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A Discussion about Innovative Programs that Aid in SUD/OUD Recovery

Elevance Health Impact
June 5, 2024

Recovery from substance use disorder (SUD) is possible. This encouraging message fuels hope for the more than 40 million Americans experiencing SUD, regardless of background.

Carelon Behavioral Health experts discussed substance use disorder in recognition of National Drug and Alcohol Facts Week. The discussion highlighted how Carelon's evidence-based treatment programs improve outcomes for people experiencing SUD and opioid use disorder (OUD). Carelon reiterated its dedication to progress in treatments, employing new, technologically advanced models, and ensuring that high-quality equitable care is accessible for people experiencing SUD/OUD.

Here are some key highlights from the discussion:

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Carelon Behavioral Health panelists included:

  • James Polo, MD, MBA, Vice President & Chief Medical Officer
  • Sandrine Pirard, MD, PhD, MPH, West Region Chief Medical Officer
  • Dheeraj Raina, MD, MBA, Manager, Medical Director
  • Shawna Zabkiewicz, BSN, RN, CCM, SSYB, Chief of Staff, Behavioral Health Services

SUD significantly impacts families and communities.

  • Dr. Polo: “I have a daughter, who when she was a teenager, went through a two-year period of significant substance use. There were days where I thought I was going to get a call in the middle of the night that she had been arrested or was dead on the highway. My wife and I spent a tremendous amount of effort getting her into treatment, providing all the support she needed, and she recovered. Today, my daughter is an attorney with a family of her own. So, I know what it’s like to be a parent and have a loved one that is going through a serious substance abuse problem where you don’t know what the outcome is going to be. 

    According to the CDC, one in seven individuals 12 and older is experiencing a substance use disorder. Alcohol and tobacco are most common, but there are prescriptive substances, opiates, sedative hypnotics, stimulants, and illicit substances such as cannabis and inhalants. We saw an uptick in many of these areas during COVID. It’s important to be able to do something to make an impact because recovery is important.”

Treatment models for SUDs are evolving, and new programs improve outcomes

  • Dr. Polo: “We know that the use of technologies, innovative clinical models and predictive data analytics can and do make an impact and improve SUD outcomes. For example, scalable use of telehealth can expand access to care and mitigate barriers related to stigma, geography, and cost. We’ve also recognized how important it is to bring in peers – people with lived experience – as a part of the treatment process.”

  • Shawna Zabkiewicz: “We launched the Empower program in January 2023, focused on women of reproductive age between the ages of 18 and 40 who are at risk for or have a SUD diagnosis. The program is a combination of resources, information, and peer support to help women take action to reduce risk and make healthy lifestyle choices before, during, and after pregnancy. By identifying and helping these at-risk women through non-clinical and digital support to facilitate wellness and recovery, we can not only help improve the lives of these current and future mothers, but also prevent newborn exposure to substances in the womb.”

  • Dr. Raina: “Our Resilience through Intervention Support and Education (RISE) program is based on a predictive model that identifies and stratifies members at risk of SUD and then supports them through case management, peer support, and a single point of contact – meaning one person helping them manage their behavioral health needs, substance use disorder, and physical health needs. This program has shown amazing results: inpatient admissions are down 63%; ER visits are down by almost 55% during the time they are engaged with us; and overdoses of any kind are down by nearly 40%.”

  • Dr. Pirard: “The Changing Pathways program is really about shifting away from traditional practices to endorsing evidence-based practice for the treatment of OUD. Changing Pathways promotes the adoption of medication for OUD right there in the inpatient setting, since we know that this is really where we see the best outcomes. We have seen a 2.5-fold increase to medication adherence as compared to patients who have been detoxed and then started on medication after release. And for those who do adhere to medication, we have seen a dramatic 74% reduction in overdose after discharge.”

Community programs help revolutionize treatment

  • Dr. Polo: “Shatterproof is an organization that was established in 2013 by Gary Mendell, whose son died by overdose, and part of his journey was feeling incredible shame and stigma. Shatterproof helps raise awareness of drug and alcohol problems, how to find evidence-based treatment, and get people into recovery. Our Foundation donated $5 million to this organization because we believe in this so much that we want to help beyond just the people we serve, but in the communities where it’s really needed.”

  • Dr. Pirard: “We also know that a lot of individuals struggling with serious addiction don’t have a stable place to live, which makes it extremely difficult to continue to work on recovery. With that in mind, one of the other Foundation grants we have awarded is to the Chris Atwood Foundation, which allows more individuals to seamlessly transition from treatment for SUD to a safe and supportive housing environment.”

The experts agreed that the issues involving SUD treatment and recovery are vast and that no single organization can create meaningful change alone. Carelon Behavioral Health continues to develop partnerships and innovative, evidence-based treatment programs that get people the help they need, when they need it. 

Click here for the full discussion. 

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