Whole-Patient Approach to Treatment of Substance Abuse Improves Outcomes and Costs



San Mateo County’s public health system is now equipped to better treat substance abuse in all patients seen, thanks to Medical Director of Behavioral Health and Recovery Services Robert Paul Cabaj, M.D. “It was astonishing—the number of people in the public-health system with substance abuse issues,” Dr. Cabaj reported. “The vast majority of them were in primary care, and it was very clear that if physicians had some guidelines, they might better address the problems—but without them, they just stepped back and let someone else deal with it.”

Referral to outside substance abuse treatment, including 12-step programs, was previously physicians’ and psychiatrists’ go-to resource for these patients. However, San Mateo treatment guidelines, now empowers physicians in all health care settings to prescribe medications to treat substance abuse.

MAT is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders. Research shows that when treating substance-use disorders, a combination of medication and behavioral therapies is most successful. Medication assisted treatment (MAT) is clinically driven with a focus on individualized patient care.”

Putting these new increasingly popular guidelines into practice, which were developed for use by behavioral health and primary care providers, has also improved collaboration among providers, says Dr. Cabaj; thus, helping to bridge the fragmentation of mental health and physical health treatment. These changes have also contributed to reduced costs and improved patient care. “In addition to the reduction in emergency services,” states Dr. Cabaj, “we have also seen a decrease in the drinking days of participants, and many participants have been able to switch to less expensive oral medication over time.”

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Additional information on medication assisted treatment can be found at: