Addressing Methamphetamine Use in Primary Care: Provider Perspectives | JoVE Visualize

Area of Science:

Addiction Medicine
Primary Care Practice
Public Health

Background:

The opioid epidemic has shifted towards a combined stimulant and opioid crisis, increasing overdose deaths.
Primary care providers are increasingly encountering patients with methamphetamine use disorder (MUD).
Current clinical practices for MUD in primary care are not well-understood, unlike established models for opioid use disorder.

Purpose of the Study:

To explore primary care providers' (PCPs) perceptions and practices regarding the identification and management of patients with methamphetamine use.
To identify barriers and facilitators to providing effective care for MUD in primary care settings.
To understand PCPs' perceived needs for improving services for patients with methamphetamine use.

Main Methods:

Conducted six semistructured group interviews with 38 primary care providers.
Focused interviews on provider experiences with patients exhibiting methamphetamine use.
Analyzed interview data using inductive and thematic analysis, categorizing findings by problem identification, clinical management, barriers/facilitators, and needs.

Main Results:

PCPs reported varied approaches to identifying and treating MUD, noting a lack of standardized screening tools and evidence-based treatments, especially medications.
Providers expressed a need for more standardized screening measures, FDA-approved medications, better connections to addiction specialists, and enhanced training.
There was notable interest in novel behavioral health interventions suitable for primary care.

Conclusions:

PCPs utilize diverse methods for MUD screening and treatment, but with limited perceived effectiveness.
Key challenges include the absence of FDA-approved medications, patient retention issues, referral difficulties, funding constraints, and inadequate training.
Harm reduction, motivational interviewing, and collaboration with addiction specialists are recommended strategies to support PCPs in managing patients with methamphetamine use.