Disconnect between addiction and primary health care

Addiction treatment services are sometimes referred to as a "black hole" by primary care physicians. This refers to the concept that once doctors refer a patient to alcohol or addiction treatment, they are usually no informed of the patient's further progress or treatment process. Where does this disconnect between patient and primary care doctor stem from? Even in recent history, addiction treatment has been viewed as a separate entity from the typical "medical model of treatment." In addition federal and state rules regarding confidentiality have created a barrier between primary care physicians and addiction patients. After a primary care physician diagnoses a patient with alcoholism or addiction they are no longer on a "need to know" basis with that patient.

Primary care physicians also do not routinely provide screenings for substance use disorders. If there is any screening at all it is simply a couple of questions on an intake form, which does not serve as the most appropriate method for the communication of such a topic. For years doctors and primary health care providers have lacked the necessary training and knowledge to address these kinds of behavioral health problems. Research by the American Society of Addiction Medicine shows that intervention by a medical provider is extremely effective in the stages between recovery and prevention.

Boston University is offering a new education program that will help to bridge the gap between primary care physician and addiction patients. It is one of 10 inaugural programs across the country that offers specialized training in addiction. Now internal medicine residents can complete their residency as a primary care doctor with a focus on caring for addicted patients. These kinds of programs are a step in the right direction towards the integration of care for addicts, especially those who are suffering from more than just their addiction.

In an ideal world there would be no drug abuse, no alcohol abuse and no one would ruin their lives. Unfortunately the real world is far from ideal. I've chosen to cover the topic of drug and alcohol abuse from a very different angle than it is normally looked at. Like many problems in life, most of us neglect to concern ourselves unless we are directly affected by the problem itself. It's easy to ignore the drug addicts who are ruining their lives and sometimes the lives of those around them. But what about when that drug addict is your mother, your brother, your best friend or your soulmate? If it was your loved one who needed medical care and treatment for addiction wouldn't you want them to get the help they need? The good news is that attention is being drawn to the issue of substance abuse in New England. In 2014 national health care law will require that insurers begin covering addiction treatment. A growing number of addiction clinics in and around Massachusetts are putting their efforts towards better care and treatment for substance abusers. Instead of simply using methadone to treat addiction, clinics in and around Massachusetts are now including additional treatments to patients.

For years treatment clinics simply prescribed a patient methadone and sent them home. It has long been used as an anti-addictive used for patients suffering from an opioid dependency. But there seems to be something wrong with the concept of treating a drug addict with another addictive substance to ween him or her off from the original narcotic. According to the U.S. National Center for Health Statistics 3,849 deaths were linked to methadone in 2004. So clearly there is more that needs to be done than just sending the drug addict home with a new drug. The Dorchester clinic has added a primary care doctor to its staff on Friday mornings. Now patients at this clinic can be treated for high blood pressure, high cholesterol and many other common health problems. When you think about it, most of these addicts haven't seen a doctor in years. Their lives have been in a downward spiral due to their drug addiction. It's not just the addiction that they need to overcome and get a hold of, they need to regain hold of their own health and bodies.

Recovery Month

It is more than half way through Recovery Month. Now where does that leave us? Somewhere between sick and well? How many people even know that September is, indeed, Recovery Month, a time to spread awareness about substance abuse and commend those around us who have overcome their struggle with addiction. Alcohol and substance abuse affects over 400,000 men and women in Massachusetts alone. Who is helping these people recover and gain hold of their lives? According to statistics released by the US Substance Abuse and Mental Health Services Administration, the number of treatment facilities in the state of Massachusetts has decreased significantly over the last four years. In addition, the state ranks one of the highest in the country for the number of people ages 18-25 who are need of treatment but are not currently receiving any. Why do we focus so much attention on prevention programs in our schools but focus significantly less attention on those who have fallen victim to the evils we are preaching about? The question isn't what more we can do, the question is where do we start from. Some clinics in Massachusetts are focusing on such questions and are trying to enhance patient care in addiction clinics around the state. These particular clinics are doing more than their jobs require: they are recognizing what else needs to be done and are taking steps towards improvement.