In our nation’s drug overdose crisis, a crisis that shows no sign of slowing, the U.S. Surgeon General’s office estimates more than 20 million people in our country have a substance use disorder. One other thing this epidemic has made painfully apparent is that, by all accounts, there are not nearly enough physicians in this country specializing in treating addiction to address the problem. What is clear to public health officials is we will not stop this epidemic until we fill this gap with enough doctors on the ground who know how to respond.
In a recent encouraging report by NBC News, it was announced that this doctor deficit is driving medical institutions around the country to create fellowships for aspiring doctors committed to acquiring the skills necessary to treat substance use disorder.
Currently, more than 60 such fellowship programs have been formed nationwide that offer physicians postgraduate training in clinics and hospitals where they learn evidence-based approaches for treating addiction.
As the NBC News report points out, historically, the path to addiction medicine was through psychiatry. Public health advocates have been pushing for years to get more physicians trained in evidence-based treatment, and this model started to change beginning in 2015. At that time, the American Board of Medical Specialties – considered the gold standard in physician certification in the U.S. – began recognizing addiction medicine as a valid subspecialty. That said, doctors remain sorely needed if we are to reduce the risk of death among people who have recovered from an opioid overdose.
“Even 10 years ago, I couldn’t find a medical student or resident interested in learning about addiction medicine if I looked under a rock. They were just not out there,” Dr. Anna Lembke, medical director of Addiction Medicine at Stanford University School of Medicine and a longtime researcher in the field, tells NBC.
Lembke now sees a change in the upcoming generation of doctors, drawn to the field because they care about social justice. This represents a potentially significant shift in the way medicine might be practiced in the future. Lembke points out that clinicians traditionally spend substantial time monitoring patients for adverse outcomes. They tend to focus on the absence of disease as a defining trait of health. Public health experts tend to home in on quantifiable measures of societal health, such as leading causes of mortality. What is being recognized is neither of these measures fully accounts for factors such as happiness, life satisfaction, character, virtue and social relationships, all of which can affect health.
This too is beginning to change.
In a recent opinion piece published in JAMA and co-authored by Harvard T.H. Chan School of Public Health’s Tyler VanderWeele, a case is made as to why clinicians and public health experts need to start focusing on the concept of “flourishing,” which can be defined as vigorous and healthy growth, when examining patients and making assessments. VanderWeele and his colleagues believe that asking questions related to human flourishing can inform and refine many complex issues for patients facing treatment decisions and has the potential to capture a picture of health more broadly than existing measures. In addition, they believe the concept can potentially guide clinicians in assessing their own personal well-being in an effort toward delivering better patient-centered care.
In pursuit of this goal, researchers have recently developed a “flourishing index” consisting of six domains that account for qualities such as happiness, financial stability and mental and physical health, among other factors. It is hoped this shift in focus will have eventually wide applications for the patient as well as society at large. Researchers are already examining how employers might use measurements of flourishing to help assess and improve employee well-being.
This development is happening at a time when complementary or integrative medical approaches have never been more popular. Nearly 30 percent of adults report using complementary or alternative medicine. Doctors are beginning to embrace such therapies, often combining them with mainstream medical approaches.
We should also not lose sight of the things we can do to improve health that do not necessarily require medical intervention.
As pointed out in a new study published in the Lancet, in 2017, poor diet was associated with 1 in 5 deaths worldwide. That’s equivalent to 11 million deaths a year; unhealthy eating habits are responsible for more deaths than tobacco and high blood pressure.
The main problem causing these health outcomes is the low intake of healthy foods. Diets high in sodium, low in whole grains and low in fruit accounted for more than half of all diet-related deaths around the world. In the United States, not eating enough whole grains was determined to be the leading dietary risk factor.
We are not alone in this. People in almost every corner of the world could benefit from rebalancing their diets. As reported on in the past, scientists have unveiled what they say is an ideal diet for the health of the planet and its people. It simply requires doubling your consumption of nuts, fruits, vegetables and legumes and cutting in half your consumption of meat and sugar.
It should also be a focus of public health interventions.
Write to Chuck Norris with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @chucknorris and Facebook’s “Official Chuck Norris Page.” He blogs at ChuckNorrisNews.blogspot.com.