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.

Comments:

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

Reference:

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.