The following is an excerpt from an article appearing in Advances in Addiction & Recovery

Deaths from prescription opioid abuse have more than quadrupled since 1999, prompting President Donald Trump to declare the opioid epidemic a national public health emergency.[1] But while discussions around opioid abuse prevention have intensified, numerous barriers to recovery continue to exist.

For example, one of the most effective ways to combat opioid addiction is through medication-assisted treatment (MAT), an evidence-based approach that combines medication with psychosocial intervention. MAT empowers those suffering from opioid use disorder (OUD) to recover from their addiction while rebuilding their lives.

However, the stigma often related to MAT—on the part of both the medical community and addiction support professionals as well as family members of patients—continues to limit its use across the industry. Further, the need to educate communities and legislators about the complex issues surrounding addiction treatment cannot be overstated. Addiction should be considered a chronic condition, and such treatments need to be viewed the same way.

You can read the rest of the article on pages 24-25 in Advances in Addiction & Recovery.

[1] https://www.cdc.gov/drugoverdose/epidemic/index.html

As we observe National Suicide Prevention Week 2017, we sat down with Dr. Shareh Ghani, vice president and medical director at Magellan Healthcare who lead Magellan’s Driving Suicide to Zero Initiative.

Magellan Health Insights: Dr. Ghani, thank you for chatting with us today. Tell us about the work you did with the Driving Suicide to Zero Initiative
 Dr. Shareh Ghani: In some parts of the healthcare community, there is a view that suicide is something ‘that just happens’; that it is unavoidable and acceptable. The Driving Suicide to Zero Initiative sought to change that paradigm. Through our efforts in a public health program, we shifted the viewpoint to one that believes that suicide can be stopped and can be driven to zero.

MHI: You have lead a number of initiatives for Magellan, what was your interest in this particular program?

SG: I have been working in mental health since 1993. From 1993 to 1995, during my residency, I had a lot of experience with suicide prevention research, and again working in community psychiatry. There is a lot of good research on the how of suicide, but I want to understand the why.

MHI: You looked at a lot of data as a part of this initiative. Tell us about that.

SG: We were managing the behavioral health contract for Maricopa County between 2007 and 2012. At the time, Phoenix had the seventh highest suicide rate in the country. The suicide rate for those with mental health issues was even higher.

During that time, we reviewed every case of completed suicide to see what could have been done differently.

MHI: What was the Driving Suicide to Zero Initiative hoping to achieve?

SG: Of course, we were looking to significantly impact suicide rates in Maricopa County. But more than that, we were looking to develop a systematized, data-driven, reproducible model.

Part of that meant preparing the clinical workforce to confidently identify at-risk individuals and improve treatment access and engagement. It also meant incorporating family and community participation to better identify early warning signs, navigate the clinical system, and support members at risk.

Finally, there was the integration of a sustainable and replicable clinical and support model and program tools into an EMR [Electronic Medical Record] to ensure that healthcare providers can, from a single source, identify, manage and plan for zero suicides through the safe management of those at risk.

MHI: And what were the results of the initiative? Was it successful?

SG: The results were highly encouraging. Between 2007 and 2012, there was a 67 percent reduction of the suicide rate for the population. Furthermore, there was a 42 percent decrease in the suicide rate of people with serious mental illness.

MHI: You mentioned earlier that the suicide rate was much higher for those with serious mental illness?

SG: Yes, it is a fact that individuals suffering from severe mental illness are six to 12 times more likely to die from suicide than the general population.

MHI: If you could hope that people would take away one thing from the Driving Suicide to Zero Initiative what would it be?

SG: That employing a rigorous, data-driven, scalable and reproducible population health approach to address suicide prevention, and creating a sustainable ecology of support around the individual and the community, is possible.

The Magellan Driving Suicide to Zero Initiative successfully incorporated population surveillance, analytics, research, early detection, intervention and monitoring to shift the paradigm from crisis mitigation to early prevention of suicide.

A study by a team of Magellan researchers, demonstrating the pervasiveness of opioid addiction, was presented at the American Psychiatric Association (APA) Annual Meeting, and was also the subject of an article by Clinical Psychiatry News.

The study, an analysis of medical and pharmacy data from 2009—2012 for 2.5 million people aged 20-64 who were part of a commercial health plan, showed that 48 percent of patients who had stopped using opioids for at least six months went on to use them again.

Dr. Shareh Ghani, vice president medical director at Magellan Healthcare, and lead author of the study spoke of the importance of fully understanding the scope of the addiction crisis: “Having worked in commercial and Medicaid markets, I have reviewed numerous cases of accidental overdose and suicides related to pain prescriptions. The opioid crisis in this country demands that we understand the issue and identify predictors of risk.”

Study co-author Gowri Shetty, vice president of analytics, underscored the importance of the work: “This study helped us understand the clinical characteristics associated with long-term and persistent opioid use and provided a better understanding of how to tailor interventions targeting those at increased risk of inappropriate opioid use.”

The opioid crisis remains a key area of research and development across Magellan Health. You can read the article by clicking here to visit the Clinical Psychiatry News website.