The Prescription of Addiction Medications After Implementation of Chronic Care Management for Substance Dependence in Primary Care

• Prescription of addiction medications for those receiving chronic care management is described.
• Factors associated with prescription of addiction medications in these individuals are described.
• A minority of patients received addiction medications despite mitigation of treatment barriers.
• Absence of drug dependence was associated with receipt of alcohol dependence medication.
• Lower alcohol addiction severity was associated with receipt of drug dependence medication.

People with addictive disorders commonly do not receive efficacious medications. Chronic care management (CCM) is designed to facilitate delivery of effective therapies. Using data from the CCM group in a trial testing its effectiveness for addiction (N = 282), we examined factors associated with the prescription of addiction medications. Among participants with alcohol dependence, 17% (95% CI 12.0–22.1%) were prescribed alcohol dependence medications. Among those with drug dependence, 9% (95% CI 5.5–12.6%) were prescribed drug dependence medications. Among those with opioids as a substance of choice, 15% (95% CI 9.3–20.9%) were prescribed opioid agonist therapy. In contrast, psychiatric medications were prescribed to 64% (95% CI 58.2–69.4%). Absence of co-morbid drug dependence was associated with prescription of alcohol dependence medications. Lower alcohol addiction severity and recent opioid use were associated with prescription of drug dependence medications. Better understanding of infrequent prescription of addiction medications, despite a supportive clinical setting, might inform optimal approaches to delivering addiction medications.