Each day, more than 130 people in the U.S. die as a result of an opioid-related overdose, according to the National Institute on Drug Abuse. Among the many clinicians grappling with this public health crisis is Joji Suzuki, MD, director of the Division of Addiction Psychiatry. In this abridged interview, originally published in Clinical & Research News, learn more about Suzuki’s passion for patient care, his perspective on the opioid epidemic and his take on motivational interviewing.
Q: What is driving the opioid crisis?
JS: Substance use disorder has been fragmented from standard medical care for years. If you had a drinking or heroin problem, a doctor would have probably told you that they don’t treat it and referred you to a community program, such as Alcoholics Anonymous, or detox. Patients across the country were told that whatever door they were knocking on was the wrong door. Mainstream medicine never really took responsibility for treating substance use disorders. Even today, if you go to a typical medical school, you’re taught very little about substance disorders.
Clinicians across the country are also faced with a dilemma on how to safely treat pain without over-prescribing and relying on opioids. At the Brigham, we are cognizant of this dilemma every day. It’s our job to care for each patient in a responsible and effective way, and to ensure that our staff is fully capable of managing pain safely. It’s also our job to determine how best to connect patients with appropriate treatment services and support.
Q: Where does the solution lie?
JS: The opioid crisis is a systemic problem. It’s about how we as states, agencies, medical schools and hospitals address substance use disorders as a system rather than as a single health care institution. Given the magnitude of scope, we cannot address the crisis alone. All parts of the system must play their part, and this crisis has exposed the deficiencies of our system. Right now, our national response has been too slow and too inadequate. A lot of people are trying, but many of the efforts are not coordinated.
Q: What behavioral health techniques do you use to help patients?
JS: I am a big proponent of motivational interviewing, which is a clinical approach that tries to accomplish behavior change by evoking from the patient his or her own reasons for and desire to change. Simply put, it’s the difference between listening to your patient versus telling them what to do. The traditional approach included a wise doctor and a novice patient, focusing solely on education, such as how to be healthy. While this approach is necessary when patients are acutely ill, this dynamic can lead to a wrestling match in patients struggling to change their unhealthy behaviors. The new approach focuses on an intricate, collaborative partnership – like a dance.
Read the full interview here. If you or someone you know would like to seek support for substance use disorder, contact the Addiction Recovery Program, an outpatient service in the Department of Psychiatry, at 617-983-7060, option 2.