Primary care physicians (PCPs) have been noticeably absent in the battle against opioid addiction, but the medical system seems to be discouraging better engagement, STAT reports. Most PCPs don’t have the training to deal with addiction and punt; referring patients to addiction centers or Narcotics Anonymous. That’s a shame, because PCPs are uniquely positioned to catch the problem early. In addition to lack of training (for which there are few incentives), Medicaid in many states will not pay PCPs for providing opioid addiction treatment. An eight-hour certification program, which includes how to treat with Subutex (buprenorphine), doesn’t fill PCPs with confidence. Opioid addiction can be a dicey condition to treat.
“In addition to writing a prescription for buprenorphine … doctors must understand how to approach patients who commonly suffer from cognitive impairments and mental health pathologies that often have their roots in early-life trauma,” STAT reports. “Doctors who coordinate treatment with mental health providers must also navigate at times thorny privacy issues, and brace for the possibility that patients will sell buprenorphine prescriptions on the black market.”