Medication Prescribing and Behavioral Treatment for Substance Use Disorders In Physician Office Settings

Excerpt

Background: More than 17 million persons aged 18 or older in the United States in 2013 (6.6 percent of the population) had alcohol use disorders (AUD), and about 2.4 million (2.9 percent of the population) had opioid use disorders (OUD). A variety of behavioral treatments for substance use disorder (SUD) are available, as well as several FDA-approved medications. This report examines the magnitude of integration of these treatments into office based practice by estimating new and continued prescribing of these medications and provision of mental health counseling. Methods: The data analyzed in this report came from the 2010 National Ambulatory Medical Care Survey (NAMCS). This survey provides information about pharmacologic and behavioral treatments for SUD provided by physicians in office-based settings. NAMCS is conducted on an annual basis from a sample of physicians who deliver care directly to patients. Results: About 4.3 million visits to physician offices in 2010 involved medication prescriptions to treat alcohol use disorder (AUD) (1.2 million visits) and opioid use disorder (OUD) (3.1 million visits).About 37.2 percent of the prescriptions for AUD and OUD were made in these office visits by general and family practice physicians, and 17.5 percent were made by psychiatrists. Behavioral treatment for SUDs was only provided in a minority of office visits (37.2 percent) during which SUD medications were prescribed. Conclusions: Continued work is necessary to achieve integration of behavioral and medical treatment of SUD into office-based care. Research on the barriers and facilitators of integration will help us to understand the possible benefits of bringing substance abuse treatment in to a more accessible setting.