Reducing the Health Consequences of Opioid Addiction in Primary Care

被引:33
作者
Bowman, Sarah [1 ]
Eiserman, Julie [2 ]
Beletsky, Leo [3 ]
Stancliff, Sharon [4 ]
Bruce, R. Douglas [2 ,5 ]
机构
[1] Rhode Isl Hosp, Dept Internal Med, Providence, RI USA
[2] Yale Univ, AIDS Program, Sch Med, New Haven, CT 06510 USA
[3] Univ Calif San Diego, Sch Med, San Diego, CA 92103 USA
[4] Harm Reduct Coalit, New York, NY USA
[5] Yale Univ, Sch Publ Hlth, New Haven, CT 06510 USA
关键词
Addiction; Buprenorphine; Harm reduction; Naloxone; Opioid dependence; Overdose; Primary care; BRIEF MOTIVATIONAL INTERVENTION; RANDOMIZED CONTROLLED-TRIAL; INJECTION-DRUG USERS; ABUSE SCREENING-TEST; SUBSTANCE-ABUSE; NEEDLE-EXCHANGE; METHADONE TREATMENT; OPIATE OVERDOSE; PRESCRIPTION DRUGS; HOME NALOXONE;
D O I
10.1016/j.amjmed.2012.11.031
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Addiction to prescription opioids is prevalent in primary care settings. Increasing prescription opioid use is largely responsible for a parallel increase in overdose nationally. Many patients most at risk for addiction and overdose come into regular contact with primary care providers. Lack of routine addiction screening results in missed treatment opportunities in this setting. We reviewed the literature on screening and brief interventions for addictive disorders in primary care settings, focusing on opioid addiction. Screening and brief interventions can improve health outcomes for chronic illnesses including diabetes, hypertension, and asthma. Similarly, through the use of screening and brief interventions, patients with addiction can achieve improved health outcome. A spectrum of low-threshold care options can reduce the negative health consequences among individuals with opioid addiction. Screening in primary care coupled with short interventions, including motivational interviewing, syringe distribution, naloxone prescription for overdose prevention, and buprenorphine treatment are effective ways to manage addiction and its associated risks and improve health outcomes for individuals with opioid addiction. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:565 / 571
页数:7
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