Integrating Buprenorphine Treatment in Primary Care
Judith Martin, M.D., FASAM
"Integrated care" is sometimes held up as an ideal for patients with multiple diagnoses that involve addiction, internal medicine and psychiatry disciplines. There are benefits and challenges to integrating care for various conditions under one roof. Funding streams for each condition might be incompatible, and 'carve outs' can get in the way. How long does an induction visit take, and how can it be managed in a busy practice? What kind of practice can see a patient weekly for the same condition? Who can do call-backs and pill counts? When patients need more intensive care, for example daily observed doses, or more counseling, how can that be done? Various answers to these and other questions will emerge in different settings.
This presentation reviews the concept of 'medical home' and 'integration' and the details about buprenorphine treatment for opioid addiction that might or might not work well when located in primary care settings.