Primary Medical Care Improves Addictive Problems
Addiction treatment and primary care commonly remain unlinked, despite potential benefits from their integration. To assess whether receipt of primary care improves addiction severity among adults with addictions, researchers studied a prospective cohort of 391 patients in a detoxification program who had previously participated in a randomized trial of linked primary care.
In analyses adjusted for potential confounders, receipt of >=2 primary care visits over 2 years, compared with fewer or no visits, was significantly associated with the following:
- lower odds of drug use or alcohol use to intoxication (odds ratio 0.5)
- lower alcohol severity (determined by the Addiction Severity Index) among patients with alcohol as their first or second drug of choice
- lower drug severity among patients with heroin or cocaine as their first or second drug of choice
- decreased substance-related problems (determined by the InDUC-2R questionnaire)
Receipt of primary care was not significantly associated with receipt of substance abuse treatment.
Receipt of primary medical care by adults with addictions was associated with reduced addictive problems over a 2-year period. Because the exposures were measured simultaneously with the outcomes, an alternative interpretation––that people with improved addictive problems seek primary care—is possible. Nonetheless, this study adds to the growing literature indicating that efforts to link addiction specialty care with primary medical care are worthwhile.Peter D. Friedmann, MD, MPH
Saitz R, Horton NJ, Larson MJ, et al. Primary medical care and reductions in addiction severity: a prospective cohort study. Addiction. 2005;100(1):70–78.