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 (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. ²P = 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  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  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.

Keywords: Health services; primary care; severity of illness; substance abuse

Document Type: Research article

DOI: 10.1111/j.1360-0443.2005.00916.x

Affiliations: 1: Department of Mathematics, Smith College, Northampton, MA, USA 2: Boston University School of Public Health, Boston, MA, New England Research Institutes, Inc., Watertown, MA and the