Ongoing Primary and Specialty Care Is Associated with Improved Substance Use Outcomes
This study analyzed data from 2 randomized trials conducted in a private managed-care health plan: 1 study compared day-hospital treatment for substance use disorders with traditional outpatient treatment, and the other studied integrated delivery of medical and addiction services. Follow-up was at 1, 5, 7, and 9 years in both studies. The sample included 991 subjects (56% of the combined cohorts) who had at least 1 follow-up interview and were with the plan for at least 5.4 years after intake. The association between remission and service use (yearly primary care, psychiatric services, and substance abuse treatment) was examined using nonlinear mixed-effects multivariable logistic regression.
- Baseline characteristics associated with remission included being female (odds ratio [OR], 1.44), being older (OR, 1.02), completing prior substance abuse treatment (OR, 2.72), and being married or living as married (OR, 1.38).
- A yearly primary care visit was also positively associated with remission (OR, 1.39), as was continuing care (OR, 2.34), defined as:
- having at least 1 yearly primary care visit,
- completing substance abuse treatment or receiving further treatment,
- receiving alcohol or drug treatment when the alcohol or drug Addiction Severity Index (ASI) score at last assessment was higher than 0, and
- receiving psychiatric services when the psychiatric ASI score at last assessment was higher than 0.