Primary Care Takes on Opioid Addiction

From the October 2017 ACP Internist

Primary care clinicians can play a key role in treating opioid addiction, but stigma about the condition, as well as laws and other regulations, create barriers.

Opioid use disorder kills hundreds of Americans each week, despite the availability of treatments that can cut mortality risk by more than half. With some education and empathy, however, internists can intervene to change this dynamic, according to experts.

The National Institute on Drug Abuse reports that using medications to treat opioid use disorder increases retention in treatment programs and decreases overdose, drug use, infectious disease transmission, and criminal activity. The scientific evidence supporting medication as a solution has grown in confluence with an epidemic of opioid overdoses that, according to CDC estimates, kills 142 Americans every day.

As part of an effort to expand access to addiction treatment, which itself involves controlled substances, the Drug Addiction Treatment Act of 2000 (DATA-2000) allowed physicians to provide office-based treatment. The first of the medications that could be prescribed as part of office-based treatment were approved in 2002: buprenorphine (Subutex and other trade names) and the abuse-deterrent formulation of buprenorphine/naloxone (Suboxone and other trade names).

“We've really gotten to the point now where there's a lot that primary care providers can do, so it's a wonderful time to be doing this work,” said internist and addiction medicine specialist Miriam Komaromy, MD, FACP, associate professor of medicine at the University of New Mexico Health Sciences Center in Albuquerque. “Yet we pretend it's somehow optional or something we don't need to deal with.”

Read the full article in ACP Internist.

ACP Internist provides news and information for internists about the practice of medicine and reports on the policies, products, and activities of ACP.

Back to the November 2017 issue of ACP IMpact