Excited for @honoraenglander Marquam Hill Lecture “reframing addiction: healing amid an opioid epidemic” @OHSUSOM @OHSU_DHM @OHSUNews (will thread a few highlight slides below) 
We have historically taken an abstinence only “just say no” approach to how we treat drug use and addiction which has been shown to not work. We need a new approach and framework
We need to think of addiction as a chronic brain disease with changes in cell connections and responsiveness. Clearly illustrated comparing brain and heart metabolism
Medication is treatment and evidence shows using medications for opioid use disorder decreases drug use, rates of HIV and HCV, hospital and ER utilization, overdose and death. Meds also support people to return to work, to live their lives
How we frame health conditions matter especially with addiction where historically the advice was “just stop.” A patient gets admitted with a diabetic foot ulcer requiring amputation we wouldn’t just cut off the foot and not talk about their blood sugar control and diet.
When we talk about addiction it’s about meds (if pts want ‘em), it’s taking a patient-centered harm reduction approach. Making sure patients have naloxone and know how to use it(and their families and friends do too!) it is about rapid access to evidence based outpatient care.
Since @OHSUSOM IMPACT started inpatient addiction med consult team has seen >1700 pts, high poly substance rates, majority experiencing homelessness. So much that needs to be done around housing access in those w/ substance use history or active use #HousingFirst #HousingCrisis
Must not let other issues get buried under opioid crisis. Polysubstances ➡️overdose deaths, esp on west coast ⬆️methamphetamine related ODs & hospitalizations @tylerwinkelman. A very legal substance - Alcohol! And unintended consequences of curbing opioid rxs @StefanKertesz
Some resources for learning more & for access to addiction-related treatment @samhsagov @HarmReduction @ProjectECHO @PCSSProjects missed photo of amazing work being done with ECHO in the state of Oregon educating clinicians all over including at frontier sites!
Good thing I have the photo from a previous talk @honoraenglander gave at @AMERSA_tweets this past November 😄
From a patient who wrote a message to all the clinicians, nurses and staff who helped take care of them on the white board in their room. “Feeling good! On the road to recovery from addiction!!”
