Ignite Magazine | Spring 2021

Page 11

the other. Things are much better now.

blaming, and general difficulty in focusing on a desire to treat instead of to punish. Our country seems to be able to only manage one crisis at a time. In this case, with more than 543,000 deaths in about the first 13 months of the pandemic, the virus became the focus. Some substance abuse facilities actually closed down because they couldn’t make social distancing work.

and attitudes; access to health care; access to technology for telehealth; substance In what ways? How are COVID-19 abuse; racial disparities; co-morbidities. NEOMED’s integrated primary and menpatients treated if they are also tal health care services is an example of addicted to opioids? Understanding the multiple interachow care has evolved to take a holistic tions between addiction and overall health approach to an individual. We’ve gained a is becoming more common. All of the lot by focusing on specialization and techaddiction programs that I’m aware of now nological interventions, but I fear we’ve provide education about COVID-19, HIV lost some of our awareness of the other and hepatitis. People suffering from aspects of patient’s lives. It’s good opioid use disorder (OUD) typithat as a psychiatrist I will be able cally are not socially distancing and to focus on mental illness, while unprotected sexual encounters are my colleagues may be looking at blood pressure or diabetes, because common. This is leading to a dual epidemic. Although it’s still very any of those individual factors may Our country seems to be able to early, all of the reports that I’ve seen also lead to the worsening of the show a dramatic increase in opiate others — including drug addiction. only manage one crisis at a time. ” deaths, from suicide and overdose. There are all sorts of terms for this – Randon S. Welton, M.D. We’ve seen a dramatic increase in — comprehensive care, whole-perOUD and a generalized increase son treatment, total patient care, or in mental health disorders. Healthy integrated care — but whatever you social support networks have disappeared want to call it, we need to treat each person for a lot of people during the pandemic, So, what have we learned? as an individual; a member of their family; so they rely on unhealthy coping strategies, We’ve learned a lot about the potential a member of their culture; and a member such as drug use. The isolation, job loss uses of technology, especially telehealth. of our society as a whole. And we have a better understanding and other stresses have reversed the trend What we‘re hearing is that telehealth endof abuse that had been dropping. The ed up being just as effective as in-person of that than we had 35 years ago. reports I’ve seen suggest that we’re going visits for many aspects of medicine. I perto be dealing with that outcome for years sonally have some concerns. I’m worried NEXT TIME Dr. Welton and many in the scientific about training future physicians to think to come. that patient care is something that we do community say this won’t be our last panHow is mental health care and medical over a phone or computer. What about demic. And one thing we learned from education different from in the 1980s? when this (COVID-19) goes away? Will the novel coronavirus of 2019 is that once We have a variety of medications today most care remain as telehealth visits be- we know what “it” is, our public health that we didn’t have years ago, with fewer cause it’s more convenient for providers and health professionals and researchers side effects. There has been an increase in and patients? Sure, there is a decrease in will again rise to slow its spread until we therapy and counseling, including social no-shows, a decrease in time needed be- can reduce its ability to harm us. But how workers and addiction counselors, along tween patients, and easier access. But what will we prepare for social cognition — the with peer counseling from folks who have about the benefits of listening, eye contact, various psychological processes that enable recovered from addiction themselves. Ad- touch and whole-person treatment? Treat- individuals to take advantage of being part diction and mental health disorders require ment via digital means doesn’t always of a social group? Will we continue to play help over an extended period of time — provide what can be given at the bedside. a blame game of “us versus them”? Unlike As far as the social determinants of the virus meeting the addict, this meeting months, even years, so peer specialists are invaluable. The idea that addiction is a health go, we’ve certainly come a long way of two forces — us and them — doesn’t disease has been around for some time, since the ‘80s in identifying the issues that have to be disastrous. but there is still a lot of shaming, a lot of affect people’s health — cultural awareness It can actually be a beautiful thing.