The impact of integrated, collaborative primary care on the opioid epidemic

In 2015, there were 52,404 lethal drug overdoses in the US. Out of that number, 20,101 were related to prescription pain relievers and 12,990 were related to heroin, reports the American Society of Addiction Medicine (ASAM). The organization also states that “23% of individuals who use heroin develop opioid addiction.”

Only a small percentage of the 20.5 million people in the US over the age of 12 who had a substance use disorder received treatment in 2015. A study conducted by Katherine E. Watkins, MD, MSHS, Allison J. Ober, PhD, and Karen Lamp, MD, and published in JAMA Internal Medicine, focused on how collaborative care could impact the treatment of those with an opioid or alcohol use disorder.

The study, “Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care,” found that “relative to usual care, the collaborative care intervention increased both the proportion of primary care patients receiving evidence-based treatment for opioid and alcohol use disorders and the number achieving abstinence from opioids or alcohol use at 6 months.”

Pointing to a need for collaborative care based in the primary care provider’s office, results from the study showed that “39% of patients treated in a collaborative primary-care model received addiction treatment versus just 17% of the group who received standard primary care.” Addiction or substance abuse treatment has typically been sought and provided at a disorder treatment program.

Given the current state of the opioid epidemic, the need for primary care physicians to coordinate with multiple providers to treat the patient with an opioid disorder is clearly noted in the study results. In addition to providing treatment to more patients as well as more effective treatment, collaborative care also has long-term effects. In the study, “32% of patients in the collaborative model reported remaining abstinent from opioids or alcohol after six months compared to 22% of patients in standard primary care.”