The Prescription of Addiction Medications After Implementation of Chronic Care Management for Substance Dependence in Primary Care

Abstract People with addictive disorders commonly do not receive efficacious medications. Chronic care management (CCM) is designed to facilitate delivery of effective therapies. Using data from the CCM group in a trial testing its effectiveness for addiction ( N = 282), we examined factors associat...

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Bibliographic Details
Published in:Journal of substance abuse treatment 2015-05, Vol.52, p.17-23
Main Authors: Park, Tae Woo, M.D, Samet, Jeffrey H., M.D., M.A., M.P.H, Cheng, Debbie M., Sc.D, Winter, Michael R., M.P.H, Kim, Theresa W., M.D, Fitzgerald, Anna, M.D, Saitz, Richard, M.D., M.P.H
Format: Article
Language:English
Subjects:
Acamprosate
Adult
Alcohol Deterrents - therapeutic use
Alcoholism
Analgesics, Opioid - therapeutic use
Buprenorphine
Chronic care management
Clinical trials
Disease Management
Drug addiction
Drug therapy
Female
Health care delivery
Humans
Male
Medications
Middle Aged
Naltrexone
Primary care
Primary Health Care
Psychiatry
Substance abuse treatment
Substance-Related Disorders - drug therapy
Treatment Outcome
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Summary:Abstract People with addictive disorders commonly do not receive efficacious medications. Chronic care management (CCM) is designed to facilitate delivery of effective therapies. Using data from the CCM group in a trial testing its effectiveness for addiction ( N = 282), we examined factors associated with the prescription of addiction medications. Among participants with alcohol dependence, 17% (95% CI 12.0–22.1%) were prescribed alcohol dependence medications. Among those with drug dependence, 9% (95% CI 5.5–12.6%) were prescribed drug dependence medications. Among those with opioids as a substance of choice, 15% (95% CI 9.3–20.9%) were prescribed opioid agonist therapy. In contrast, psychiatric medications were prescribed to 64% (95% CI 58.2–69.4%). Absence of co-morbid drug dependence was associated with prescription of alcohol dependence medications. Lower alcohol addiction severity and recent opioid use were associated with prescription of drug dependence medications. Better understanding of infrequent prescription of addiction medications, despite a supportive clinical setting, might inform optimal approaches to delivering addiction medications.
ISSN:0740-5472
1873-6483
DOI:10.1016/j.jsat.2014.11.008