I would like to welcome several addiction specialists who have joined us in recent days and weeks. We look forward to learn from your experience and expertise.
Thank you to everyone who has contributed to the discussion so far. We would now like to address Question 6: How can we identify and manage opioid use disorders?
The healthcare system plays a central role in early detection and treatment. We invite discussion around the folllowing questions:
6.1. What are the clinical signs of problematic use? Are healthcare professionals aware of them? Have they been trained to recognize them?
6.2. What screening tools are used in practice?
6.3. How can the topic be addressed with patients without causing stigma?
6.4. What actions should be taken when misuse is suspected?
6.5. How does stigma influence access to and continuity of treatment?
Re 6.1, I imagine a number of scenarios. For example:
- a patient presents with overdose
- a patient who has been prescribed opioids presents with more frequent requests for further prescriptions
- a person presents to a health professional with concerns about a friend or relative
Re 6.2, I am aware of a quick tool Opioid Risk Tool (takes less than 1 minute) to assess the risk of any individual patient. It seems to be especially suited for primary care situations. However, it relies on self-reporting and I'm not sure how widely it is used (or useful) in practice.
Re 6.3, this question is open to different interpretations. From a health professional perspective, it is important to be non-judgemental and to address a patient as having a medical disorder rather than a character weakness or moral failure.
I invite your inputs on the above and also on questions 6.4 and 6.5.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org