Henry X. Nieves-Díaz, MD, DABFM
Angélica M. Fuentes-Armesto, MD, DABFM
Michelle A. Cabán-Ruiz, PhD
Andrés E. Calvo-Díaz, MD

Universidad Central del Caribe, Bayamón, Puerto Rico

Background

Substance use disorders (SUDs) represent a critical public health challenge worldwide, demanding multidisciplinary and evidence-based approaches for effective prevention and treatment. As part of their training, fellows from UCC’s Addiction Medicine Fellowship are required to provide specialized services in preventive and addiction medicine at CUMIC at least one day per week for at least 12 months. This study aimed to evaluate service utilization, demographic patterns, and clinical outcomes to identify gaps and guide future strategies for enhanced care delivery.

Description

The analysis covered data from July 2024 to January 2025, focusing on patient demographics, diagnosis trends, treatment modalities, and service utilization. The clinic operates in an urban setting, offering services such as medication for addiction treatment (MAT) and psychoeducation. A retrospective observational design was employed, utilizing anonymized patient records. The key population includes individuals with alcohol and opioid use disorders, with additional co-occurring mental health conditions. Activities analyzed include MAT uptake, mental health service engagement (external), and patient retention rates.

Lessons Learned

Key findings revealed that 81.7% of patients were male, highlighting a need for gender-responsive programs, while 42.5% utilized MAT, emphasizing its role in reducing opioid-related mortality. External mental health services were accessed by 46.7% of patients, with psychiatry services used by only 15%, indicating barriers to comprehensive care. Although most patients engaged for at least three months, retention declined over time. Alcohol and opioid use disorders were prevalent, often accompanied by anxiety or depression.

Conclusions / Next Steps

The findings underscore the critical role of MAT and psychological services in improving SUD outcomes. The study suggests expanding on-site psychiatric services, enhancing gender-specific interventions, improving retention strategies, and utilizing real-time data monitoring to optimize care delivery. These insights will inform future strategies at CUMIC to improve outcomes in SUD treatment and recovery.

Keywords

Substance Use Disorder; Medication for Addiction Treatment; Psychological Services; Patient Retention; Addiction Medicine