Richard Saitz1, Nicholas J Horton, Mary Jo Larson, Michael Winter, Jeffrey H Samet. 1. Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA. rsaitz@bu.edu
Abstract
AIMS: To assess whether receipt of primary medical care can lead to improved outcomes for adults with addictions. DESIGN: We studied a prospective cohort of adults enrolled in a randomized trial to improve linkage with primary medical care. METHODS:Subjects at a residential detoxification unit with alcohol, heroin or cocaine as a substance of choice, and no primary medical care were enrolled. Receipt of primary medical care was assessed over 2 years. Outcomes included (1) alcohol severity, (2) drug severity and (3) any substance use. FINDINGS: For the 391 subjects, receipt of primary care (> or = 2 visits) was associated with a lower odds of drug use or alcohol intoxication (adjusted odds ratio (AOR) 0.45, 95% confidence interval (CI) 0.29-0.69, 2 d.f. chi(2)P = 0.002). For 248 subjects with alcohol as a substance of choice, alcohol severity was lower in those who received primary care [predictedmean Addiction Severity Index (ASI) alcohol scores for those reporting > or = 2, 1 and 0 visits, respectively, 0.30, 0.26 and 0.34, P = 0.04]. For 300 subjects with heroin orcocaine as a substance of choice, drug severity was lower in those who received primary care (predicted mean ASI drug scores for those reporting > or = 2, 1 and 0 visits, respectively, 0.13, 0.15 and 0.16, P = 0.01). CONCLUSIONS: Receipt of primary medical care is associated with improved addiction severity. These results support efforts to link patients with addictions to primary medical care services.
RCT Entities:
AIMS: To assess whether receipt of primary medical care can lead to improved outcomes for adults with addictions. DESIGN: We studied a prospective cohort of adults enrolled in a randomized trial to improve linkage with primary medical care. METHODS: Subjects at a residential detoxification unit with alcohol, heroin or cocaine as a substance of choice, and no primary medical care were enrolled. Receipt of primary medical care was assessed over 2 years. Outcomes included (1) alcohol severity, (2) drug severity and (3) any substance use. FINDINGS: For the 391 subjects, receipt of primary care (> or = 2 visits) was associated with a lower odds of drug use or alcohol intoxication (adjusted odds ratio (AOR) 0.45, 95% confidence interval (CI) 0.29-0.69, 2 d.f. chi(2)P = 0.002). For 248 subjects with alcohol as a substance of choice, alcohol severity was lower in those who received primary care [predicted mean Addiction Severity Index (ASI) alcohol scores for those reporting > or = 2, 1 and 0 visits, respectively, 0.30, 0.26 and 0.34, P = 0.04]. For 300 subjects with heroin or cocaine as a substance of choice, drug severity was lower in those who received primary care (predicted mean ASI drug scores for those reporting > or = 2, 1 and 0 visits, respectively, 0.13, 0.15 and 0.16, P = 0.01). CONCLUSIONS: Receipt of primary medical care is associated with improved addiction severity. These results support efforts to link patients with addictions to primary medical care services.
Authors: Richard Saitz; Jessie Gaeta; Debbie M Cheng; Jessica M Richardson; Mary Jo Larson; Jeffrey H Samet Journal: J Urban Health Date: 2007-03 Impact factor: 3.671
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