDA states:

“To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems.”

Note the word must. This wording does not permit any variance from their guideline.

Now compare that wording with this wording from an HHS guideline for the administration of buprenorphine for opioid addiction treatment:

“Medication-based treatment for opioid-use disorder (OUD), as part of a comprehensive treatment plan that may also include counseling and behavioral therapies, is an effective approach that can sustain recovery and prevent overdose.”

This guide does not insist on a well-rounded approach to treatment for addiction to opioids. This much softer guideline leaves the door open to omitting counseling and behavioral therapies.

What is your opinion of this softer guideline? Would it be as effective as an insistence on addressing associated medical, psychological, social, vocational and legal problems?

Sources:

https://nida.nih.gov/sites/default/files/podat_1.pdf

https://www.federalregister.gov/documents/2021/04/28/2021-08961/practice-guidelines-for-the-administration-of-buprenorphine-for-treating-opioid-use-disorder