Is Integrating Primary Care into Addiction Treatment Right?

According to the treatment industry addiction is a complex disease. However, there are many guidelines or “levels of severity” instituted around the addiction industry. Some wonder if integrating primary care into addiction treatment is the right thing to do. So what does it mean? Simply it means that there would be a process assigned to a person after addiction treatment, meaning a person would be sent to treatment to stabilize their “addiction” and then assigned to a primary care physician to continue to manage their addiction as well as other medical disorders that appear in substance users.

Their primary care doctor would create a follow up plan or in some cases medication to help manage their disease(s). However there are severe flaws in this system, but regardless these procedures will soon be put into action with the Affordable Care Act.

The current relapse rate after alcohol or drug treatment is around 50 percent, due to the fact that there are many flaws and lack of solutions for addiction, this is because there is no cure to addiction, as it is more of a lifestyle habit than a disease such as diabetes, leukemia or aids. Addiction can be stopped by the substance users own free will. The truth is a large majority of people who overuse substance, never get help or are treated for addiction; they rather grow up, move past their drinking or drugging issues and stop using. The major problem in our society today is the cultural stigma we put on “addictions” and now by integrating primary care into addiction treatment, more people will feel victimized by their substance use rather than having the ability to rationalize it’s a habit they can control and stop.

Another reason why the government is looking to integrate primary care into addiction treatment is because of its cost-saving effectiveness for instance on-site delivery of primary care reduces emergency department (ED) visits and inpatient hospital stays months among adult patients in methadone maintenance or in long-term residential treatment programs (drug-abuse.gov). The Journal of the American Medical Association (JAMA) has determined through a study on integrating primary care with addiction treatment that the integration of the two can be cost-effective. According to the JAMA study, “These findings are relevant given the high prevalence and cost of medical conditions among substance abuse patients, new developments in medications for addiction, and recent legislation on parity of substance abuse with other medical benefits.”

However, according to the same study, “there were no differences in total abstinence rates between the integrated care and independent care groups.” This is because addiction treatment does not provide an effective solution for substance use, and involving a primary care physician will not improve results, besides making care available to those with a true medical disorder.

Even though this is cost-saving solution a primary care physician must now be properly trained to help someone deal with a substance use problem as well as any other disorder they might have such as hypertension, coronary artery disease, liver disease, hepatitis C, and forms of depression and anxiety (JAMA). Typically a common practice is to assign the person with a replacement therapy medication or other forms of prescription drugs, which is not only ineffective but rather is a quick fix solution without getting down to the root of the true issues surround their drug or alcohol use.

Family physicians must be knowledgeable to manage all levels of substance use properly in order to truly integrate primary care into addiction treatment. Another issue is the process of referrals to a specialist if that primary care doctor feels it is necessary or not confident enough to manage the severity of an illness or disorder outside of substance use, this could mean weeks of waiting for someone to get help or to manage their illness. As the Affordable Care Act opens up nationwide, this may even push waiting periods for specialists to months.

Drug and alcohol use should be managed by the substance user rather than by the hands of a primary care provider regardless of the cost to the facility and/ or patient. Substance use can be controlled effectively without medication starting with a safe detox process and then an alternative program that can help the individuals realize why they are making the choice to use drugs and alcohol in the first place, rather than be treated for an “illness.” In many cases people use the pain of an external illness or chronic disease as an excuse to use substance, and it is easier to continue to use then facing their problems or seeking medical attention.

If you or someone you know is dealing with a substance use problem call Saint Jude’s today to find a solution that is 12 times more successful than traditional treatment. 1-888-424-2626