Philadelphia clinics pioneer new ways to address substance abuse in primary care setting

    Drug researchers are urging doctors and policy makers to treat addiction more like they do heart disease and cancer — by using regular prevention screens and follow-up care.

    The Affordable Care Act (often called Obamacare) will move addiction treatment and prevention more into the primary care setting says Tom McLellan who heads the Treatment Research Institute, something he believes will fundamentally change the nation’s approach to addiction.

    “The only thing we have ever had was treatment for very seriously affected individuals, in really segregated facilities,” explained McLellan. “The Affordable Care Act will bring the treatment of substance use disorders, not just addiction, but problematic use, into the same venues were we are now treating diabetes, hypertension and asthma. “

    Several Philadelphia health centers are pioneering this approach, including the Care Clinic and 11th Street Family Health Services. They have behavioral health counselors on staff, making substance abuse interventions available in the same office.

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    Addiction researcher Adam Brooks with the Treatment Research Institute is evaluating how effective this approach is.  He says for patients with risky drug and drinking patterns, just asking about their habits can make a difference, even if there’s no immediate action. “Let’s keep it on the table and keep talking about it, and whatever you choose to do about it is up to you – but just that act, of asking people to watch a habit, causes people to do less of that habit,” said Brooks.

    Brooks adds that having these services under the same roof is vital, as many people don’t follow up on referrals.

    Psychologist Travis Cos is a counselor at the Care Clinic on Callowhill Street, which is part of the Public Health Management Corporation.

    He says with some patients who are abusing substances but are not at a dependency or crisis level, encouraging positive behavior changes and teaching coping skills is effective. Many of the clients he sees drink or abuse drugs as a way to deal with stress, anxiety, panic disorder and other life circumstances.

    “We discuss what can you do when you are feeling in crisis, and encourage them to try activities such as an AA meeting to find support,” explained Cos. He said that in working with several clients, he was able to gradually reduce their drinking, adding that it is easier to address these issues before they reach crisis levels.

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