Top Five SUD Treatment Challenges and Opportunities for Providers in 2021 and Beyond

The last 18 months have been a roller-coaster ride for substance use disorder (SUD) treatment providers. The rapid changes in established practices, the inflow of complicated cases, and the looming threat of the pandemic for personnel and vulnerable populations were just a few of the challenges to tackle. In the more stable second half of 2021, there is some time to reflect on the SUD treatment challenges and outline opportunities for improvement.

Industry challenge 1: The overall 13% increase in SUD exasperates other health complications

The ebb and flow of stress from the COVID-19 pandemic have caused a variety of behavioral health challenges. Anxiety and depression have escalated, and opioid and stimulant abuse saw a dramatic rise during this period. The Centers for Disease Control and Prevention reported that during the first four months of the pandemic, at least 13% of Americans began abusing or increased their use of substances to ease stress and cope with their emotions. This self-medicating caused a leap in overdoses in 2020 that was almost 17% higher than in 2019. The American Medical Association reports this as a nationwide crisis, with 40 states having seen a spike in opioid-related mortality.

To complicate the crisis is the sad reality that those with SUD are not only more likely to contract COVID-19 but are also more likely to suffer worse symptoms than the general population, including higher rates of death.

The perfect storm of stress, economic upheaval and isolation has driven this disturbing escalation.

The flipside: Breakthroughs in telehealth, case monitoring and evidence-based SUD treatment

In the early days of the pandemic, many who sought help were struggling to find a way to see behavioral health providers. But as clinics and community-based providers shut their doors in the face of the virus, telemedicine and telehealth options increased swiftly. Soon, more and more providers were seeing clients online, and once payers saw the need, it enabled even more to get treatment. Even Narcotics Anonymous, Alcoholics Anonymous, Al-Anon and other support organizations lifted restrictions and allowed the use of telehealth access for behavioral health and SUD treatment.

Remote services are improving with the use of online treatment. Providers are reporting more clients showing up for appointments than before the pandemic.

Industry challenge 2: Pandemic-related SUD treatment challenges in staffing and operating centers

The pandemic has created an especially challenging environment for staff and clients in the SUD industry. Given the reality that substance abusers tend to contract and suffer worse conditions from COVID-19, it places staff at SUD centers in more direct danger. The new variant is reasserting that concern, even as many states relax physical distancing and other restrictions. Community transmission has become more complicated.

The flipside: New resources from the NIDA and SAMHSA to support providers and staff

The National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) have both responded quickly to the call. The wide range of support, funded in part by the Biden administration's inflow of $2.5 billion, covers providers in many ways. This includes:

• Practice guidance.
• Telehealth support.
• Emergency room instruction.
• Drug testing protocols.
• Guidance for SUD treatment challenges.
• National and state guidance.
• Toolkits.
• Provider support.
• Webinars.
• Updated research.
• SUD-specific information.
• Grants.
• Facility support.

Industry challenge 3: SUD cases are more varied and entrenched due to the socio-economic situation

SUD cases are a direct result of the lifestyles of individuals in economic strife, and the pandemic has compromised these populations even more. Some factors known to have a direct tie between substance abuse and economic status are education, child abuse, genetic predisposition, behavioral health status, race, drug and alcohol addiction in the family, and poverty.

The flipside: Public attention on SUD, even in overlooked groups such as incarcerated populations

There has been a renaissance in overlooked populations suffering from SUD, such as those who are in jails and prisons. Expertise from behavioral health professionals has influenced improved training of prison and jail staff, with a focus on reducing stigma relating to SUDs. However, society is also embracing the acceptance to seek outside treatment when in-house is not enough.

Industry challenge 4: Demand for more diverse skills in the workforce regarding CODs

As addictions have become more prevalent in populations, the coexistence of both a mental health and a substance use disorder — a co-occurring disorder (COD) — has driven SUD treatment staff to acquire more diverse skills to meet this challenge. The necessity for integrated competencies includes specific attitudes, values, knowledge and skills.

The flipside: Increased relevance of small community practices and local providers

The  established guidelines for successfully treating SUD clients with CODs match the skills and capabilities already available in small community practices:

1. Use an alliance - a provider team approach.
2. Have a positive focus with a recovery perspective.
3. Prioritize continuity of care.
4. Address common clinical issues like countertransference with sensitivity.
5. Monitor symptoms (like self-harm) individually.
6. Use empathic counseling.
7. Have culturally responsive awareness.
8. Be motivational in approaches.
9. Prepare clients for relapse through prevention techniques.
10. Focus on skill-building.

The intimacy of local providers enables them to treat SUD clients with CODs in a customized SUD treatment strategy. As a result, successes improve.

Industry challenge 5: Slow adoption of new technology, integration and related staff training

SUD EHR (electronic health record) is on the threshold of promoting best practices in addiction treatment. However, one of the many SUD treatment challenges is that centers have struggled to adopt EHR quickly enough to meet needs.

The flipside: An established SUD EHR/EMR to offer comprehensive, personalized SUD treatment

Adopting an established and proven SUD EHR system has a dramatic impact on improving processes and reducing errors and redundancy when coordinating between multiple practitioners. This is critical to address SUD treatment challenges, especially for clients with CODs. The three data-driven interoperable capabilities of an established SUD EHR system (like Core Solutions' Inc. Cx360 platform) covers:

1. The collection and storage of electronic client data.
2. A facility to share data with multi-disciplinary providers.
3. Evidence-based tools for clinicians.

Core Solutions, Inc. empowers substance use disorder treatment providers with integrated records, building bridges for client care coordination. We help SUD providers integrate EHR to ensure all practices can make their treatment centers efficient and more effective. Contact Core today to discuss how the Cx360 platform can change everything for your centralized care coordination.