Medicaid reimbursement of primary care providers for treatment of substance use disorders

2002 ◽  
Vol 23 (sup1) ◽  
pp. 95-104
Author(s):  
Mary R. Haack ◽  
Farrokh Alemi
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Medicaid Reimbursement

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel

10.2196/21015 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e21015
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

Background Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. Objective The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. Methods To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. Results To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. Conclusions This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. International Registered Report Identifier (IRRID) DERR1-10.2196/21015

scholarly journals Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Dexter L. Louie ◽  
Mehret T. Assefa ◽  
Mark P. McGovern
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Self Efficacy ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Narrative Review ◽  
Public Health Issue ◽  
Care Providers ◽  
Negative Attitudes

Abstract Background The opioid epidemic is a major public health issue associated with significant overdose deaths. Effective treatments exist, such as the medication buprenorphine, but are not widely available. This narrative review examines the attitudes of primary care providers (PCPs) toward prescribing buprenorphine. Methods Narrative review of 20 articles published after the year 2000, using the Consolidated Framework for Implementation Research (CFIR) to organize the findings. Results Three of the five CFIR domains (“Intervention Characteristics,” “Outer Setting,” “Inner Setting”) were strongly represented in our analysis. Providers were concerned about the clientele associated with buprenorphine, diversion, and their self-efficacy in prescribing the medication. Some believed that buprenorphine does not belong in the discipline of primary care. Other barriers included philosophical objections and stigma toward substance use disorders. Notably, two studies reported a shift in attitudes once physicians prescribed buprenorphine to actual patients. Conclusions Negative attitudes toward buprenorphine encompassed multi-layered concerns, ranging from skepticism about the medication itself, the behaviors of patients with opioid use disorders, and beliefs regarding substance use disorders more generally. We speculate, however, that negative attitudes may be improved by tailoring support strategies that address providers’ self-efficacy and level of knowledge.

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel (Preprint)

2020 ◽  
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

BACKGROUND Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. OBJECTIVE The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. METHODS To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. RESULTS To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. CONCLUSIONS This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/21015

Treating Substance Use Disorders in Integrated Care Settings

2017 ◽  
Author(s):  
Patricia Pade ◽  
Laura Martin ◽  
Sophie Collins
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Integrated Care ◽  
Substance Use Disorders ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Assessment Process ◽  
Care Providers ◽  
Care Environment

Addiction and substance use disorders (SUDs) are extremely prevalent and are commonly encountered in the primary care setting. The traditional separation of SUD treatment from mainstream medicine has not been an optimal model of effective patient care. Primary care providers can play a crucial role in the recognition, intervention, and treatment of SUDs. This chapter provides an overview of the assessment process, intervention strategies, and pharmacologic and nonpharmacologic treatments that can be effectively implemented in an integrated care environment or primary care setting for a variety of SUDs. The integration of SUD treatment into integrated care environments holds the promise of improving acceptability to patients, decreasing the stigmatization of SUDs, enhancing satisfaction for providers, and improving outcomes for patients.

Pain and Addiction in Patients with Post-Traumatic Stress Disorder (DRAFT)

2018 ◽  
Author(s):  
Steven A. Eraker
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Psychiatric Symptoms ◽  
Primary Care Providers ◽  
Psychiatric Diagnoses ◽  
Care Providers ◽  
Post Traumatic Stress ◽  
Basic Principles ◽  
Post Traumatic

Addressed equally to psychiatrists and to primary care providers, this chapter is intended to explore non–substance use disorder psychiatric diagnoses as they impact the perception of pain and the treatment of substance use disorders. A screening checklist emphasizing basic principles of psychiatric history-taking is provided to help identify the patient’s requirements. The author reviews the classes of psychiatric diagnoses most likely to be present in the pain/addiction and other comorbidly-ill patients, and reviews suicide risks. Similarly, the classes of medications employed in psychiatry and their capacity for alleviation or aggravation of substance use disorders are reviewed, with notations of drug–drug interactions. A final section addresses the role of emotions and psychiatric symptoms in the perception and management of pain.

scholarly journals Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jinhee Lee ◽  
Thomas F. Kresina ◽  
Melinda Campopiano ◽  
Robert Lubran ◽  
H. Westley Clark
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Opioid Dependence ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Addictive Disorders ◽  
Care And Treatment

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

Pain and Addiction in Patients with Co-Occurring Psychiatric Disorders (DRAFT)

2018 ◽  
Author(s):  
Penelope P. Ziegler
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Final Section ◽  
Psychiatric Symptoms ◽  
Primary Care Providers ◽  
Psychiatric Diagnoses ◽  
Psychiatric History ◽  
Care Providers ◽  
Basic Principles

Addressed equally to psychiatrists and to primary care providers, this chapter is intended to explore non–substance use disorder psychiatric diagnoses as they impact the perception of pain and the treatment of substance use disorders. A screening checklist emphasizing basic principles of psychiatric history-taking is provided to help identify the patient’s requirements. The author reviews the classes of psychiatric diagnoses most likely to be present in the pain/addiction and other comorbidly-ill patients, and reviews suicide risks. Similarly, the classes of medications employed in psychiatry and their capacity for alleviation or aggravation of substance use disorders are reviewed, with notations of drug–drug interactions. A final section addresses the role of emotions and psychiatric symptoms in the perception and management of pain.

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