Psychology’s role in the national drug epidemic

By Jodi Andes, Associate Editor
March 22, 2017

Psychology’s role in the national drug epidemicDrug overdose deaths continue to soar, while the prescriptions of opioids continue at alarming levels and public discontent has been overflowing into the streets.

Those are signs that the nation’s drug epidemic is not likely to level off anytime soon and may continue to worsen. But is there anything psychologists can and should be doing to help fight this epidemic? Psychologists whose work has them on the front lines of the problem say yes and advocate small steps that could help curb the problem.

Amanda Merchant, Ph.D., is a clinical psychologist and the past president of the Kentucky Psychological Association who, in dealing with her work with chronic pain, has combated the problem for years. She said psychologists, no matter what their specialty, can help.

“Because of the widespread nature, everyone needs to take a part now,” Merchant said. “The opioid epidemic has affected everyone’s life at this point whether through a family member, a friend or your community.”

For starters, psychologists can make small changes in their daily practices, such as adding new questions in initial evaluations.

“We ask for medication lists, and use of substances like alcohol, smoking and marijuana, but we often don’t ask about use of pills like pain pills or anxiety medications for recreation use. As this has become more prevalent, we should try to ask more regularly. And if someone is prescribed potentially addictive medication, such as opioids or benzodiazepines, take time to assess for potential red flags for abuse or misuse,” she said.

Gleaning for such details could help better treat the patient and in return, help society.

There is no question the epidemic is getting worse. Deaths have been on the rise over the last 15 years with more than half a million people having died from addiction between 2000 and 2015. There is also little debate that opioids are a large part of the problem; six out of 10 of those deaths can be connected with opioids, according to the Centers for Disease Control (CDC).

So the approach each psychologist takes with patients can make all the difference, said Gail F. Melson, Ph.D. Melson is a research psychologist and a professor emerita for the Department of Human Development and Family Studies at Purdue University and works with many graduate students as they prepare to enter the profession.

The effects of the epidemic are so broad they should be treated with the care of other widespread health issues, such as Ebola, she said. The U.S. government spent more than $2.3 billion in fighting Ebola, and there were 513 deaths in two years worldwide due to the disease, according to the CDC.

Melson said her point is not to disagree with how Ebola is handled, but rather to show how being proactive can make a difference.

Consider, Melson said, how societal issues like domestic abuse began to be more recognized and treated after the mental and medical profession took a more proactive approach in patient screening. Addiction should be viewed in the same light, she said.

Questions about personal or family drug use will likely be as equally hard to get people talking about, but the conversation needs to start.

“We need to think through a non-threatening but good way to get at that information,” Melson said.

Another way psychologists can play a role in battling the epidemic is simply by treating patients once considered too transitional.

A big problem with the epidemic is the lack of sufficient treatment beds; meaning even those who want to move into recovery must wait until space is available. Many psychologists don’t like to treat someone in such a transitional phase, but this is not a typical illness.

“Be willing to see people while they are waiting to get into treatment programs. Be that bridge,” Merchant said.

Overall, the psychologist’s approach is key, she said.

“There needs to be a community perspective. We are hearing a lot about stresses where factories shut down and people have a sense of hopelessness and depression. This makes them more vulnerable to addiction. If you only focused on the individual you may never see the risks that could feed into the addiction.”

Addiction is spreading more into traditional practices than many people realize, Merchant said. For example, law enforcement agencies have closed pain clinics in many states that served as pill mills for virtually any patients who wanted drugs. The closures, though, mean that patients are going somewhere else for the drugs.

Some have turned to traditional physicians, who as a result, are seeing addiction at rates greater than they have ever seen before. Psychologists helping physicians identify which patients are most at risk for addiction could make a significant difference.

This approach only works if psychologists are willing to take the extra step and commonly communicate with more than just the patient.

“Be a part of the health care team. If you have a concern about opioid medication use or how it affects their medical care, get a release. It works better with a team approach,” Merchant said.

The last piece of advice from both is for psychologists to stay up to date. New information is becoming available regularly on neurobiology, substance abuse and other aspects related to the disease, so taking continuing education courses on these topics are important.

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