Web of addiction, mental illness

Another viewpoint is a column The Morning Journal makes available so all sides of an issue may be aired. Donald Sheldon, MD, of Avon is one of the leads for the Philanthropic and Community Coalition to End the Opioid Epidemic in Lorain County. Addiction and mental illness are both significant chronic diseases. To make matters worse, these two illnesses often occur together. When diseases occur together, especially when they significantly impact each other, you must treat them together if you want to maximize your chances of a successful outcome. Treatment is more effective when clinicians treat addiction and mental illness as co-occurring diseases. Our approach to these co-occurring diseases must change in Lorain County. The connection between mental health and addiction is undisputed by experts. Dr. Stephen Gilman, MD, an addiction psychiatrist at New York University says, “Fifty percent of those with an addictive disorder will have a psychiatric disorder. And for those who have a psychiatric disorder, about 20 percent have an addiction problem.” James Garbutt, MD, a professor of psychiatry at the University of North Carolina at Chapel Hill, says that percentage increases to nearly 50 percent in patients with schizophrenia and bipolar disease. According to Ron Manderscheid, PhD, if someone is depressed his or her chance of becoming addicted to opioids triples. To make matters worse, Carolyn C. Ross, MPH says, “roughly one in three people who die from suicide are under the influence of drugs, typically opiates such as oxycodone or heroin, or alcohol.” If we step back and look at the picture as a whole the connection between these two diseases is clear. When you’re in a weakened mental state you are more vulnerable to the temptations or escape provided by drugs. When your life is falling apart because of drugs, depression and even suicidal thoughts can further consume your rational thinking. As a community, we need to better understand the connection between these two diseases to provide the best care for those who are suffering. All of this is further complicated when a patient seeks help or is brought in for treatment by loved ones. Where do they start? Where do they go? When people are ready for help, we need to be ready to help them. The Philanthropic and Community Coalition to End the Opioid Epidemic in Lorain County has been working to solve this problem for our community. We have reviewed the literature, visited best practice sites in other states, and talked to the experts. The best answer is to create a single-entry point door open 24/7/365, and place where any patient facing addiction and/ or mental health challenges can get the treatment they need from professionals in both fields. The Coalition wants to bring this model to Lorain County. It would include a crisis intake center where an initial assessment occurs and an individualized comprehensive treatment plan is created. Many patients can then be discharged for outpatient care to one or more of the treatment programs already in place in our community. However, not surprisingly, some patients are not stable enough to go home and require a more intensive level of care. Fortunately, very few patients would need expensive inpatient hospital care and, for most, there is a better, more cost-effective solution. For those that requiring additional care, co-located with the crisis intake center would be a behavioral health stabilization unit and a withdrawal management unit for addiction. Both are successful in treating and stabilizing patients. Both are staffed with specialists in their fields. Both are there for the many patients who need… both. The end result is the best, most comprehensive care, at the lowest possible cost. The Coalition is working to make this solution a reality in our community. Together we can get there. Together we can save and restore lives. Every life is sacred. Too many have been lost and too many other lives have been impacted. Please visit www.endtheepidemiclc.org for further information.

Donald Sheldon, MD