Tuesday, October 3, 2017

ACP Internist - Primary care takes on opioid addiction

ACP Internist

Primary care takes on opioid addiction
There's a lot that primary care clinicians can do to treat opioid addiction, but stigma about the condition, as well as laws and other regulations, throw up barriers.

People with opioid use disorder who receive opioid agonist treatment with methadone have less than one-third the mortality risk of those who do not receive it, according to a systematic review and meta-analysis published in 2017 by The BMJ. Opioid agonist treatment with buprenorphine also appears to be associated with a reduction in mortality, although this finding was based on fewer studies, the reviewers said. Patients who discontinued treatment with either drug had increased mortality risk.
But the legal stipulations around providing such treatment reflect the stigma surrounding the disease, said ACP Member Laura Fanucchi, MD, MPH, a primary care internist for patients with HIV and addiction and assistant professor at University of Kentucky College of Medicine in Lexington.

Other obstacles to treatment include physicians' attitudes and beliefs. “I hear comments like, ‘We don't want those patients in our office, in our waiting room,’ etc., but the reality is that addiction doesn't discriminate,” said internist and researcher Chinazo Cunningham, MD, MS, professor of medicine at Albert Einstein College of Medicine and associate chief of the division of general internal medicine at Montefiore Medical Center in New York City. “So I tell people that ‘those patients' are your neighbors, your colleagues, your family members, your friends.” 

Read the article: http://www.acpinternist.org/archives/2017/10/primary-care-takes-on-opioid-addiction.htm

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