Leaving the front line of fighting opioid use disorder is bittersweet
Just over a year ago, I left the federal government to cope with my family’s struggle with substance use disorder. I chose to channel the grief over my uncle’s overdose into taking the helm of an opioid treatment program at ground zero of the addiction crisis. Below are some insights from the past year that could be used to inform the design of future policy, care models, technology, and advocacy approaches related to helping people achieve recovery from opioid use disorder (OUD).
- Without addressing social determinants, addiction will not go away
- Integration of care is key to sustained recovery
- Work requirements don’t work, Medicaid expansion does
- Behavioral health needs, but isn’t ready for, value based payment
- Behavioral health software is ripe for disruption
- If we focus on one population, it should be people in the prison system
I’ve spent the last year translating my entrepreneurial and policy expertise into improving addiction treatment at the front line. Working so close with providers and patients has been incredibly therapeutic for me. It helped me sublimate the angst from my uncle’s death into productive work and learning. I no longer wake up in the morning anxiously perseverating about what I could have done differently to avert my uncle’s overdose.
Part of what made my experience so personally therapeutic was working with inspirational team members. I am incredibly grateful to them. Their compassion for and dedication to the patients is profound. I’ve seen staff who themselves are on the cusp of poverty give their own food to starving patients. I’ve seen staff cry alongside their patients. I’ve seen staff work overtime and still make time for night school so they could provide the highest standard of patient care.
Over the past year, the work in the community led to emergency room utilization reduction by half for patients in intensive outpatient treatment. The team was able to increase access to care for over 600 people per day. We defied stigma by hiring people in recovery, people with criminal records, and other people with lived experience that made them exceptionally qualified to provide the best, most empathetic care to a complex patient population. Our work has been nationally recognized by leading academic and advocacy organizations, such as the National Academies of Medicine.
Now it is time for me to look for other ways to curb the addiction crisis. Last Friday, Dec 21st, was my last day working on the front line. I will deeply miss working with my colleagues there.
While I’m sad to leave, my next project will inevitably remain in the behavioral health space. But instead of helping one patient at a time, or hundreds of patients per day, I want to impact the lives of millions of people. And the fastest way to scale impact is to go back to my roots in growing technology companies.
Whether high-tech or front-line, I continue to remain in the service of our behavioral health community. I look forward to continuing to help addressing social determinants, integrating care, shaping policy, informing software design, and reforming the criminal justice system. Please don’t hesitate to reach out to me at @andreyostrovsky to keep the conversation going.
Thank you for reflecting with me on this past year. And I wish you a Happy 2019.
