Substance abuse group develops new screening tools

Primary care physicians can play a large role in moving patients into treatment, NIDA officials say.

By Susan J. Landers — Posted May 5, 2009

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The National Institute on Drug Abuse has developed a set of online resources designed to help primary care physicians screen their patients for tobacco, alcohol and illicit drug use as well as for the nonmedical use of prescription drugs (link).

Included is an online screening tool designed for use during routine office visits. It guides physicians through a short set of questions that cover the frequency of use of various substances including tobacco products, alcoholic beverages, sedatives and prescription opioids. Based on patients' responses, a score is generated that suggests the level of intervention needed.

"Many patients do not discuss their drug use with their physicians, and do not receive treatment even when their drug abuse escalates," said NIDA Director Nora Volkow, MD. The new screening tools, called NIDAMED, enable physicians to be "the first line of defense against substance abuse and addiction," she added.

The resources were unveiled at an April 20 press briefing in Washington, D.C.

Research shows screening, brief interventions and referral to treatment by physicians in a general medical setting can help patients who are abusing drugs, according to NIDA materials.

One former heroin user who spoke at the briefing credits his physician with saving his life. "He worked hard to build my trust, he listened to my fears in a nonjudgmental way and he arranged for me to get both detox and treatment," said John Roser, also known as Mink Rockmoore, a former Boston-area radio announcer who is now training to be a substance abuse counselor.

But there are a large number of substance abusers, and their needs are not now being met, said American Medical Association Executive Vice President and CEO Michael Maves, MD, MBA. "In 2007, more than 23 million people needed help for a drug or alcohol problem, and more than 21 million did not receive it. And these are just the ones we know about."

In addition to the screening tool, the new resources include a guide with detailed instructions on implementing the tool, discussing results, offering a brief intervention and making referrals. A quick reference guide is also included to prompt physicians to initiate a screening, and there is also a postcard that encourages patients to tell their physicians about their drug use.

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