PROVIDENCE – A report co-authored by a Brown University professor makes a series of recommendations on how to combine care for opioid use disorder with treatment for a number of infectious diseases increasingly associated with opioid abuse.
While opioids are to blame for tens of thousands of U.S. deaths yearly, it is also to blame for rises in HIV and staph infections, hepatitis C and sexually transmitted diseases, the report says.
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In a report published recently by the National Academies of Science, Engineering and Medicine, co-author Dr. Josiah Rich contends that various clinics and prisons see thousands of people per year suffering from both opioid addiction and infectious diseases.
Rich, a professor of medicine and epidemiology at Brown University and director of the Center for Prisoner Health and Human Rights at The Miriam Hospital, says clinics and correctional institutions should be equipped to care for multiple conditions at once.
“The sharing of needles, risky sexual behaviors and decreased access to health care create an intimate link between opioid use disorder and infectious disease,” Rich said. “Integrating care for both is more efficient, more effective and can reduce stigma. But there are policy, funding, training, organizational and logistical obstacles that keep the two siloed. This report provides direction on how to break down those two silos to provide integrated care and prevention.”
Often, restrictions on the types of services groups can provide stand in the way of providing integrated care, the report says.
Examples include tight restrictions on which providers can prescribe buprenorphine, Medicaid regulations that don’t allow medical care and behavioral care services to be billed on the same day, and failure to screen or provide medication for opioid addiction at many prisons.
The report outlines nine obstacles standing in the way of integrated care, and makes recommendations specific to each.
“We debriefed the team at Health and Human Services who commissioned the study and there was a sense that they have been thinking along similar lines,” Rich said. “Of course, many of these recommendations will require funding, but we are optimistic that members of Congress understand the dire needs of these devastating and interwoven epidemics.”
