The prescription of addiction medications after implementation of chronic care management for substance dependence in primary care

J Subst Abuse Treat. 2015 May:52:17-23. doi: 10.1016/j.jsat.2014.11.008. Epub 2014 Dec 2.

Abstract

People with addictive disorders commonly do not receive efficacious medications. Chronic care management (CCM) is designed to facilitate delivery of effective therapies. Using data from the CCM group in a trial testing its effectiveness for addiction (N=282), we examined factors associated with the prescription of addiction medications. Among participants with alcohol dependence, 17% (95% CI 12.0-22.1%) were prescribed alcohol dependence medications. Among those with drug dependence, 9% (95% CI 5.5-12.6%) were prescribed drug dependence medications. Among those with opioids as a substance of choice, 15% (95% CI 9.3-20.9%) were prescribed opioid agonist therapy. In contrast, psychiatric medications were prescribed to 64% (95% CI 58.2-69.4%). Absence of co-morbid drug dependence was associated with prescription of alcohol dependence medications. Lower alcohol addiction severity and recent opioid use were associated with prescription of drug dependence medications. Better understanding of infrequent prescription of addiction medications, despite a supportive clinical setting, might inform optimal approaches to delivering addiction medications.

Trial registration: ClinicalTrials.gov NCT00278447.

Keywords: Acamprosate; Buprenorphine; Chronic care management; Medications; Naltrexone; Substance abuse treatment.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol Deterrents / therapeutic use*
  • Analgesics, Opioid / therapeutic use*
  • Disease Management
  • Female
  • Humans
  • Male
  • Middle Aged
  • Primary Health Care*
  • Substance-Related Disorders / drug therapy*
  • Treatment Outcome

Substances

  • Alcohol Deterrents
  • Analgesics, Opioid

Associated data

  • ClinicalTrials.gov/NCT00278447