A Case for Enhanced Linkage of Substance Abusers to Primary Medical Care

Abstract

Alcohol and drug abuse continue to be problems of major significance throughout the United States. Although experts have advocated linking substance abusers with primary medical care to help achieve both individual and public health goals, few successful and generalizable methods for linkage have been developed. Specific potential benefits for such linkage include HIV testing and initiation of therapy, treatment of tuberculosis and sexually transmitted diseases, appropriate immunizations, cervical cancer screening, promotion of healthy behaviors regarding sexual and drug practices, and encouragement of cessation of substance use. Distributive or decentralized models linking patients receiving addiction treatment to existing primary medical care services need evaluation, as they may be more generalizable and cost-effective compared with on-site integrated programs. Health care providers and policy makers need to explore innovative approaches to bring substance abusers into a medical care system in a way that will provide continuity, comprehensiveness, and prevention so as to improve health care utilization patterns and reap benefits of improved addiction, behavioral, and health outcomes.