title: Can Substance Use Disorders be Managed Using the Chronic Care Model? Review and Recommendations from a NIDA Consensus Group.
abstract: Brain imaging and genetic studies over the past two decades suggest that substance use disorders are best considered chronic illnesses. The passing of the Affordable Care Act in the United States has set the occasion for integrating treatment of substance use disorders into mainstream healthcare; and for using the proactive, team-oriented Chronic Care Model (CCM). This paper systematically examines and compares whether and how well the CCM could be applied to the treatment of substance use disorders, using type 2 diabetes as a comparator. The chronic illness management approach is still new in the field of addiction and research is limited. However comparative findings suggest that most proactive, team treatment-oriented clinical management practices now used in diabetes management are applicable to the substance use disorders; capable of being implemented by primary care teams; and should offer comparable potential benefits in the treatment of substance use disorders. Such care should also improve the quality of care for many illnesses now negatively affected by unaddressed substance abuse.
authors.affiliation: The Treatment Research Institute, Philadelphia PA, USA.
authors.forename: A Thomas
authors.initials: AT
authors.lastname: McLellan
authors.affiliation: Albert Einstein College of Medicine and Monte ore Medical Center, Bronx, NY, USA.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Starrels
authors.affiliation: National Institute of Health, National Institute on Drug Abuse, Bethesda, MD, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Tai
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Gordon
authors.affiliation: University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Brown
authors.affiliation: National Institute of Health, National Institute on Drug Abuse, Bethesda, MD, USA.
authors.forename: Udi
authors.initials: U
authors.lastname: Ghitza
authors.affiliation: New York University School of Medicine, Department of Population Health, New York, NY, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Gourevitch
authors.affiliation: National Institute of Health, National Institute on Drug Abuse, Bethesda, MD, USA.
authors.forename: Jack
authors.initials: J
authors.lastname: Stein
authors.affiliation: The Mosaic Group, Baltimore MD. USA.
authors.forename: Marla
authors.initials: M
authors.lastname: Oros
authors.affiliation: Christiana Care Health System, Division of Addiction Medicine, Wilmington DE, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Horton
authors.affiliation: The EMMES Corporation, Rockville, MD, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Lindblad
authors.affiliation: New York University School of Medicine, Department of Population Health, New York, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McNeely
keywords: Substance use disorders; chronic care model; chronic illness; electronic health records; healthcare reform; type 2 diabetes management