Abstract
Background: One of the most important issues for opiate maintenance therapy efficacy is the involvement of primary care physicians (PCPs) in opiate use disorder treatment, especially after referral from specialized units. This study aimed to analyze the progress of subjects in a specialized center and after referral to PCPs. Methods: This study was an observational prospective study. Recruitment took place in a specialized addictive disorder center in western France. All patients were evaluated (sociodemographical data, severity of substance use disorders through the TMSP scale, the quality of life through the TEAQV scale) by physicians during the 5-year-follow up of the study. Analysis focused on four main times during follow-up: entry/last visit into specialized care and into primary care. Results: 113 patients were included in this study; 93% were receiving methadone and 7% buprenorphine. Ninety (90) were referred to primary care. In primary care follow-up, the probability of the lowest severity score for substance use disorders remained stable over time. Conclusions: In daily practice, a center specialized in addictive disorders referred OMT management to PCPs for a majority of patients, and benefits regarding substance use disorders severity and quality of life remained stable after referral. Our results need to be confirmed.
Highlights
Opioid use disorders (OUD), whether related to illicit or non-medical drug use, are a major public health issue worldwide
Twenty-three patients remained and were followed up in the center specialized in addictive disorders, and ninety patients were referred to primary care
The same pattern of change in Quality of Life (QoL) domains was observed for patients who were referred to primary care. This prospective study in daily practice analyzed the evolution of the level of severity of addictive disorders among 113 subjects following opioid maintenance therapies (OMT) for an OUD after referral from a specialized center to primary care
Summary
Opioid use disorders (OUD), whether related to illicit or non-medical drug use, are a major public health issue worldwide. Recommendations underline the need to maintain OMT over a long period of time [6,9] This is a way of reducing the high risk of mortality due to opioid overdose [10], estimated at 30 deaths/1000 personyears in the 4 weeks after OMT cessation [11]. One of the most important issues for opiate maintenance therapy efficacy is the involvement of primary care physicians (PCPs) in opiate use disorder treatment, especially after referral from specialized units. In primary care follow-up, the probability of the lowest severity score for substance use disorders remained stable over time. Conclusions: In daily practice, a center specialized in addictive disorders referred OMT management to PCPs for a majority of patients, and benefits regarding substance use disorders severity and quality of life remained stable after referral.
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