Southwest
Magellan Promotes Inpatient and Outpatient Use of Medications in the Treatment of Substance Use Disorders
Alcohol and drug addiction have a major impact on society. The effect is seen in decreased job productivity and attendance, and in increased health care costs, and frequently plays a part in the escalation of situations involving domestic violence and violent crimes. Addiction also has a significant psychosocial impact on families and relationships. Research in the treatment of alcohol or other drug disorders has shown that several medications (e.g., Suboxone, Naltrexone, Campral) can be useful clinical supports to enhance the quality and outcome of addiction treatment.
A primary area of focus for Southwest Care Management Center in 2008 is to re-establish a new baseline for the clinical quality improvement activity developed to improve the use of pharmacological treatment for members with a primary AOD diagnosis during inpatient treatment.
In 2007, the results of our clinical initiative to increase use of appropriate pharmacological therapy for members receiving inpatient treatment for a primary alcohol or other drugs (AOD) disorder continued to show significant improvement from baseline to each re-measurement.
Results
Year |
AOD pharmacology during stay |
AOD pharmacology at discharge |
|---|---|---|
2004 (baseline) |
15% |
12% |
2005 |
25% |
22% |
2006 |
42% |
34% |
2007 |
48% |
44% |
The United States has seen a gross escalation of opioid dependence during the past 20 years. In 2007, the Institute of Social Research at the University of Michigan estimated that one in every 20 high school seniors has tried OxyContin in the past year. Little had been done to combat this issue until the U.S. Congress enacted the DATA ACT of 2000, which allowed for office-based prescribing of opioids by specifically certified physicians.
Because of the escalation of opioid dependence and because the treatment for opioid addiction does not end with the completion of detoxification, the Southwest Care Management Center is promoting office-based opioid treatment (OBOT) as a means of potentiating the use of AOD pharmacology at discharge. OBOT has been shown to be an effective, confidential, accessible and safe means of care leading to overall retention of patients in substance abuse treatment, recovery and in the mainstream.
Benefits of Office-Based Opioid Treatment
- Office-based treatment programs are a breakthrough in access to care for patients who find it difficult to attend an outpatient program daily and who are not able to travel long distances to obtain treatment.
- These programs also allow for better integration of health care needs for patients and thus serve to improve the quality of care provided. See the Spring 2008 Provider Focus article on this topic for more information.
If you have any questions about these initiatives, contact Lorence Miller, PhD, director of quality improvement and compliance, at (214) 692-3912 or LSMiller@MagellanHealth.com.