Can Primary Care Practices Help Address the Health Crisis Fueled by Prescription Opioids?
Authors: E. Jennifer Edelman, David A. Fiellin
Journal: Annals of Internal Medicine (2016)

Editorials21 February 2017Can Primary Care Practices Help Address the Health Crisis Fueled by Prescription Opioids?E. Jennifer Edelman, MD, MHS and David A. Fiellin, MDE. Jennifer Edelman, MD, MHSFrom Yale University School of Medicine, New Haven, Connecticut.Search for more papers by this author and David A. Fiellin, MDFrom Yale University School of Medicine, New Haven, Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-2666 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Despite internists' landmark contributions to the treatment of opioid use disorder, most internists do not provide such treatment. Fifty years ago, the internist Vincent Dole, citing growing heroin use, called on the medical profession to develop a new attitude toward addiction, better educate itself on the topic, avoid moral frameworks, and advance therapies with a focus on improved patient function rather than avoidance of medications (1). Along with another internist, Mary Jeanne Kreek, he conducted pivotal research developing methadone as a treatment for opioid use disorder—one that can decrease crime, infectious disease, and overdose. They developed office-based treatment models with ...References1. Dole VP. In the course of professional practice. N Y State J Med. 1965;65:927-31. [PMID: 14265340] MedlineGoogle Scholar2. Jasinski DR, Pevnick JS, Griffith JD. Human pharmacology and abuse potential of the analgesic buprenorphine: a potential agent for treating narcotic addiction. Arch Gen Psychiatry. 1978;35:501-16. [PMID: 215096] CrossrefMedlineGoogle Scholar3. Fiellin DA, O'Connor PG. New federal initiatives to enhance the medical treatment of opioid dependence. Ann Intern Med. 2002;137:688-92. [PMID: 12379070]. doi:10.7326/0003-4819-137-8-200210150-00014 LinkGoogle Scholar4. Doot MC, Payte JT, Van Zee A. Response: integrating buprenorphine therapy into clinical practice. Sci Pract Perspect. 2004;2:20-3. [PMID: 18552730] CrossrefMedlineGoogle Scholar5. Loxterkamp D. Helping ‘them': our role in recovery from opioid dependence. Ann Fam Med. 2006;4:168-71. [PMID: 16569721] CrossrefMedlineGoogle Scholar6. Turner L, Kruszewski SP, Alexander GC. Trends in the use of buprenorphine by office-based physicians in the United States, 2003–2013. Am J Addict. 2015;24:24-9. [PMID: 25823632] doi:10.1111/ajad.12174 CrossrefMedlineGoogle Scholar7. Saloner B, Karthikeyan S. Changes in substance abuse treatment use among individuals with opioid use disorders in the United States, 2004–2013. JAMA. 2015;314:1515-7. [PMID: 26462001] doi:10.1001/jama.2015.10345 CrossrefMedlineGoogle Scholar8. Korthuis PT, McCarty D, Weimer M, Bougatsos C, Blazina I, Zakher B, et al. Primary care–based models for the treatment of opioid use disorder. A scoping review. Ann Intern Med. 2017;166:268-78. doi:10.7326/M16-2149 LinkGoogle Scholar9. Amato L, Minozzi S, Davoli M, Vecchi S. Psychosocial combined with agonist maintenance treatments versus agonist maintenance treatments alone for treatment of opioid dependence. Cochrane Database Syst Rev. 2011:CD004147. [PMID: 21975742] doi:10.1002/14651858.CD004147.pub4 CrossrefMedlineGoogle Scholar10. Schwartz RP. When added to opioid agonist treatment, psychosocial interventions do not further reduce the use of illicit opioids: a comment on Dugosh et al. J Addict Med. 2016;10:283-5. [PMID: 27471920] doi:10.1097/ADM.0000000000000236 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Yale University School of Medicine, New Haven, Connecticut.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2666.Corresponding Author: E. Jennifer Edelman, MD, MHS, Yale University School of Medicine, 367 Cedar Street, ESH A, New Haven, CT 06510; e-mail, ejennifer.[email protected]edu.Current Author Addresses: Drs. Edelman and Fiellin: Yale University School of Medicine, 367 Cedar Street, ESH A, New Haven, CT 06510.This article was published at Annals.org on 6 December 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPrimary Care–Based Models for the Treatment of Opioid Use Disorder P. Todd Korthuis , Dennis McCarty , Melissa Weimer , Christina Bougatsos , Ian Blazina , Bernadette Zakher , Sara Grusing , Beth Devine , and Roger Chou Metrics Cited byConcerns and Help-Seeking Among Patients Using Opioids for Management of Chronic Noncancer PainChronic preoperative opioid use is a risk factor for increased complications, resource use, and costs after cervical fusion 21 February 2017Volume 166, Issue 4Page: 307-308KeywordsDisclosureHIVHealth care providersHeroin useMedical conditionsOpioid addictionOpioid use disorderOpioidsPatientsPrevention, policy, and public health ePublished: 6 December 2016 Issue Published: 21 February 2017 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...