Now is the Time to Address Substance Use Disorders in Primary Care

Saitz, Richard; Daaleman, Timothy P.

doi:10.1370/afm.2111

Cited by 42 publications

(32 citation statements)

References 25 publications

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“…However, the prevalence of SUDs in this study was based on treatment-seeking patients’ routine healthcare data that were influenced by treatment-seeking behaviors, severity of medical problems, and medical practice. Due to a lack of systematic assessments for alcohol/drug use disorders in general medical settings, alcohol/drug use disorders tend to be underdiagnosed (Saitz and Daaleman, 2017; Wakeman et al, 2016). …”

Section: Discussionmentioning

confidence: 99%

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Zhu

Ghitza

2018

Drug and Alcohol Dependence

118

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Background: Chronic diseases are prevalent and the leading causes of mortality. Comorbidity of substance use disorders (SUDs) and chronic diseases is understudied to inform behavioral healthcare integration. Objectives: This study leveraged electronic health record (EHR) data of 211,880 adults from a large health system to examine prevalence and correlates of comorbidity of SUDs and nine chronic disease groups and to determine their association with hospitalization. Methods: Logistic regression analyses were conducted to estimate associations between chronic diseases and SUDs. To control for severity of diagnosis, analyses of associations between SUD and hospitalization were stratified by the number of chronic conditions. Results: In the sample, 48.3% had ≥1 chronic condition (hypertension 33.7%, arthritis 16.2%, diabetes 13.7%, chronic kidney disease 9.9%, asthma 9.1%, chronic obstructive pulmonary disease 8.9%, ischemic heart disease 8.3%, cancer 4.6%, and hepatitis 1.3%). Prevalence of SUD (overall 13.3%) among patients increased with multiple chronic conditions (14.3% having SUD among patients with one condition; 21.2% having SUD among patients with two to three conditions; and 32.5% having SUD among patients with 4–9 conditions). Chronic conditions were associated with increased odds of SUDs. For all SUD groups, hospitalization was more prevalent among patients with SUD than those without it; prevalence of hospitalization increased with the number of comorbid chronic conditions. Conclusions: Findings reveal a striking pattern of multicomorbidity of SUD and chronic diseases and its positive association with hospitalization. Behavioral healthcare integration should consider efforts to assess and treat comorbid SUD and chronic diseases, especially among adults with multiple chronic conditions.

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Section: Discussionmentioning

confidence: 99%

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Zhu

Ghitza

2018

Drug and Alcohol Dependence

118

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“…The US Department of Health and Human Services forecasts a national shortage of 6080–15 400 psychiatrists by 2025 . Thus, the case for primary care management of opioid use disorder (OUD) is increasingly compelling. Although medical education for primary care providers is comprehensive, there is a paucity of formal training during medical school and residency in the diagnosis and treatment of substance use disorders (SUD) .…”

mentioning

confidence: 99%

Extension for Community Healthcare Outcomes (ECHO) as a tool for continuing medical education on opioid use disorder and comorbidities

2018

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“…In North America, prescription of opioid analgesics was multiplied by 10 between 1990 and 2010 . This sharp increase has been linked to the difficulties in managing chronic non‐cancer pain, and was responsible for increased mortality by accidental overdoses and somatic disorders, such as asthenia, sleep disorders, cognitive and memory disorders .…”

Section: Examples Of the Strong Involvement Of French Gps In Addictovmentioning

confidence: 99%

Identification and tracking of Addictovigilance signals in general practice: which interactions between the general practitioners and the French Addictovigilance Network?

Gentile

Jego

Spadari

et al. 2018

Fundamemntal Clinical Pharma

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Addictovigilance is a health vigilance dedicated to the survey of medicinal or illicit psychoactive substance use disorders (SUDs). France is the only European country to have a vigilance system specifically dedicated to substances with an abuse/addiction potential. The French Addictovigilance system is organized in a network of regional tertiary centres (called Abuse and Dependence Monitoring Centres, CEIP-Addictovigilance) and works in close collaboration with Regional and National health authorities. Because of the essential and unavoidable nature of their practice in the French Healthcare system, general practitioners (GPs) are key actors to identify and track Addictovigilance signals. They have been involved in several of the pharmacoepidemiological surveys implemented by the French Addictovigilance Network (FAN). Now, they increasingly participate in clinical research projects and studies. In this article, interactions between GPs and the FAN are illustrated with two examples: patients on opioid substitution treatment and patients on opioid analgesics. Collaborations between GPs and the FAN could be further potentiated. In particular, more effective communication on psychoactive SUDs including abuse/addiction is necessary to optimize the implementation of preventive measures for patients on psychoactive substances medications, and to improve the attitudes of GPs and more widely health professionals in the management of any psychoactive user suffering from SUDs. In addition, both adapted training and improved collaborative research could contribute to the optimization (safety, quality) of professional practices.

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Now is the Time to Address Substance Use Disorders in Primary Care

Cited by 42 publications

References 25 publications

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Multicomorbidity of chronic diseases and substance use disorders and their association with hospitalization: Results from electronic health records data

Extension for Community Healthcare Outcomes (ECHO) as a tool for continuing medical education on opioid use disorder and comorbidities

Identification and tracking of Addictovigilance signals in general practice: which interactions between the general practitioners and the French Addictovigilance Network?

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