Differences in patient and provider views in substance use treatment services

Discordance may exist between what providers believe are desired ancillary services for substance use disorder (SUD) treatments and self-reported patient needs. Prior to implementation of new services, CODA, Inc., the largest non-profit SUD treatment facility in Oregon, conducted three anonymous patient surveys to determine: 1) leading health concerns (n = 85); 2) desired patient services (n = 311); and 3) smoking practices (n = 63). A priori, staff advocated for annual medical screening and yoga as a Complimentary and Alternative Medicine (CAM) option. Patient self-reports were not in alignment with initial staff assessments. Taken together the surveys form a compelling composite of patient reported health concerns, CAM services wanted, and smoking habits. Age (mean = 40 years), gender (57% female), and race (85% white) were comparable between the surveys. Chronic pain (53%), anxiety (40%), and liver disease, i.e. Hepatitis C (27%) were the leading patient reported health concerns. Desired CODA patient CAM services were massage (65%), weight training and exercise (59%), and acupuncture (53%). 30% of patients listed massage as the first choice service, compared to 27% of patients that listed chronic pain as the primary concern. Similarly, 47% of patients requested smoking cessation services and 47% of smokers listed smoking cessation as a health concern. However, 58% of smokers reported spending $11-30 per week on cigarettes, while 43% reported unwillingness to spend anything on smoking cessation services. Assessment and incorporation of patient-driven services may lead to enhanced patient compliance and retention with SUD treatment.