Addiction Treatment in Primary Care
James MacKillop, George A. Kenna, Lorenzo Leggio, Lara A. Ray in Integrating Psychological and Pharmacological Treatments for Addictive Disorders, 2017
It is well established that substance use disorders (SUDs) represent chronic conditions comprised of biological and behavioral factors requiring screening, diagnosis, intervention, and medical management. To date, strategies used to manage and/or treat other chronic illnesses in primary care have not been widely adopted for the management and treatment of SUDs in the primary care setting [1]. In 2012, approximately 23 million people in the United States required treatment for an alcohol use disorder (AUD) or SUD, while only 11% actually received treatment [2]. The National Epidemiologic Survey on Alcohol and Related Conditions reports that only 26% of alcohol-dependent individuals ever sought treatment, including self-help groups (e.g., Alcoholics Anonymous), highlighting the underutilization of addiction treatment and support services [3]. And for those who do receive treatment for AUD, 40–60% are expected to relapse within one year [1]. Furthermore, one prospective cohort study found that only 63% of participants in an alcohol detoxification program (n = 400) accessed primary medical care [4]. Taken together, these statistics emphasize the need to boost the effectiveness of existing treatments for both AUD and SUD. One possible alternative to this complex issue of addiction services utilization that has garnered much attention in recent years consists of identifying a role for addiction medicine in a primary care setting.
Medical Strategy: Interventions
Robert K. White, Deborah George Wright in Addiction Intervention, 2014
First, the physician must be aware of the resources available in the community. This includes not only acute detoxification, which may be done as an outpatient or at the other extreme of intensity of care may be hospital-based, but also other types of providers of services. The physician should establish relationships as a referral source with at least one or two intermediate care facilities specializing in the treatment of addictive disorders. The physician should also have available the names, addresses, and telephone numbers of various outpatient providers of addiction services. Psychiatrists who are trained in addiction medicine, as well as addictionists of other specialty backgrounds, should be known to the primary care physician. The American Society of Addiction Medicine can provide a list of physicians trained in addiction medicine in any practitioner's area.
Alcohol Use Disorders: Diagnosis and Treatment
James M. Rippe in Lifestyle Medicine, 2019
Addiction medicine specialists welcome referrals, and consultations can provide the following services:To clarify the diagnosis of alcohol use disorderTo guide the process of detoxificationTo assist with determining the level of care required for detoxification and for early recoveryTo initiate pharmacologic treatment and to coordinate care with providers of non-pharmacologic treatments (including, but not limited to, psychotherapy, mutual help groups, and alternative treatments) individually tailored to patients’ goalsTo develop a relapse prevention planWhen other substance use disorders are comorbid, such as benzodiazepines and opioid use disorders
An international consultation on case reports in addiction medicine
Published in Substance Abuse, 2021
Rouhollah Qurishi, Joost P. H. Drenth, Alexander Baldacchino, Barbara Broers, Victor J. A. Buwalda, Cornelis A. J. De Jong
Addiction Medicine is a specialty that focuses on prevention, evaluation, diagnosis, treatment, and recovery of individuals with pharmacological and non-pharmacological related physical, psychological and social problems. Addiction Medicine specialists are increasingly challenged with new clinical challenges such as concomitant medical,7 psychiatric disorders,8 adverse social determinants9 and/or combinations of these issues.10 However, despite the popularity among readers, Casen Reports find themselves in a difficult spot on the editorial selection table. Casen Reports are frequently rejected from main stream journals because they rank low on the hierarchical ladder of evidence based medicine11 and attract less citations than other reports. So, from a clinical perspective Case Reports are worthwhile to be published but appear to get not much support to do so in the scientific arena.
Physical therapists’ attitudes are associated with their confidence in and the frequency with which they engage in prescription opioid medication misuse management practices with their patients. A cross–sectional study
Published in Substance Abuse, 2022
John (Jake) Magel, Gerald Cochran, Nancy West, Julie M. Fritz, Mark D. Bishop, Adam J. Gordon
Misuse of prescription opioids includes using opioids other than prescribed or using opioids longer than intended1,2 and opioid use disorder (OUD) or addiction occurs when the patient attempts unsuccessfully to control their opioid use and social problems and failure to fulfill obligations is a result.3 For the purposes of this paper, we collectively refer to opioid misuse and OUD as prescription opioid medication misuse (POMM). In the US, approximately 9.9 million individuals misused prescription opioids in 2018,4 and nearly 30% of patients taking long–term prescription opioid medications for painful orthopedic conditions may be misusing them.5 The diagnosis and treatment of opioid misuse has relied primarily on physicians being properly trained in opioid risk assessment, risk mitigation, and addiction.6 Recently, physician and nurse leaders in addiction medicine have advocated for other health care provider types such as nurses, public health professionals and counselors to be trained to diagnose substance use disorders and to use non–pharmacologic approaches to manage substance use.7 Physical therapists are members of the health care team that commonly manage patients with painful orthopedic conditions taking prescription opioid medications.8 Physical therapists, therefore, could play a prominent role in screening, diagnosing and treating patients with POMM.
Exploring the Long-term 12-Step Collegiate Recovery Experiences of Emerging Adults: An Interpretive Phenomenological Analysis
Published in Alcoholism Treatment Quarterly, 2022
Thomas G. Kimball, Nicole D. Hune, Sterling T. Shumway, Spencer D. Bradshaw
Addiction is a chronic brain disease that alters neural pathways and impairs executive control and decision-making (American Society of Addiction Medicine American Society of Addiction Medicine (ASAM), 2019; Morrill & Axelrath, 2019). Characterized by compulsive use and physical cravings, addiction is also complicated by biological, environmental, and psychological impairments (American Society of Addiction Medicine (ASAM), 2019). In 2019, 20.4 million people aged 12 or older had a substance use disorder (SUD) in the past year (Substance Abuse and Mental Health Services Administration Substance Abuse and Mental Health Services Administration (SAMHSA), 2020). Severe SUDs, used interchangeably with addiction, are especially prevalent among emerging adults in college (Johnston, O’Malley, Bachman, & Schulenberg, 2009; SAMHSA, 2013). According to the National Institute on Alcohol Abuse and Alcoholism (2020), p. 20% of college students (18–22 years of age) met criteria for alcohol use disorder (AUD) within the past year, while over 14% of college students met criteria for SUDs (SAMHSA, 2019ab). Fortunately, many emerging adults have found a pathway out of addiction, as approximately 600,000 college students identified as being in recovery (Brown, Ashford, Heller, Whitney, & Kimball, 2018; SAMHSA, 2019b; Vest, Timko, Kelly, & Humphreys, 2021).
Related Knowledge Centers
- ADDiction
- Alcohol
- Drug Rehabilitation
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- Substance Dependence
- Substance-Related Disorder
- Prescription Drug
- Public Health
- Psychology
- Psychiatry