Overdose deaths in the U.S. rose to over 100,000 in 2021. As this number continues to rise, it also reflects a shift in the underlying substances responsible for the majority of overdose deaths. Most people who die from overdose use multiple substances, often a combination of opioids and stimulants. While the American Society of Addiction Medicine and the American Academy of Addiction Psychiatry have made positive strides updating clinical guidelines for Stimulant Use Disorder (StUD), the recommendations still fall short of addressing the needs of the growing population of people who use both stimulants and opioids.
In a new Viewpoint article published in JAMA Psychiatry, Allison Lin, M.D., and Lara Coughlin, Ph.D., joined with lead author Benjamin Howell, M.D., Assistant Professor of Medicine at the Yale School of Medicine, to highlight the urgent need for research-informed clinical guidance to better support people with co-occurring Stimulant and Opioid Use Disorders.
“It is exciting to see the growing interest in tackling addiction,” Lin says. “But, we wanted to draw attention to the importance of some of the most underserved patients today—those who struggle with opioid and stimulant addiction who often experience multiple other mental health conditions and psychosocial stressors.”
In the paper, Howell, Lin and Coughlin identified key barriers clinicians face such as gaps in evidence-based research, limited access to effective behavioral treatments like contingency management, and challenges meeting the complex psychosocial needs of patients in clinical settings.
“We have treatments, especially contingency management treatment, that have long standing, robust support and yet are not widely available to people who are struggling with opioid and stimulant use,” Coughlin says. “We’re working to shine a light on opportunities for clinics, health systems, payers and policymakers to really make a meaningful dent in overdose deaths by making sure people have access to the treatments we know work.”
The researchers’ recommendations include more focus on holistic, “whole person” interventions that incorporate an awareness of individuals’ structural needs (such as housing insecurity) into their treatment plan. Additionally, they call for deeper investment in research studies that focus on the specific needs of people experiencing co-occurring addiction as well as advocacy and collective action to push forward crucial financial and policy-level changes to increase access to contingency management and other services.
Lin says, “there are important things we need to work on today, bringing together addiction and mental health experts and making sure our treatment programs can offer effective treatments to those who need it the most.”
Click here to read the full article published in JAMA Psychiatry on July 10, 2024.
