The VA has a lot of wonderful
programs in place. However, we need to really emphasize
education amongst primary care physicians so that they have a
better understanding of what addiction really is and
deconstruct some of the stereotypes and stigma that I
myself carried around with me ever since residency.
I think the change in stigma really is going to start with
with us because if we understand the problem in a
different way, we're going to explain it to the patient.
In a way that.
That starts to destigmatize it.
Where we fall short sometimes is.
Is just getting rushed in our day to day tasks and failing to
recognise something really important, like the fact that
somebody has an opioid use
disorder. And at least from my perspective as a primary care
physician, it doesn't always get the attention that it deserves.
The other thing that I think is really important is to have some
peer to peer support, and by that I mean you know
specifically primary care doctors helping other primary
care doctors. Primary care. Doctors tend to be very very
pragmatic group and they want to understand the problem, but they
also want to know in a very straightforward way. OK, what do
I do next?
A little hand holding goes goes along way when
you're asking people to.
Address of what can be a very complicated problem.
I think the main complaint from most primary care providers
within the VA is that hey packed. Sounds great, but what
I'm working with is not packed because we don't have a nurse on
my team or we don't have a clinical pharmacist to assist us
or we don't have a social worker. We need to have more
people who who want to make a career out of the VA, not just
physicians, but nurses and
schedulers and. Pharmacists and the like.
What I'm saying is that there's just a real.
Number one lack of recognition of what opioid use disorder even
is and how it's different from
chronic pain. There's just not the same appreciation for
addiction opioid use disorder in particular as as as a
disease like. It truly is. That, again, is no different
than any of the other.
Chronic medical problems that that we treat.
In missing these problems and not having the tools to treat
it, it becomes in ever press and present frustration as opposed
to an opportunity to feel like you're really able to be
successful with your patients in managing such problems.
I don't think we should never take for granted the little
things that we can do that we can say or that we can do
that make a world of difference to our patients
who have been stigmatized.
In some cases, their entire adult life.