In the late 1990s, pharmaceutical companies reassured medical providers that opioid painkillers, such as oxycodone, codeine, and morphine, were safe and non-addicting. In response, doctors began prescribing these drugs at greater rates. This trend led to increased availability and widespread abuse of both prescription opioids and non-prescription varieties, such as heroin.
These substances were, in fact, highly addictive and even deadly — and they are everywhere. In 2017, the U.S. Department of Health and Human Services declared opioid use a public health emergency. In America, an estimated 130 people die from opioid-related drug overdoses every day. Nearly 900,000 have used heroin, and 11.4 million people have reported misusing prescription opioids.
Managing this tidal wave of abuse falls to professionals in many different areas. Key among them are social workers, who make up one of the largest groups of addiction and substance abuse service professionals. Social workers need specialized knowledge and skillsets to serve opioid abusers and their families. The educational foundation to do this kind of work can be obtained from a program such as Ohio University’s online master’s in social work, which can prepare candidates not only to help problem populations but also to reap the benefits of a career in social work.
There is no one-size-fits-all solution to the opioid crisis. However, the Addiction Technology Transfer Center Network (ATTC) has identified several practical approaches that social workers can take when confronted with opioid-related issues. The first is to help clients access medications that can be helpful in treating opioid use disorder (OUD) or in preventing overdoses. Used in conjunction with counseling, this medication-assisted treatment (MAT) is the gold standard for addressing opioid dependency issues.
In terms of medication, the ATTC says social workers can be helpful in several ways, including:
- Linking and referring patients to MAT through service locator tools
- Partnering with providers who deliver drugs used in opioid treatment, such as buprenorphine and naltrexone
- Educating and providing the highest-risk patients with kits containing naloxone, a fast-acting medication that counters the effects of opioid overdose
- Coordinating with syringe exchange programs to ensure that high-risk clients are, at minimum, using clean equipment
When the medication component is in place, social workers can focus on providing high-quality psychosocial services to the client. Such services address the client’s deeper issues — the “why” of his or her opioid problem. Studies have shown that patients have a much better chance of recovery with a combination of psychosocial and medical therapy than if they receive medication alone.
The ATTC identifies several types of psychosocial services that social workers can either deliver or facilitate:
- Integrating comprehensive case management strategies, such as the one developed by the Center for Substance Abuse Treatment
- Gaining training and specialization in the delivery of psychosocial treatments for mental health disorders that tend to co-occur with opioid abuse, such as depression, anxiety, and PTSD
- Connecting with peer recovery specialists, patient navigators, and other community resources and initiatives, including groups such as Families Against Narcotics and Hope Not Handcuffs
- Advocating for at-risk groups such as racial minorities, low-income populations, and those with gender-specific needs
Leading the Field
A third and less direct way that social workers can help is by leading the charge to awareness.
Social workers, says Dr. Jamey J. Lister, have a unique social work perspective on drug policy reform. Along with this perspective goes “a responsibility to promote and deliver evidence-based practices [and] push back against unethical and pseudo-scientific perspectives on OUD and treatment.”
Harmful ideas that Lister identifies include “medication-assisted treatment replaces one addiction for another,” “people with addiction cannot be trusted,” and “people with addiction will never change.” Reframing these ideas into productive narratives, says Lister, has the potential to decrease stigma and promote help-seeking for opioid addiction
In addition to championing accurate information, the ATTC says social workers can take these practical steps to raise awareness and help their communities:
- Supervising and teaching social work students about opioid use and abuse
- Developing or delivering training about opioid use and abuse
- Joining task forces and community advisory boards that help improve coordination, trust, and knowledge exchange between community members and professional stakeholders
Anyone who questions the importance of social workers in the opioid crisis needs to look no further than America’s law enforcement agencies. Inundated with opioid-related problems, officers in hard-hit areas are being forced to act as unofficial drug counselors and social workers.
They are administering needle exchange programs, handing out naloxone, and visiting overdose survivors, and encouraging them to enter rehab. These efforts are untraditional but essential.
“If we weren’t doing the work we are doing, imagine how bad it would be,” says Mark Skeffington, assistant special agent in charge of the DEA’s New England field division. “If we weren’t taking [opioids] off the streets, it would be chaos.”
Along with the law enforcement field, insurers are also feeling the heat. For CeltiCare, a Massachusetts health insurance company, the costs related to the opioid epidemic are staggering. Nearly a quarter of its hospital admissions are now related to substance use, and the insurer spent more than 10% of its budget last year on a medication to treat narcotic addiction.
To combat these costs, CeltiCare is hiring social workers and assigning them to some patients as a medical benefit. The hope is that patients with OUD will be cured, or at least much improved. “At the end of the day, we think it’s going to cost a lot less,” says Jay Gonzalez, CeltiCare’s president and CEO.
CeltiCare will surely not be the last company to take this approach. As the opioid crisis continues, organizations will be seeking ways to reduce its financial impact, and social workers will be part of the equation. This strategy is a win-win for everybody: for the organizations that will be saving money, for the population living with OUD and needing help, and for social workers seeking a way to make a lasting, positive difference.
About Ohio University’s Online Master of Social Work
Ohio University’s online Master in Social Work degree program prepares graduates for careers in social work. Graduates assist at-risk populations with various life challenges, including those that stem from addiction and substance abuse problems.
The MSW program, which is offered through the university’s College of Health Sciences and Professions, is 100% online and does not require a GRE for admission.
U.S. Department of Health & Human Services, Opioid crisis fact
Addiction Technology Transfer Center Network, Medication access
Addiction Technology Transfer Center Network, Psychosocial services
Addiction Technology Transfer Center Network, Leading the field
Washington Times, Law enforcement doing social work
NPR, Social workers in insurance