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.