E.  Can Treatment Plan Be Implemented In Primary Care?

 

OBJECTIVE

 

Identify the patient who does not require specialty care.

 

ANNOTATION

 

Consider the appropriateness of implementing the treatment plan in primary care, based on the following:

1.               Review of the integrated summary and initial treatment plan.

2.               Availability of a willing primary care provider with whom the patient has an ongoing clinical relationship.

3.               Severity and chronicity of the SUD.

4.               Active involvement with support for recovery in the community.

5.               Prior treatment response.

6.               Patient preference and likelihood of adherence.

 

Consider rehabilitation in specialty care for more complex clinical presentations, especially where problem severity is greater or patient motivation is less clear (Annotation F).

 

DISCUSSION

 

Different subtypes of patients referred for specialty assessment of SUDs might be appropriate for alternatives to rehabilitation in a specialty care setting, given the availability and willingness of a primary care provider to address and monitor their substance use as part of ongoing clinical care.  For some patients the treatment plan might emphasize involvement in a previously effective self-help group, along with monitoring by the primary care provider.