ASAM Launches Physician Clinical Support System for Primary Care

More patients are confiding in their primary care physicians about their addiction problems, and helping these doctors help their patients will be the American Society for Addiction Medicine’s newest mentor network, the Physician Clinical Support System for Primary Care (PCSS-P).

“Increasingly, primary care physicians are faced with the complications of substance abuse disorders on their patients’ medical outcomes and may be limited in training and tools to evaluate and treat these problems,” said a PCSS-P medical director, David A. Fiellin, M.D., professor of medicine, Yale University School of Medicine, New Haven, Conn. “The increased prevalence of addiction issues makes it necessary for primary care physicians to address these cases directly.”

The PCSS-P is funded by a grant from the National Institutes of Health’s National Institute on Drug Abuse (NIDA), and is administered by the ASAM, with the New York Academy of Medicine providing the evaluation component. Through the PCSS-P, participating primary care providers may access clinical resources, information, and materials, and link up by phone or email to addiction clinical experts who will serve as mentors in providing education about managing substance abuse. Mentors can also assist primary care physicians in incorporating into their practices substance abuse screening, brief intervention, and treatment.

“The important message is for primary care physicians to identify those patients for whom they can provide direct care and those patients in whom it is best to refer to specialty treatment programs,” Dr. Fiellin said. “Part of the strategy is to make effective referrals and motivate patients to seek outside support in a way that increases the likelihood that they will receive the assistance they need.”

Primary care clinicians may sign up with the PCSS-P by calling the warm-line service 877-630-8812, sending an email to PCSSproject@asam.org, or visiting the website www.pcssmentor.org. (Warm line means a reply within 24 hours.) Additionally, the NIDAMED website www.drugabuse.gov/nidamed provides a compilation of evidence-based tools and resources for managing substance abuse in a primary care setting. One particularly useful screening tool, NIDA Med ASSIST, helps primary care physicians in developing a recommended plan of care in substance abuse cases.

The PCSS-P was created to increase the use of these tools in clinical settings and to advise NIDA on the ways in which these tools can be made more useful for practicing primary care clinicians, Dr. Fiellin said. The structure of PCSS-P is modeled after the recent Physician Clinical Support System for Buprenorphine coordinated by ASAM that resulted in a successful six-year run. Other key elements of the PCSS-P include oversight by two leading addiction experts, Louis E. Baxter, Sr., M.D., FASAM, and Dr. Fiellin, as medical directors, and counsel provided by the Clinical Advisory Committee of family medicine, internal medicine, and emergency medicine leaders.

“The goal will be to work as much as possible with major medical organizations that serve primary care physicians to promote the services of the PCSS-P,” Dr. Fiellin said. “We anticipate that our clinical advisers will conduct brief sessions at local, state, or national meetings to go through the tools available from the NIDAMED website, get direct feedback from primary care clinicians about how useful they find these types of resources, and what they would like to see in future versions.”

It was a natural role for ASAM to serve as a coordinating partner with NIDA in bringing the PCSS-P services to primary care physicians.

“Because we are a leading organization in the field of addiction medicine with many physicians trained in primary care specialties,” Dr. Fiellin said, “we are particularly sensitive and aware of the knowledge, skills and attitudes that are needed to address substance use and addiction in primary care settings.”