That’s the sobering truth about a crisis that has gripped the country for more than a decade, according to the Centers for Disease Control and Prevention, which found that more than 399,000 people died from overdoses from 1999-2017.
But Kevin Moore, Psy.D., wants his fellow psychologists to know that they can help change that dismal number.
“There’s a huge amount of good that psychologists can do for this epidemic,” said Moore, a clinical psychologist and director of care coordination for Accessible Recovery Centers in Pennsylvania and New Jersey. As well as seeing patients, Moore supervises and trains other providers and writes policies for the centers.
Perhaps his greatest passion, however, is teaching other psychologists through seminars and a book he’s published on how they can help patients who are opioid users.
The first step, Moore said, is obvious but sometimes difficult: learning if a patient is using opioids.
“Clinical psychologists in private practice likely are already seeing people with opioid addiction, although they typically don’t know it,” he said. To find out, he suggests asking every patient a series of questions as part of an initial screening process: Do you use alcohol? Cigarettes? Opioids? If so, how often?
For patients who take opioids, a psychologist then should have a conversation about why they’re used, how much has been prescribed and how long they’ve been used. Then psychologists have a choice: Refer the patient to a psychologist with special training in helping opioid patients or get training in that area, he said. He recommends training, because the addiction is so common.
“It’s normative for people to be given opioids,” Moore said. “Millions of people still are being prescribed opioids for chronic pain, and psychologists who are seeing these folks may not realize that.”
Jennifer Read, Ph.D., a psychology professor at the University of Buffalo, said she encourages her students to ask every patient about substance abuse, including opioid use, and ask if he or she has chronic pain.
“Some people may perceive they are using opioids for pain and not be aware it’s a problem,” she said.
To illuminate the issue, Read and psychologist Brian Borsari, Ph.D., a psychiatry professor at the University of California San Francisco, co-edited a special issue of the Journal of Consulting and Clinical Psychology that focused specifically on the opioid crisis. The issue, published online Sept. 25, 2019, featured research articles on clinical psychology as it relates to opioid treatment.
“We wanted the science of this to be strong, but wanted it to focus on clinical implications,” Read said. “It’s really clear that there are ways of managing pain that clinical psychologists can help with. There is a scarcity of treatment providers around the country, and one of the things the papers focused on was telehealth: How do we reach parts of the country that do not have easy access to treatment?”
Moore said the gold standard of treatment for those addicted to opioids is medically assisted treatment (MAT), which includes medication that reduces the urge to use as well as counseling.
According to the Substance Abuse and Mental Health Services Administration, patients who received MAT cut their risk of death in half. Moore said research has shown that 90 percent of people with an opioid addiction will relapse without medication as part of their treatment, while those who have medication plus therapy have success about 50 percent of the time.
“Psychologists have to play a role in this,” he said. “We have standing in the community to say that this works and if we stand behind this we can save a lot of lives.”
Federal funding also is on the way to help psychologists deal with the opioid crisis.
Last fall, the Health Resources and Services Administration awarded more than $17 million to universities and nonprofits to train doctoral health psychology students, interns and post-doctoral residents in the prevention and treatment of Opioid Use Disorder (OUD) and other substance abuse disorders in high-need and high-demand communities.
The University of Missouri is using that grant and other federal money to add seven doctoral internships in psychology each year for three years and to help telehealth clinics reach patients who are suffering from substance abuse or are at risk for substance abuse.
Idaho State University plans to use its federal grants to train doctoral psychology students how to prevent and treat opioid use and to develop an infrastructure for telehealth and integrated behavioral health programs to treat patients addicted to opioids.
Note: The special issue of the Journal of Consulting and Clinical Psychology dealing with the opioid crisis is available at APA PsycNET. The American Psychological Association also has online The Opioid Guide: A Resource Guide for Practicing Psychologists. Both are available at APA.org.