In honor of Alcohol Awareness Month in April, learn about the LINKAGE program, Kaiser Permanente’s unique, regional approach to supporting members who struggle with alcohol and drug problems.
At Kaiser Permanente Northern California, dismantling the stigma associated with addiction is a top priority — and thousands of members are benefiting from this focused effort each year.
According to the 2015 National Survey of Drug Use and Health, 15.1 million adults ages 18 and older suffer from an alcohol dependency, but only about 6.7 percent of adults who have an alcohol dependency have received treatment in the past year.
Considering this statistical discrepancy, how does Kaiser Permanente Northern California help and encourage alcohol and drug treatment patients to engage in their own treatment and overall health care?
“We’re leading the country in how we address people who suffer from alcohol addiction, showing them that if they are engaged in their own overall health, their outcomes will be better,” said Stacey Nelson PhD, director of Chemical Dependency Services at Kaiser Permanente San Rafael and chair of the Kaiser Permanente Northern California Chemical Dependency Program Directors Committee. “Kaiser Permanente offers a psychosocial and biological approach to treatment. We work to get our members to understand that alcohol use affects the whole person in mind, body, and spirit.”
Dr. Nelson says that’s where Kaiser Permanente’s newest Addiction Medicine program, LINKAGE, comes in, which encourages addiction treatment members to use electronic health records and online patient portals to effectively engage in health education, prevention, and facilitate communication with their medical providers. The program consists of 6 class sessions, ranging from understanding the patient’s role on their health care team to learning how to access laboratory results and after-visit summaries. Currently, there are about 3,000 participants enrolled across the region.
“The program develops effective connections between addiction treatment and primary health care,” continued Dr. Nelson. “It also works to reduce stigma and puts addiction medicine in the same arena as other medical conditions.”
Empowering the Individual
In 2013, Kaiser Permanente Northern California conducted a study focused on increasing alcohol and drug treatment patients’ engagement in their own health care. Researchers found that patients who participated in the 6 LINKAGE sessions had greater involvement in managing their health care than those receiving fewer sessions.
“Patients being treated for a chemical dependency often rely on Emergency Department services, rather than preventive care, for their health care. They are 3 times more likely to visit the Emergency Department than non-addiction treatment patients in the 18 months before they enter treatment,” said Constance M. Weisner, DrPH, chief of Behavioral Health and Aging at the Kaiser Permanente Northern California Division of Research and a professor at the UCSF Department of Psychiatry. “LINKAGE participants became activated health system members. We found that they started having more primary care visits, and returning for an Addiction Medicine ‘booster’ visit, if needed, over the following several years.”
Members who participated in the LINKAGE program logged into KP.org 2 ½ times more than the average number of member log on days. Members also reported talking to their physician about alcohol and drug problems more than members who did not participate in the program.
Patients who participated in all components of the LINKAGE program also had significantly better outcomes at 6 months than those who did not participate — 84 percent of the LINKAGE participants abstained from alcohol versus 72 percent of those who did not participate. Overall, patients in the study who felt more responsible for their own health and also engaged more with the health care system were more likely to be abstinent from alcohol and drugs at 2 years (60 percent) compared to patients who were less activated and engaged (41 percent).
Continuing to Thrive
With thousands of participants enrolled across the region, and more signing up each day, the program continues to successfully encourage addiction treatment patients to manage their health and well-being. Members can self-refer to the program or be referred by their physician.
Heather, a LINKAGE participant, said the program helped her gain the confidence needed to take control of her health.
“I have been sober for more than four years. Since participating in the study, I have gotten married and I am currently trying to get pregnant. From the tools I learned through LINKAGE, I was able to gain the confidence to talk to my doctor and change to one who I felt was better suited for my needs. I learned from LINKAGE to take control of my health, and I gained the confidence to stand up for my own health care.”
See the Alcohol Use Care Guide, a self-assessment tool and resource for both members and primary care physicians. Also, read more about the LINKAGE study, and find more resources on alcohol problems and treatment.