Primary medical care and reductions in addiction severity: a prospective cohort study
Article first published online: 10 DEC 2004
Volume 100, Issue 1, pages 70–78, January 2005
How to Cite
Saitz, R., Horton, N. J., Larson, M. J., Winter, M. and Samet, J. H. (2005), Primary medical care and reductions in addiction severity: a prospective cohort study. Addiction, 100: 70–78. doi: 10.1111/j.1360-0443.2005.00916.x
- Issue published online: 10 DEC 2004
- Article first published online: 10 DEC 2004
- Submitted 25 March 2004; initial review completed 25 June 2004; final version accepted 16 August 2004
- Health services;
- primary care;
- severity of illness;
- substance abuse
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. χ2P = 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.