Integrating primary care and methadone maintenance treatment

Implementation issues

Merrill Herman, Marc Gourevitch

Research output: Contribution to journalArticle

Abstract

Linking primary medical care with methadone maintenance treatment brings critical services to drug users, many with HIV/AIDS, tuberculosis and other illnesses. However, a variety of important philosophical, ethical, and systems issues may impede the process of implementing a 'linked' service delivery model. Conflicting paradigms, such as the traditional 'doctor-patient' relationship with its emphasis on continuity of care and the substance abuse treatment model of limit-setting and behavioral consequences, create tension in the treatment system. This article describes these tensions and uses clinical vignettes to demonstrate how to address these implementation issues. In conclusion, solutions are proposed for successful integrating services for medically ill substance abusers.

Original languageEnglish (US)
Pages (from-to)91-102
Number of pages12
JournalJournal of Addictive Diseases
Volume16
Issue number1
DOIs
StatePublished - 1997

Fingerprint

Methadone
Primary Health Care
Continuity of Patient Care
Drug Users
Ethics
Substance-Related Disorders
Acquired Immunodeficiency Syndrome
Tuberculosis
Therapeutics
HIV

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Integrating primary care and methadone maintenance treatment : Implementation issues. / Herman, Merrill; Gourevitch, Marc.

In: Journal of Addictive Diseases, Vol. 16, No. 1, 1997, p. 91-102.

Research output: Contribution to journalArticle

@article{9137ed6f3ff5449aabc732b1d1479688,
title = "Integrating primary care and methadone maintenance treatment: Implementation issues",
abstract = "Linking primary medical care with methadone maintenance treatment brings critical services to drug users, many with HIV/AIDS, tuberculosis and other illnesses. However, a variety of important philosophical, ethical, and systems issues may impede the process of implementing a 'linked' service delivery model. Conflicting paradigms, such as the traditional 'doctor-patient' relationship with its emphasis on continuity of care and the substance abuse treatment model of limit-setting and behavioral consequences, create tension in the treatment system. This article describes these tensions and uses clinical vignettes to demonstrate how to address these implementation issues. In conclusion, solutions are proposed for successful integrating services for medically ill substance abusers.",
author = "Merrill Herman and Marc Gourevitch",
year = "1997",
doi = "10.1300/J069v16n01_06",
language = "English (US)",
volume = "16",
pages = "91--102",
journal = "Journal of Addictive Diseases",
issn = "1055-0887",
publisher = "Routledge",
number = "1",

}

TY - JOUR

T1 - Integrating primary care and methadone maintenance treatment

T2 - Implementation issues

AU - Herman, Merrill

AU - Gourevitch, Marc

PY - 1997

Y1 - 1997

N2 - Linking primary medical care with methadone maintenance treatment brings critical services to drug users, many with HIV/AIDS, tuberculosis and other illnesses. However, a variety of important philosophical, ethical, and systems issues may impede the process of implementing a 'linked' service delivery model. Conflicting paradigms, such as the traditional 'doctor-patient' relationship with its emphasis on continuity of care and the substance abuse treatment model of limit-setting and behavioral consequences, create tension in the treatment system. This article describes these tensions and uses clinical vignettes to demonstrate how to address these implementation issues. In conclusion, solutions are proposed for successful integrating services for medically ill substance abusers.

AB - Linking primary medical care with methadone maintenance treatment brings critical services to drug users, many with HIV/AIDS, tuberculosis and other illnesses. However, a variety of important philosophical, ethical, and systems issues may impede the process of implementing a 'linked' service delivery model. Conflicting paradigms, such as the traditional 'doctor-patient' relationship with its emphasis on continuity of care and the substance abuse treatment model of limit-setting and behavioral consequences, create tension in the treatment system. This article describes these tensions and uses clinical vignettes to demonstrate how to address these implementation issues. In conclusion, solutions are proposed for successful integrating services for medically ill substance abusers.

UR - http://www.scopus.com/inward/record.url?scp=0031055162&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031055162&partnerID=8YFLogxK

U2 - 10.1300/J069v16n01_06

DO - 10.1300/J069v16n01_06

M3 - Article

VL - 16

SP - 91

EP - 102

JO - Journal of Addictive Diseases

JF - Journal of Addictive Diseases

SN - 1055-0887

IS - 1

ER -