Supporting individualized patient journeys in substance use recovery

Harm reduction (and not abstinence alone) plays a part

By Chris Squillaro, DO, and Anita Kelly

We are five years into the declaration of the opioid epidemic as a public health emergency. Thirty years have passed since the first wave of the epidemic started in the early 1990s. Every facet of medical care and every community has been called to arms to help combat it. Despite this, we often hear from provider organizations, physicians, and other staff that there is ambivalence about treatment philosophies for substance use disorders. The first question to ask is, is your organization’s philosophy abstinence or harm reduction?

Since the path to recovery is different for each person, there is an infinite number of possible journeys. It’s critical that we all be aligned on this. Staff who say, “abstinence is how I got sober” represent a one-size-fits-all solution, not a population health strategy.

Individualized treatment planning should include consideration of all evidence-based forms of medication-assisted treatment (MAT) while at the same time effectively coordinating care, working through relapse, and supporting a person’s overall well-being in the community.

If you support harm reduction and individualized care, it’s important to consider all options when deciding on treatment, especially around MAT. Whether it’s Methadone, Buprenorphine or Naltrexone, it’s our job to present all available options. If you’re a provider in recovery yourself, you may be able to speak to your own journey as inspiration, understanding that it is only one path to successful recovery.

Scientific evidence no longer supports abstinence as the only course of action. We should engage every medical and community resource at our disposal as each patient has individualized needs and a unique story to tell about the path to recovery.