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What is substance use disorder?

Alcoholism, drug dependence and addiction, known as substance use disorders, are complex problems. People with these disorders once were thought to have a character defect or moral weakness; some people mistakenly still believe that. However, most scientists and medical researchers now consider dependence on alcohol or drugs to be a long-term illness, like asthma, hypertension (high blood pressure), or diabetes. Most people who drink alcohol drink very little, and many people can stop taking drugs without a struggle. However, some people develop a substance use disorder—use of alcohol or drugs that is compulsive or dangerous (or both).

What is opioid use disorder?

Opioids reduce the perception of pain but can also produce drowsiness, mental confusion, euphoria, nausea, constipation, and, depending upon the amount of drug taken, can depress respiration. Illegal opioid drugs, such as heroin and legally available pain relievers such as oxycodone and hydrocodone can cause serious health effects in those who misuse them. Some people experience a euphoric response to opioid medications, and it is common that people misusing opioids try to intensify their experience by snorting or injecting them. These methods increase their risk for serious medical complications, including overdose. Other users have switched from prescription opiates to heroin as a result of availability and lower price. Because of variable purity and other chemicals and drugs mixed with heroin on the black market, this also increases risk of overdose. Overdoses with opioid pharmaceuticals led to almost 17,000 deaths in 2011. Since 1999, opiate overdose deaths have increased 265% among men and 400% among women.

In 2014, an estimated 1.9 million people had an opioid use disorder related to prescription pain relievers and an estimated 586,000 had an opioid use disorder related to heroin use. Symptoms of opioid use disorders include strong desire for opioids, inability to control or reduce use, continued use despite interference with major obligations or social functioning, use of larger amounts over time, development of tolerance, spending a great deal of time to obtain and use opioids, and withdrawal symptoms that occur after stopping or reducing use, such as negative mood, nausea or vomiting, muscle aches, diarrhea, fever, and insomnia.

What is substance use disorder treatment?

Treatment programs licensed and reviewed by the Minnesota Department of Human Services employ specially trained counselors licensed to provide substance use disorder treatment. About half of these counselors are people who are in recovery themselves. Treatment programs utilize a treatment team approach. Depending on the type of treatment, teams can be made up counselors, care coordinators, social workers, peers, doctors, nurses, psychologists, psychiatrists, or other professionals. Some programs specialize in providing adolescent, culturally specific, co-occurring mental health and substance use disorder, medical and children’s services.

In addition to substance use disorder treatment programs, some individually licensed clinicians have it within their scope of practice to treat substance use disorders. Substance use disorder can be treated in physicians’ offices and mental health clinics by a variety of individuals, including counselors, physicians, psychiatrists, psychologists, nurses and social workers. Treatment is delivered in a range of settings from outpatient, residential, and hospital inpatient based on an individual’s assessed need. Although specific treatment approaches often are associated with particular treatment settings, a variety of therapeutic interventions or services can be included in any given setting.

What is an OTP?

Opioid Treatment Program or OTP means a program or practitioner engaged in opioid treatment of an individual that provides dispensing of an opioid agonist treatment medication, along with a comprehensive range of medical and rehabilitative services, when clinically necessary, to an individual to alleviate the adverse medical, psychological, or physical effects of an opioid addiction. OTP includes detoxification treatment, maintenance treatment, comprehensive maintenance treatment, and interim maintenance treatment.