The Opioid Crisis is a Wicked Problem

Jonathan C. Lee, MD — American Academy of Addiction Psychiatry; Fall 2017; Volume 33, Number 3

Wicked problems are endemic complex systems with components that interact in complicated, poorly understood and unpredictable ways.1 Interventions into the system produce downstream consequences that cannot be known in advance and cannot be undone. It is impossible to establish a single locus for a wicked problem because changing one element of the system changes the dynamics of the entire system. The wicked problem definition changes depending on both the focal point of interventions and the responses that any proposed solution generates.2

Featured: Omar Manejwala, MD, MBA, Senior VP and Chief Medical Officer of Catasys

I looked for a state that’s taken the opioid epidemic seriously. I found Vermont.

Vermont declared an emergency over the opioid crisis — and actually did something about it.

German Lopez — Vox; October 31, 2017

BURLINGTON, Vermont — A group of more than a dozen addiction care providers gathered at a community health center one morning in September for their monthly meeting, where they chatted about their latest thorny problem.

One of their patients had vanished. Again.

The missing man, a 28-year-old whom I’ll call Tyler, was never an easy patient. On and off, he had used two to eight bags of heroin each day for the past seven years. He was strongly resistant to medication-assisted treatment (MAT), in which patients use medications such as methadone or buprenorphine to stave off withdrawals and reduce cravings — widely considered the gold standard for opioid addiction care.

Featured: Omar Manejwala, MD, MBA, Senior VP and Chief Medical Officer of Catasys

How I Reached Clarity In My Confusing Relationship With Antidepressants

My world, my words

By Hayden Manders — Nylon; October 02, 2017

I was depressed for a little over a decade before I sought treatment. It took a broken heart—a real broken heart—to lose my desire to do pretty much anything other than go through the motions after I’d pulled myself out of bed. I was a junior in college.

Up until my breaking point, I had grown accustomed to sadness, anger, and worry. The heaviness I felt and the overall sense of being “over it,” often before anything began, was my norm. I knew it wasn’t normal, per se, but I was doing really well and excelling. I appeared fine—fabulous, even—but I knew that at any moment, something or someone could send me reeling.

Featured: Omar Manejwala, MD, MBA, Senior VP and Chief Medical Officer of Catasys