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Pitt study finds that primary care is key to prevent drug-related complications and deaths

A spread of ointments, gauze, sterile water and other items stocked inside Prevention Point Philadelphia's mobile wound care unit.
Elana Gordon
A spread of ointments, gauze, sterile water and other items stocked inside Prevention Point Philadelphia's mobile wound care unit.

Even though the number of fatal drug overdoses continues to rise in the U.S., many primary care clinics do not provide addiction medicine services. But a new study from University of Pittsburgh researchers finds that a more holistic approach from these providers would save lives.

The Pitt scientists, working in concert with a team at the University of Colorado Anschutz Medical Campus, took existing epidemiological data to create a model that simulated different health outcomes, depending on the kind of care received by people who use illicit drugs.

They found that the life expectancy of patients can increase by up to 2.5 years when primary care providers incorporate elements of addiction medicine into their practice.

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Changes in practice could include prescribing medication that helps prevent withdrawal symptoms from opioid use. Another vital strategy is offering patients harm-reduction tools: safer injection equipment, safer smoking supplies and wound kits.

The study shows that taking these measures saves lives, says lead author Dr. Raagini Jawa, an addiction medicine and infectious disease physician. She argues that fewer patients would overdose or develop serious health complications — such as soft tissue infections and endocarditis — if the interventions modeled in the paper were implemented.

"I've seen too many patients suffer and, unfortunately, pass away from drug-related harms. And I think it's time for us to really rethink how we're serving them better," said Jawa, who hopes that policymakers will implement changes that her paper puts forth, which she argues are both pragmatic and cost-effective.

While physicians and pharmacists can dispense syringes, many choose not to, says Aaron Arnold, executive director of Prevention Point Pittsburgh, a drug-user health organization. Locally, many people go to one of Prevention Point’s five locations to obtain safe injection equipment and other harm-reduction supplies.

But Arnold says it would make sense for primary care clinics to implement the model Jawa and her collaborators layout in their paper: “Just on a practical level it makes sense that taking care of more health care needs in one place is going to have better results than having someone run all over town and use more of their time and other personal resources to access the same services.”

The study was published on Wednesday in JAMA Network Open.

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.