While treatment in specialty care settings is important for individuals with severe substance dependence, access to this type of care is limited. To determine whether addiction can be addressed in the more widely accessible primary care setting, Rand Corp. researchers enrolled 377 people with opioid or alcohol use disorders, assigning 190 to typical primary care treatment and 187 to a collaborative care approach.
The collaborative care intervention was designed to increase the use of medication-assisted treatment for addiction, including long-acting injectable naltrexone for alcohol use disorders and buprenorphine for opioid use disorders. The intervention also encouraged patients to participate in brief psychotherapy treatment sessions. After six months, 22.3 percent of patients who received regular primary care reported substance abstinence compared to 32.8 percent in the collaborative care group.
“This new model of integrating treatment for substance use disorders with a patient’s primary medical care could expand access to drug treatment at a lower cost and in a more accessible fashion,” said Katherine Watkins, MD, the study’s lead author and a senior physician scientist at RAND. “This is a way to increase access to evidence-based substance use treatment, without having to convince patients to go to a specialized drug treatment center.”
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