Outcomes for Physicians with Opioid Dependence Treated without Agonist Pharmacotherapy in Physician Health Programs
Highlights
- Participants in physician health
programs were grouped based on their substance(s) of abuse.
- Opioid users had similar treatment
outcomes as alcohol only and non-opioid drug users.
- Abstinence-based PHP care management
produces long-term abstinence.AIMS:
To compare
treatment outcome among substance dependent physicians enrolled in a physician
health program (PHP) who have a history of alcohol use only, any opioid use, or
non-opioid drug use, in order to determine whether the distinctive PHP system
of care management is as effective for individuals with opioid use disorders as
for those with alcohol or other drug use disorders.
METHODS:
A 5-year,
retrospective chart review, intent-to-treat analysis was conducted for all
physicians admitted to 16 physician health programs (N=702; 85.5% male; age
range=24-75). Analyses compared treatment outcomes for participants based upon
their substance(s) of abuse [i.e., 1) "Alcohol Only" (n=204), 2)
"Any Opioid" with or without alcohol use (n=339), and 3)
"Non-Opioid" drug use with or without alcohol use (n=159)].
RESULTS:
In this
sample, 75-80% of physicians across the three groups never tested positive for
alcohol or drugs during their extended care management period with random drug
testing. This included physicians with opioid dependence who did not receive
opioid substitution therapy (OST). Of the 22.1% of physicians who had a
positive test, two thirds (i.e., 14.5% of the total sample) had just one
positive test, and only one third (i.e., 7.6% of the total sample) had more
than one positive test. These results were similar in all three groups.
CONCLUSIONS:
These
results indicate that individuals with opioid use disorders who are managed by
PHPs can achieve long-term abstinence from opioids, alcohol, and other drugs
without OST through participation in abstinence-based psychosocial treatment
with extended, intensive care management following discharge.
By: Merlo LJ1, Campbell MD2, Skipper GE3, Shea CL4, DuPont RL5.
- 1University of Florida, Department of Psychiatry, 4001 SW 13th St, Gainesville, FL 32608. Electronic address: lmerlo@UFL.edu.
- 2Institute for Behavior and Health, Inc., 6191 Executive Blvd, Rockville, MD 20852 USA. Electronic address: Campbell.Mike@jeassociates.com.
- 3Promises Treatment Centers, 2515 Wilshire Blvd, Santa Monica, CA 90403. Electronic address: gregory.skipper@gmail.com.
- 4Institute for Behavior and Health, Inc., 6191 Executive Blvd, Rockville, MD 20852 USA. Electronic address: corinne.shea@ibhinc.org.
- 5Institute for Behavior and Health, Inc., 6191 Executive Blvd, Rockville, MD 20852 USA. Electronic address: BobDuPont@aol.com.
- J Subst Abuse Treat. 2016 May;64:47-54. doi: 10.1016/j.jsat.2016.02.004. Epub 2016 Feb 13.
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