What health outcomes are improved for individuals with Substance Use Disorder (SUD) when they engage with primary care?

From the Guidelines

Engaging with primary care significantly improves multiple health outcomes for people with Substance Use Disorder (SUD), including better management of co-occurring physical health conditions, increased likelihood of receiving evidence-based medications for addiction treatment, and improved mental health outcomes. The most recent and highest quality study, 1, published in 2015 in the Annals of Internal Medicine, supports the effectiveness of integrating behavioral health into primary care, demonstrating substantial reductions in care use and improved outcomes for patients with SUD. Some key benefits of primary care engagement for individuals with SUD include:

• Better management of co-occurring physical health conditions such as hepatitis C, HIV, cardiovascular disease, and respiratory problems
• Increased likelihood of receiving evidence-based medications for addiction treatment, including buprenorphine for opioid use disorder, naltrexone for alcohol dependence, and appropriate medications for withdrawal management
• Reduced emergency department visits and hospitalizations
• Lower mortality rates
• Improved mental health outcomes for conditions like depression and anxiety that frequently co-exist with substance use
• Access to preventive care services such as vaccinations, cancer screenings, and chronic disease monitoring
• Better coordination of care across multiple providers and specialists, ensuring comprehensive treatment that addresses both substance use and other health needs simultaneously. As noted in 1, a primary care approach to substance misuse can be effective in identifying and managing substance use disorders, and brief validated screening tools can allow for rapid and efficient identification of problematic drug use. Overall, the evidence suggests that primary care engagement is essential for improving health outcomes for individuals with SUD, and primary care providers should prioritize integrating behavioral health into primary care to address the complex interplay between addiction and overall health.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Health Outcomes for Individuals with Substance Use Disorder (SUD)

Engaging with primary care can lead to several improved health outcomes for individuals with Substance Use Disorder (SUD), including:

• Better overall health outcomes 2
• Reduced inpatient and emergency department utilization 3
• Increased engagement in outpatient care 3
• Improved management of co-occurring conditions and social determinants of health 4
• Enhanced access to substance use disorder services 5

Specific Health Improvements

Some specific health improvements that can be expected when individuals with SUD engage with primary care include:

• Increased knowledge and attitudes regarding primary care 2
• Improved medication management for substances such as nicotine, opioid, and alcohol use disorders 4
• Reduced hospital days and ED visits 3
• Increased primary care visits 3
• Improved treatment outcomes for polysubstance use and understanding of approaches used in SUD care 4

Barriers and Challenges

Despite the potential benefits, there are several barriers and challenges to integrating SUD services with primary care, including:

• Stigma 6
• Scheduling and staff buy-in 2
• Changes in patient acuity and insurance 2
• Need for comprehensive approaches to care 4
• Limited access to addiction pharmacotherapy and recovery coaching 3