Expanding Primary Care to Treat Substance Abuse
In 2018, 53 million people over age 12 in the US reported using illegal drugs or misusing prescription medications. That number jumps to more than 60 million when including alcohol and tobacco. Because substance abuse has historically been viewed as a social or criminal issue rather than a health care issue, people face many obstacles to get help.
In 2019, 67,000 people died of a drug overdose in the US. Millions of people have damaged their lives, hurt family members, lost custody of their children, lost their jobs and destroyed their finances because of drugs or alcohol.
Social stigmas associated with drug use are among the reasons people are reluctant to seek specialized care, especially in small or rural communities where individual activities are well-known. Specialty care is also expensive and, in many instances, not covered by insurance.
Substance abuse devastation can be especially hard on rural and urban underserved communities where the treatment needs often outweigh the availability of services. Primary care practices in underserved communities are often at the forefront of substance abuse issues. They focus on addressing patient health proactively rather than reactively to preempt possible complications by identifying risk factors early. Stigmas and discrimination often cloud the understanding of substance use, both for the public and health care providers. In reality, however, providers can catch drug and alcohol disorders early through screenings and intervention, as with many other conditions.
Supported scientific evidence indicates that closer integration of substance use-related services in mainstream health care systems will be beneficial to both sectors. Substance use disorders are medical conditions and their treatment impacts other mental and physical health conditions. Integration can help address health disparities, reduce health care costs for both patients and family members, and improve overall health outcomes.
Expanding primary care to treat substance abuse requires financial support to train or hire additional staff and finance construction for renovations or new structures.
The opioid epidemic is responsible for 70 percent of total overdose deaths in the US. Studies have shown that it is particularly prevalent in rural communities, which recorded the highest opioid prescribing rates and highest rates of opioid deaths.
The Primary Care Development Corporation (PCDC) Transformation Loan Fund was instrumental in transforming the Community Health and Wellness Center of Greater Torrington (CHWC), which serves a rural community in Connecticut, to address its opioid crisis. The funding made it possible for the center to launch an opioid treatment program that includes Medication-Assisted Treatment (MAT), which combines medication with counseling and behavioral therapies to prevent opioid overdose.
Another example of PCDC’s success in integrating substance abuse with primary care is its investment in The Wright Center for Community Health and its affiliated entity, The Wright Center for Graduate Medical Education in Scranton, Pennsylvania. Scranton is designated as medically underserved by the federal government and hard hit by the opioid crisis. The Wright Center for Community Health recently became the first practice in the country to be awarded NCQA School-Based Medical Home recognition—a designation developed in part by PCDC.
Promising scientific evidence suggests that integrating care for substance use disorders into mainstream health care can increase the quality, effectiveness, and efficiency of health care. Learn how your organization can integrate substance abuse treatment through PCDC’s financial support and expertise to help eliminate barriers for people who need help.