Resource Guide for Applying Public Health Informatics to Addiction Treatment

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An electronic medical record system on a tabletIntroduction

Drug and alcohol addiction is a serious problem that can damage users’ health, ruin their relationships and destroy their lives. It’s also widespread: According to data published by Addiction Center, over 20 million Americans over the age of 12 suffer from addiction to some form of legal or illicit substance, excluding tobacco. These substances include alcohol, marijuana, illegal drugs like heroin and cocaine, and prescription opioids such as oxycodone and codeine.

The roots of addiction are planted early. Studies indicate:

  • 2 percent of individuals under 18 have used illicit drugs.
  • Rates of illicit drug use spikes among people ages 18 to 25.
  • Over 90 percent of addicts began drinking or taking illicit drugs before turning 18.

For those involved in the public health field, this unfortunate prevalence of addiction makes the development and delivery of effective treatment solutions a necessity. One tactic that has risen to the forefront over the last few years is using the technology tool known as public health informatics to develop treatment strategies.

This guide aims to provide medical and public health professionals with resources to help them create high-quality health-informatics-driven treatment strategies for those suffering from addiction to alcohol and drugs. These resources can lead to the development of targeted plans singularly tailored to individuals, which could make the goal of successful recovery more attainable.

Chapter 1: Public Health Informatics: An Overview

While the use of public health informatics is growing, many in the health care field don’t fully understand what it is. However, given its potential value in creating treatment solutions, it is essential that both public health officials and treatment-seeking individuals learn about public health informatics and how it can work for them. Once they gain this understanding, the caregiver and the individual can utilize health informatics and its derived data to collaborate on the plan that will work best for the patient. This intimate form of treatment could potentially revolutionize addiction treatment.

Public Health Informatics Defined

The Centers for Disease Control and Prevention (CDC) defines public health informatics as “the systematic application of information, computer science and technology to public health practice, research and learning.” In other words, it’s an innovative concept that applies computer science along with technology-driven data analysis and record-keeping to health care for the purpose of delivering highly targeted care strategies.

The concept of health informatics has been around longer than one may think, given its association with modern technological concepts. In the 1960s, various health organizations including the American Society for Testing and Materials (ASTM) began standardizing several key components of health informatics, including:

  • Laboratory message exchange.
  • Electronic health record (EHR) system properties.
  • Data content.
  • Health information system security.

Eventually, these standards branched into specified areas of care, which were typically identified by a specialized clinical outlet or trade organization. Some of these groups include:

  • The American College of Radiology and the National Electrical Manufacturers Association, which created the Digital Imaging and Communications in Medicine standard.
  • The National Council for Prescription Drug Programs, which created the Logical Observation Identifiers Names and Codes database.

Because health informatics is so heavily reliant on tech-driven data, some may view it as a subset of information technology (IT). However, a closer look at the two reveal vast differences. Health informatics is associated with the following duties:

  • The design of patient data systems.
  • Management of health care databases.
  • Analysis and interpretation of patient data.
  • Coordination of IT-directed regulatory mandates, such as research or billing.

IT in the context of health care, on the other hand, involves the following responsibilities:

  • Creation of electronic health data files.
  • Safeguarding patient data privacy.
  • Overseeing data and medical law compliance.

The differences ultimately help to highlight that health care informatics gathers, analyzes and interprets patient records to extract the most comprehensive patient information possible.

For additional information on public health informatics and its functionality, visit the American Medical Informatics Association.

Applying Public Health Informatics

The data gathered through public health informatics can be used to create health strategies that specifically align with a patient’s sensibilities, as opposed to relying on a general plan of care. This could have substantial ramifications in providing treatment plans for those battling addictions.

Because health informatics has taken a more prominent role in health care thanks to the industry’s increasing acceptance of technology, it has become important for public health professionals to thoroughly explain health informatics to patients and how it is applied for the patient’s benefit. This can be done by sharing the following:

  • Easier-to-access patient records, leading to more efficient care.
  • Reduced medical errors, which may reduce costs.
  • Less repeat routine testing like blood work, reducing patient out-of-pocket expenses.
  • Less risk of prescription issues, such as allergic reactions.

These conversations are important to have with patients. Health informatics is poised to derive numerous advantages for patients and facilities. For instance, public health informatics can be utilized in the following ways:

  • Coordination of community wellness.
  • Prevention of disease outbreaks.
  • Proactive preparation for emergencies.

Additional Resources for Public Health Informatics

Centers for Disease Control and Prevention. This national health protection agency provides a PDF and a PowerPoint-formatted presentation breaking down the basic concepts behind health informatics. These presentations are public domain and can freely be used by health care professionals.

Healthcare Information and Management Society (HIMSS). HIMSS is a not-for-profit organization that aims to help shape optimal global health through technology and tech-driven information. This page provides a detailed history on the concept of health informatics.

Public Health Informatics Institute. This branch of the international nonprofit organization The Task force for Global Health strives to provide health care practitioners the tools needed to effectively utilize the data culled from concepts like health informatics.

SAMHSA-HRSA Center for Integrated Health Solutions. This organization highlights developed primary and behavioral health services to help individuals with substance abuse conditions or adverse mental health diagnoses. Health informatics is one of the key services highlighted by this organization.

Critical Data on Drug and Alcohol Addiction

Substance addiction continues to be a serious issue in the United States. It’s also one that takes many forms, from the long-standing problem of alcohol and illicit drug addiction to the emerging crisis of prescription opioid addiction. Whatever the substance, addiction can cause a wide range of negative side effects for individuals, ones that can damage the user’s health, career and relationship. Because the stakes are so high, it’s crucial that the treatment given to those seeking help is optimized to yield consistently effective results — a goal that may be attained with the help of health informatics.

Drug Addiction Statistics

Studies indicate that about one in every 20 individuals around the world have used illicit drugs. According to a 2011 report by the Substance Abuse and Mental Health Services Administration, 8.9 percent of the U.S. population 12 and older would meet the criteria that defines substance abuse disorder, a statistic that translates to 22.1 million persons. Unfortunately, only 2.6 million people are receiving treatment.

In addition to illegal drug addiction, there is also an ongoing prescription drug addiction crisis in the country. According to data published by Talbot Recovery, roughly 54 million people 12 and over have used prescription drugs beyond their intended purposes at least once in their lives. This number represents a larger number than combined usage numbers for cocaine, heroin and methamphetamine, and it places prescription drugs as the second-most-abused drug in the country, behind marijuana.

Talbot alsor reports the most abused prescription drugs are as follows:

  • Painkillers — 3.3 million users.
  • Tranquilizers — 2 million users.
  • Stimulants — 1.7 million users.
  • Sedatives — 0.5 million users.

Sometimes, drug and alcohol addiction can be deadly, and this unfortunate situation has grown dramatically over the years. Data from the Centers for Disease Control (CDC) indicate there were 16,849 drug overdose deaths in the U.S. in 1999. This number increased to 70,237 in 2017.

While studies show that the use of alcohol and nonprescription drugs among youth has decreased over time, it is still enough of an issue to raise serious concern. For instance, according to data culled from the Addiction Center website:

  • Over 90 percent of addicts began drinking or using illicit drugs prior to turning 18.
  • Rates of illegal drug use peaks among individuals ages 18 to 25.

Studies also indicate that men are more likely to use and abuse most illicit drugs than women. It should also be noted that statistical data on illicit drugs still categorizes marijuana as an illegal drug due to federal law.

For a comprehensive look at the 2011 Substance Abuse and Mental Health Services Administration report, click this link to the full SAMHSA document.

Alcohol Addiction Statistics

The consumption of alcohol remains a legal and popular activity for many adults. Data mined from Talbot Recovery indicate that 51.8 percent of Americans ages 12 and older imbibe. Unfortunately, it also remains an agent of addiction for numerous individuals. According to the Addiction Center website:

  • 6 million Americans suffer from alcoholism.
  • 6 million alcoholics are also addicted to an illicit substance.

A common component of alcohol addiction is the concept of binge or heavy drinking. When this behavior is isolated, the numbers can be staggering. The 2011 report by the Substance Abuse and Mental Health Services Administration indicates:

  • 7 percent of Americans ages 12 and older report heavy drinking.
  • 6 percent of young adults ages 18 to 25 have participated in binge drinking.

Like drug addiction, alcohol addiction can have deadly consequences. According to a report published in the Journal of the American Medical Association:

  • 88,000 people die from alcohol-related causes annually.
  • 62,000 of the deceased are male.
  • 26,000 of the deceased are female.
  • Alcohol is the third-leading preventable cause of death in the United States.

Alcohol abuse is a problem that spans multiple demographics. According to the 2015 National Survey on Drug Use and Health (NSDUH):

  • 1 million (or 6.2 percent) of American adults have alcohol use disorder (AUD).
  • 8 million adult men have AUD.
  • 3 million adult women have AUD.
  • 5 percent of adolescents ages 12 to 17 have AUD.
  • 3 percent of adolescent males have AUD.
  • 7 percent of adolescent females have AUD.

For a complete breakdown of the 2015 National Survey on Drug Use and Health (NSDUH), visit this link produced by SAMHSA.

Peripheral Addiction Statistics

Despite the fact that driving under the influence (DUI) of alcohol or drugs can yield tragic results, leading to significant legal and life-altering consequences for those who get caught, it is still something that occurs regularly.

  • Over 11 percent of Americans have driven under the influence, per data reported by Addiction Center.
  • The CDC reports that More than 1 million drivers were arrested for DUIs in 2016.
  • 6 percent of drivers who were tested for drugs after being involved in fatal driving accidents tested positive for drugs or alcohol, per the National Institute on Drug Abuse
  • The CDC also states legal and illicit drugs are involved in roughly 16 percent of vehicular accidents.

According to various surveys, addiction also carries substantial economic ramifications relating to money spent on crime, health care and lost work productivity. In the United States:

  • Alcohol abuse cost $249 billion in 2010.
  • Illicit drugs cost $193 billion in 2007.
  • Prescription opioids cost $78.5 billion in 2013.

The dramatic rise in opioid-related overdose deaths indicates a serious epidemic that demands attention. The CDC indicates:

  • The number of opioid-related deaths in 2017 was six times higher than the number reported in 1999.
  • Roughly 68 percent of drug overdose deaths in 2017 involved some sort of opioid.
  • An estimated 130 people die every day from an opioid overdose in the United States.

Additional Resources for Drug Addiction Statistics

National Institute on Alcohol Abuse and Alcoholism. This branch of the National Institute of Health (NIH) provides comprehensive data on the serious damage caused by alcohol abuse.

Drugabuse.com. This resource-driven offshoot of American Addiction Centers provides a wealth of data regarding the abuse of drugs and its aftermath.

Centers for Disease Control and Prevention: This page from the national health protection agency features an in-depth look at the opioid crisis.

Using Informatics to Deliver Treatment Solutions

Unfortunately, not everyone addicted to drugs or alcohol gets help. For those who do seek treatment, professionals can use public health informatics to create treatment strategies that reach patients at their level. This can enable a more personalized form of treatment that may not only help patients battle the disease of addiction, but can also allow them to receive a higher level of overall care. Through various forms of data and devices, informatics can also help patients feel like they have some say in their treatment process, an element that could give them a better overall sense of the process.

Medical and Treatment Statistics

The path toward seeking drug or alcohol treatments can sometimes start with a scary incident, like a trip to the emergency room (ER). There has been a sharp rise in these kinds of facility visits. Data from the National Institute on Alcohol Abuse and Alcoholism indicate:

  • Alcohol-related ER visits rose by 47 percent between 2006 and 2014.
  • The demographic with the most alcohol-related visits during that time was adults 45 to 54 years old.
  • Drugs were also involved in 14 percent of alcohol-related visits in that time frame.
  • While more men go to the ER than women, there was a greater rise in women going to the ER during this time.

Additionally, data gathered by DrugAbuse.com indicate ER visits due to pharmaceutical abuse more than doubled between 2004 and 2009.

How Informatics Can Help

As mentioned earlier in this guide, health informatics is used to analyze patient data so a personalized treatment plan can be created for individuals seeking treatment. The goal behind a custom plan is to provide a more effective means of treatment that aligns with the parameters of a patient’s past data.

There are various ways that this data can be gathered, including:

  • Recorded information via a patient portal.
  • Biometric information gathered through health monitoring equipment.
  • Wearable technology, such as fitness devices worn outside of a clinical setting.

The types of data gathered by these devices include:

  • Patient demographics.
  • Lab tests.
  • Monitoring data.
  • Past hospitalizations, diagnoses and treatments.
  • Insurance coverage.

The gathered information makes up a patient’s electronic health record (EHR) database. This information can be accessed by a public health professional to check on various metrics important to building a personalized strategy, such as:

  • Previous attempts at treatment.
  • What patient prescriptions may conflict with treatment strategies.
  • If there are other medical issues that need to be addressed.
  • Any risk or protective elements that can potentially cause or prevent a relapse.

Informatics Resources

As the field of health informatics becomes further integrated into drug and alcohol treatment plans, the number of informatics resources continues to grow.

  • The National Institute on Drug Abuse has several links to pages that detail the various components of health informatics, from computerized systems to software usage.
  • This SAMHSA page contains directions on how to use the basic tools found within the concept of health informatics, such as EHRs.
  • Further information on health informatics, including its history and a glossary of familiar terms, can be found by visiting this link at Open Clinical.

Sources:

Addiction Center, Addiction Statistics

American Public Health Association, What Is Public Health?

CDC, Drug Overdose Deaths

CDC, Impaired Driving: Get the Facts

CDC, Introduction to Public Health Informatics

CDC, “The Role of Public Health Informatics in Enhancing Public Health Surveillance”

CDC, Opioid Overdose: Understanding the Epidemic

Drugabuse.com, “Drug Abuse Statistics”

Frameworks Institute, Health Informatics

HIMSS, “Evolution of Healthcare Informatics Standards”

MentalHelp.net, Addiction Statistics: How Big of a Problem Is It?

National Institute on Alcohol Abuse and Alcoholism, Alcohol Facts and Statistics

National Institute on Alcohol Abuse and Alcoholism, “NIH Study Shows Steep Increase in Rate of Alcohol-Related ER Visits”

National Institute on Drug Abuse, Clinical Informatics

National Institute on Drug Abuse, Drugged Driving

National Institute on Drug Abuse, Overdose Death Rates

National Institute on Drug Abuse, Predictive Factors for Drug Addict Patients’ Treatment Results

National Institute on Drug Abuse, Treatment Statistics

National Institute on Drug Abuse, Trends & Statistics

Public Health Informatics Institute, “Defining Public Health Informatics”

SAMHSA, Informatics

ScienceDirect, Public Health Informatics

Statista, Drug Use in the U.S. — Statistics & Facts

Talbot Recovery, “2018 Prescription Drug Abuse Statistics You Need to Know”

University of Illinois at Chicago, “A Brief History of Health Informatics”

University of Illinois at Chicago, “Four Ways Health Informatics Improves Patient Care”