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Primary medical care and reductions in addiction severity: a prospective cohort study
Author(s) -
Saitz Richard,
Horton Nicholas J.,
Larson Mary Jo,
Winter Michael,
Samet Jeffrey H.
Publication year - 2005
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2005.00916.x
Subject(s) - medicine , odds ratio , addiction , prospective cohort study , confidence interval , medical record , cohort study , heroin , randomized controlled trial , psychiatry , drug
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. χ 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 ≥ 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.