Entry into primary care-based buprenorphine treatment is associated with identification and treatment of other chronic medical problems

Abstract

BackgroundBuprenorphine is an effective treatment for opioid dependence that can be provided in a primary care setting. Offering this treatment may also facilitate the identification and treatment of other chronic medical conditions.MethodsWe retrospectively reviewed the medical records of 168 patients who presented to a primary care clinic for treatment of opioid dependence and who received a prescription for sublingual buprenorphine within a month of their initial visit.ResultsOf the 168 new patients, 122 (73%) did not report having an established primary care provider at the time of the initial visit. One hundred and twenty-five patients (74%) reported at least one established chronic condition at the initial visit. Of the 215 established diagnoses documented on the initial visit, 146 (68%) were not being actively treated; treatment was initiated for 70 (48%) of these within one year. At least one new chronic medical condition was identified in 47 patients (28%) during the first four months of their care. Treatment was initiated for 39 of the 54 new diagnoses (72%) within the first year.ConclusionsOffering treatment for opioid dependence with buprenorphine in a primary care practice is associated with the identification and treatment of other chronic medical conditions.

Illicit buprenorphine use, interest in and access to buprenorphine treatment among syringe exchange participants

“…If improving access to BMT also resulted in diversion to opioid naïve polysubstance users, there could be an overall negative public health impact; however, if concern about diversion resulted in stricter regulations, access to treatment could suffer, widening the treatment gap, and making it more difficult for marginalized PWUD to initiate BMT (Clark & Baxter, 2013). Additional data are necessary to estimate the prevalence of buprenorphine abuse; however, encouraging illicit buprenorphine users to initiate BMT instead of self-treating their addiction has clear advantages, such as education about risks, monitoring for other substance use, and treatment of co-morbid chronic conditions (Rowe, Jacapraro, & Rastegar, 2012; Schuman-Olivier et al, 2013). This requires access though, and even in a setting like New York City with numerous opioid treatment programs, capacity for treatment is only half of what is needed (McNeely et al, 2012).…”

Screening and brief intervention for unhealthy substance use in patients with chronic medical conditions: a systematic review

“…2003). Among PC patients treated for opioid dependence, 74% reported at least one established CMC initially, and at least one newly identified CMC was subsequently found in 28% of patients (Rowe et al . 2012).…”

Patient predictors of substance use disorder treatment initiation in primary care

“…Addressing these factors can facilitate targeted interventions that increase access to care and treatment initiation. Although several studies have examined patient-level predictors of treatment initiation in SUD specialty care settings, we are only aware of one study that has examined SUD treatment initiation in a primary care setting, finding that entry into a primary care-based buprenorphine treatment program was associated with identification of other chronic medical conditions (Rowe, Jacapraro, & Rastegar, 2012).…”