Don't Ignore Treatment for Substance Use Disorder; Open Dor Care Network’S Top Doc Addresses Topic

-- According to the latest statistics provided by The National Institute on Drugs and Addiction (NIDA), more than 40 million Americans (or more than 17 percent of those 12 years of age and older) battle Substance Use Disorders (SUDs).

Closer to home, Westchester County hospitals in 2024 recorded more than 17,000 emergency department encounters involving SUD diagnoses, representing 4.4% of all ER visits in the county.

The National Institute on Drugs and Addiction (NIDA) views SUDs as a chronic, treatable brain disorder that can be prevented and treated, thereby helping millions reduce their risk of overdose and recover from addiction.

And, yet, according to a 2023 National Survey on Drug Use and Health (NSDUH), only about 23% of Americans who needed substance use treatment in that year received it.

“One of the most common misconceptions about addiction is that it’s not treatable,” said Dr. Daren Wu, Chief Medical Officer at Open Door Care Network (formerly known as Open Door Family Medical Center). “In fact, addiction is VERY treatable and manageable. It’s like high blood pressure or diabetes. If patients are motivated to seek care, and are able to access care, the prognosis is actually quite good. In fact, approximately three-quarters of patients with substance use disorders can attain substantial remission or harm reduction that brings about meaningful quality of life.”

The biggest stigma, however, according to Dr. Wu, is the misconception it's "the patient's fault." "These are legitimate medical conditions that largely stem from genetic factors, environmental factors, and patterns and habits that develop into addictions," he explains. "There's often a tendency to view addiction through a lens of personal responsibility rather than recognizing it as a complex health condition."

What should you know about substance use disorder? Dr. Wu answered these common questions:

Do patients come to Open Door seeking treatment for an alcohol or substance use problems or is this more commonly something you uncover?

More commonly this is something we uncover. Although we regularly receive and care for patients who come requesting help with substance/alcohol use, we find potential concerns about its use all the time, due to our aggressive screening. Different health care settings will have different types of issues, and in our demographic, the two big substances are alcohol and marijuana use.

What are some of the common symptoms of Substance Use Disorders?

The most prevalent substance use disorder in our population is alcohol use. For many, they are not aware that their pattern of use is a potential problem or covering up other pathology (behavioral health issues). Overuse patterns are often normalized as “social” drinking – for example, having 10-20 beers in a single sitting with friends in one day. Interestingly, many of these same individuals do NOT drink a single drop during the rest of the week. However, the weekend binge pattern is a health hazard, of course.

What common treatments do you offer in terms of types of medication and psychotherapy? Anything new in the toolbox?

For alcohol use, we most commonly prescribe naltrexone, less frequently acamprosate. For opioid use disorder, we prescribe buprenorphine. For all patients with substance use concerns who consent to collaborative care, we co-manage their conditions through our medical and behavioral health care teams. In addition to 1:1 behavioral health counseling, we also offer group sessions (for tobacco, alcohol, opioid).

Is the more realistic outcome total abstinence or harm reduction (getting patients to reduce their use)?

While we aim for abstinence, we are happy to achieve sustained harm reduction and patients continuing to be engaged with care. Sustaining harm reduction is the more common outcome. Treatment is not a linear process, but as long as patients remain engaged in care and are motivated to improve their circumstances, we work with them even if they hit bumps along the way.

Are most addictions also due to mental health issues (e.g. anxiety, depression, etc,) where people self-medicate?

Yes, ample data links use of substances with behavioral health conditions. Also, there are strong inheritable genetic factors that raise the risk of addiction in family members. The environment in their upbringing (around relatives and parents with addiction issues) also significantly increases the risks of substance use disorders.

Do you have many examples of successful outcomes?

Absolutely! Numerous patients have either been treated to abstinence or long-term harm reduction sufficient for them to achieve normalcy in their lives, measured in terms of family or relationship stability, finding and holding on to employment, and not getting into legal or financial trouble (as most substance use issues are very costly to maintain). What makes our approach particularly effective is our emphasis on early identification through routine screening, combined with our integrated team approach. We meet patients where they are in their journey, whether that's their first conversation about substance use or their tenth attempt at recovery. The key is maintaining that therapeutic relationship and continuing to offer support, because recovery looks different for everyone, and every step forward matters.