The effects of substance abuse on individuals and our community are many and well-chronicled. What is less widely known is that the people in medical treatment for drug addiction are often still without care for chronic health conditions.
“When talking about ‘recovery’ for opioid addicts, it is natural that healthcare providers focus on addressing the addiction that brought the patient to us,” said Tim Hartnett, CODA’s executive director. “Yet we also now know that these patients have higher prevalence rates of diabetes, liver, heart and respiratory disease than the general population.” Often these patients are without primary care providers or they worry about being judged for their addiction, so are less likely to seek help and articulately describe their symptoms, Hartnett added.
A partnership between Providence Health, Kaiser Permanente and the Oregon Community Fund is changing this dynamic at CODA and elsewhere, raising awareness and putting resources into projects that “advance the goals of healthcare reform by reducing the impact of mental health and/or substance abuse on individuals, the health system and the community.”
In the case of CODA, the $299,350 grant supports creation of “health homes” for such patients, and among other services will teach self-management strategies to individuals with chronic health conditions—such as hypertension, chronic obstructive pulmonary disease, diabetes, nicotine dependence. This will take place in the same Portland clinic where they undergo methadone maintenance treatment for opioid addiction. This is an environment in which trust and patient accountability are already present or much more easily developed than a separate primary-care setting. It is also a cost-effective, time-efficient model that can reduce the strain on hospital emergency rooms in the area.
Among other services, the grant will:
- Strengthen the relationships betweenCODA patients and their current primary care providers. For those without care providers, CODA will work to help them establish treatment relationships in the community.
- Provide assistance to patients seeking medical care via appointment reminders, transportation assistance and by advocating on the patient’s behalf.
The grant awarded to CODA is part of a $1.2 million fund. Three other local projects received funds along with CODA: Lifeworks NW (Washington County); Oregon Primary Care (multiple counties); and Volunteers of America (Multnomah County).
As the Oregon Community Fund’s Winter 2013 newsletter puts it: “As health care continues to transform, health systems and safety net providers face daunting challenges. Responding to these challenges requires innovative solutions, partnerships and processes.”



