Tackling the SUD Surge at Going Digital BHT 2023

Dr. Ludwing Salamanca, Collaborative Care Medical Director at RubiconMD, delivered a thought-provoking CE presentation at the Going Digital 2023 Behavioral Health Tech Conference, sharing innovative strategies for combating Substance Use Disorders (SUDs) in primary care. The key? Virtual specialty care. When PCPs are equipped with tools to deliver comprehensive care for SUD patients, they can help foster healthier lives and address critical gaps in current treatment strategies.

With long wait times and stigma related to psychiatric care, primary care presents an accessible and tangible opportunity to diagnose and treat SUD patients, but only with the right approach. The numbers support this: While 80% of people living with an SUD visit their PCP annually, only a small portion report experiencing improvement in their condition. Dr. Salamanca explored why this is a chance for PCPs to bolster treatment capacity and start taking action today. Younger patients or those early in the course of misuse, and with more personal and social resources have a better chance of responding to SUD treatment. When PCPs intervene quickly, patients have a stronger chance of treatment success. 

Today, 50% of SUD patients still remain unscreened in primary care due to multiple obstacles. Dr. Salamanca identified these barriers: time constraints, inadequate clinical training, limited mental health resources, and the stigma surrounding seeking SUD treatment. Virtual care has emerged as the champion for closing gaps and improving access to behavioral specialty care and better patient outcomes.

Dr. Salamanca introduced three distinct virtual specialty care approaches tailored to various SUD treatment stages, each with unique benefits and actionable recommendations:

1. Submit psychiatric eConsults with specific patient questions and get a response from a virtual specialist within 3.5 hours
2. Apply a programmatic approach for entire patient cohorts to establish proactive care plans, or  
3. Implement the Collaborative Care model (CoCM) led by a psychiatrist to address depression, anxiety, and SUD collectively. This strategy is unique for its holistic support of PCPs and patients, destigmatizing SUD by integrating its care with other chronic diseases.

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