Main Body
Burnout in Addiction Treatment: Implications for Leadership and Public Health
Trevor Moffitt
Introduction
Coined the “opioid epidemic,” the United States’ public health crisis of rising opioid-related overdoses and overdose deaths has finally garnered medical, social, and political attention and focus. In October of 2017, President Trump declared the opioid crisis a “public health emergency,” potentially paving the way for more national resources to be allocated to opioid-related treatment and research (Davis, 2017). Some states have been affected more than others by the epidemic, although all of them have at least 2.4 opioid-related overdose deaths per 100,000 people per year (NIDA, 2018). Ohio ranks third in states with most of these overdose deaths and has 36.8 such deaths per 100,000 people (Columbus Public Health, 2018). Franklin county, Ohio’s second most populous county, has seen its rate of unintentional drug overdose deaths rise by 423% since 2003 (Columbus Public Health, 2018).
While more research studies are underway and are being funded as the crisis continues, more work is needed to answer basic questions. What are best practice guidelines for delivering treatment to those with Opioid Use Disorder (OUD)? How can opioid users be effectively linked to treatment during a crisis? How can users avoid relapse or further need for intensive treatment? At the center of each of these questions is the individual “OUD treatment experience.” Even critics of the government’s handling of drug epidemics, past and present, see the need for treatment as a vital focus moving forward (Stobbe, 2017). It appears the nation is primed for a great influx of addiction treatment centers to treat the rise in drastic number of Americans dying of opioid-related overdoses. However, the data show a low level of engagement among opioid users with treatment centers. In 2016, only 18% among those needing treatment for an illicit drug use problem received treatment at a specialized facility (Park-Lee, Lipari, Hedden, Copello, & Kroutil, 2016). With such a low treatment engagement level, it is essential that addiction treatment leaders prioritize quality for both staff and clients. This may or may not dictate a surge in new treatment center construction but does impact the quality of treatment offered during treatment interventions.
Focusing on the healthcare providers specifically, like counselors, social workers, or nurses, treatment center staff encounter a breadth of occupational stressors: resistance from clients, poor treatment outcomes, coworker turnover, and pressure to meet company goals. In addition to these barriers, which several other professions could reasonably face, addiction treatment center providers are confronted with overwhelming client workloads, emotional stories of loss and devastation, and the uncertainty of final outcomes of treatment (Volker et al., 2010). Healthcare providers, specifically addiction treatment providers, may thus fac