Going Beyond Dreamland

Posted Friday, November 3, 2017 by Scott Good in Healthcare Research & Strategy

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Addressing the Opioid Epidemic via Community Action Assessments

It has been over two and half years since Sam Quinones masterfully described the threads that have created the opioid epidemic in his book Dreamland. Last week the President directed the Department of Health and Human Services to declare the opioid crisis a public health emergency. Current estimates are that it is killing 90 people a day.

Our health assessments in some of the regions hardest hit suggest community size, affluence, geographic location, and other factors commonly associated with community health status have distinct differences when it comes to opioid use. A quick review culled from Crescendo’s work over the last two years, as well as the multiple “Task Force” recommendations, highlights some of the critical components in the solution set to this national problem.

Leverage Local Leadership and a Systematic, Coordinated Approach

While frustration can be a catalyst, leadership and a centralized effort focused on positive impact is essential to overcoming a disaggregation of services, siloed agencies, and overlapping service areas. 

Discover How the World Has Changed in Your Backyard 

Today, the mix of policies, insurances, demographics and treatment providers varies dramatically by state and municipality. Some the threads that created the crisis were 20 years in the making and the economic triggers from the great recession began ten years ago. Each of these core elements impacts how you build the “solution work plan.”

Assessing what you know and what you don’t know is essential. For example, without physician AND therapist involvement, communities may merely be re-tooling their “pill-mills” if they rush to create methadone, Suboxone, buprenorphine, and/or naltrexone treatment clinics without providing concurrent counseling to overcome the addiction.

Use an Assessment to Action Model

It is highly efficient to combine the work to assess the community changes with the process of engaging community partners. The most effective programs engage those who will help implement the action plan in building it. Using an assessment also follows the wisdom of “what gets measured, gets done.”

Be A Leader and a Learner

You have experts in your own community, and everyone has improvements they can make. Stakeholders who are willing to work together and learn from one-another can create the rapid-cycle change we need to stop the epidemic.



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