Substance Use Disorders, Primary Care, and Overall Health

October 21, 2019

It’s a fact: people with substance use disorders (SUDs) have a significantly higher prevalence of primary health problems than people who have no such ailment.  We have known for some time now that SUDs and other medical conditions are common, and that SUDs are associated with many chronic illnesses.

We know, for example, that alcohol use disorder is associated with cardiovascular diseases, stroke and cirrhosis, cancers and injuries.  And that opioid use disorder is concomitant with such conditions as chronic pain, arthritis, musculoskeletal disorders, and of course opioid-related overdoses (and that opioid use disorder has a greater mortality risk than other SUDs).  Cannabis use disorder is known to contribute to cannabis users’ respiratory and cardiovascular illnesses.  That there continues to be a decreased perception of harm related to cannabis use and ongoing reinforcement of the three most common myths about it (that it’s not addictive; that it’s not associated with withdrawal; that it has less effect on behavior than other SUDs) is detrimental to efforts to identify and treat this particular SUD.

It’s important that primary care clinicians and we in the SUD treatment field expand our collaboration.  Increased partnership has already greatly enhanced patient care.  Prompt, consistent, comprehensive communication from medical practices has, for example, helped us determine whether a patient’s SUD caused any of their other existing medical problems or if their medical conditions influenced the development of their SUD.  Collaboration like this has allowed us to administer appropriate, effective SUD medical and clinical treatment at Tully Hill.    

Primary care clinicians have become key partners in successful SUD treatment and care.  Their increased knowledge about SUDs has greatly improved their recognition of them, and their understanding of the need to address these illnesses to help reduce them and advance overall patient health.  Most if not all primary care clinicians now know, for example, that not everyone who uses alcohol or other drugs will become addicted, and that drug use can and does change how certain brain circuits work.  And they are more aware than ever that those changes make it very hard for users to stop using a drug even when they want to.  Likewise, that those changes can generate recognizable, short-term effects in their patients, including fluctuations in appetite, mood, heart rate, and blood pressure, and increased restlessness and insomnia.

Expanding our collaboration with primary care clinicians is a chief goal of ours at Tully Hill.  We know it will result in improving overall patient health and help lower health care costs.  As important, it can help shrink the broader, negative outcomes related to levels of education, employment and housing, and involvement with the criminal justice system inherent to SUDs.

We look forward to growing our relationship with primary care providers, to achieve with them the level of overall health our mutual patients need and deserve.  



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