A Boston Medical Center (BMC) program that incorporates addiction treatment into primary care for patients who either have or are at risk of contracting HIV was recently proven to decrease patients' dependence upon substances and increase the odds that they might seek treatment; findings gleaned from the program were published online in the Journal of Substance Abuse Treatment.
"We know that this patient population often seeks care in emergency rooms where they see physicians who may not know their medical history," Dr. Alexander Walley, attending physician in general internal medicine at BMC and the study's lead author, said. "As a result, unhealthy drug and alcohol use often goes unaddressed. Our model aims to integrate evidence-based addiction treatment into primary care."
For the study, 265 participants, all of whom had been dependent on drugs or alcohol for a year or longer, enrolled in the program, titled BMC's Facilitated Access to Substance Abuse Treatment with Prevention and Treatment for HIV (FAST PATH), which ran from Feb. 1, 2008 to March 31, 2012. Two specialized healthcare teams at BMC that address addiction and substance use issues oversaw the program.
Participants underwent multidisciplinary assessment by a primary care physician, nurse and addiction counselor, had access to weekly addiction counseling sessions, HIV risk reduction and overdose prevention counseling. They also received medication-assisted treatment and were offered prescriptions for buprenorphine, a medication used to combat opioid addiction.
After six months, patients were reassessed. Across the board, substance dependence of participants dropped to 49 percent after six months, and 64 percent made two visits in the first 14 days and two additional visits in the next 30 days.
"Given depression's association with adverse health outcomes in this patient population, including mental health treatment in primary care holds potential to improve addiction treatment outcomes," Walley said.
