NIDA Announces Effort to Help Docs Screen Patients for Drug, Alcohol Problems

By Hugh C. McBride

Effective drug and alcohol treatment programs have helped thousands of previously addicted individuals regain control over their behaviors and resume their pursuit of a healthy, drug-free lifestyle. But before people can benefit from drug or alcohol treatment, either they or someone who cares about them must acknowledge that a problem exists.

On April 20, the National Institute on Drug Abuse (NIDA) announced an initiative to increase the likelihood that substance abuse problems will be identified, and that those who are suffering from these conditions will get the help they need.

Introducing ‘NIDAMED’

According to an April 20 NIDA press release, the institute’s Physician Outreach Initiative (which has been dubbed ‘NIDAMED’) provides tools and resources that will increase the ability of primary care physicians to screen patients for problems related to the use and abuse of alcohol, tobacco and illicit drugs, as well as for the nonmedical or recreational use of prescription medications.

Equipping primary care physicians, the release noted, will help to bridge a communication gap that often occurs between doctors and their patients, while also enabling essential screening services to be provided to a larger pool of individuals who may be in need of drug or alcohol treatment:

The NIDAMED resources include an online screening tool, a companion quick reference guide, and a comprehensive resource guide for clinicians. The initiative stresses the importance of the patient-doctor relationship in identifying unhealthy behaviors before they evolve into life threatening conditions. …

The NIDAMED tools were developed because doctors are in a unique position to discuss drug-taking behaviors with their patients before they lead to serious medical problems. Research shows that screening, brief intervention, and referral to treatment by clinicians in general medical settings, can promote significant reductions in alcohol and tobacco use.

“Many patients do not discuss their drug use with their physicians, and do not receive treatment even when their drug abuse escalates,” NIDA Director Dr. Nora Volkow said in the April 20 release. “NIDAMED enables physicians to be the first line of defense against substance abuse and addiction and to increase awareness of the impact of substance use on a patient’s overall health.”

The NIDA release highlighted the following components of the NIDAMED outreach effort:

  • The online screening tool is an interactive website that guides clinicians through a short series of questions and, based on the patient’s responses, generates a substance involvement score that suggests the level of intervention needed.
  • NIDAMED also includes an online resource guide with detailed instructions on how to implement the screening tool, discuss screening results, offer a brief intervention, and make necessary referrals.
  • The physician toolkit also includes a postcard that encourages patients to “Tell Your Doctors About All the Drugs You Use” and offers Web links for further information. Doctors are encouraged to put the cards in their waiting rooms to be read by patients before their appointments.

The Extent of the Problem

Across the nation, drug and alcohol abuse continues to plague adolescents, teens, and adults of virtually every age, both genders, and all socioeconomic groups.

NIDA has estimated that almost 20 million American adolescents, teens, and adults (or about 8 percent of the U.S. population in the 12-and-above age group) have used illegal drugs in the past 30 days. Within the 18 to 25 demographic, the percentage of those who have used illicit substances in the past month jumps to about 20 percent.

These statistics do not include alcohol abuse such as binge drinking, which has been associated with a wide range of health and developmental problems. Older teens and college-age men and women are most likely to engage in binge drinking, which is defined as consuming five or more drinks (for men) or four or more drinks (for women) in a two-hour period).

The U.S. Centers for Disease Control and Prevention (CDC) indicates the severity of binge drinking among young people:

  • About 90 percent of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks.
  • About three-fourths of the alcohol consumed by adults in the United States is in the form of binge drinks.
  • The proportion of current drinkers that binge is highest (51 percent) in the 18- to 20-year-old demographic group.

Though often viewed as little more than an edgy phase or a “rite of passage” into adulthood, alcohol abuse can have a long-term impact on a person’s health and well-being – an impact that NIDA officials and other experts hope to lessen by preparing primary care physicians to identify problems and help patients get the drug or alcohol treatment they need.

About Drug & Alcohol Treatment

Once a problem has been identified (either by the person who is suffering from the problem, or by a doctor or other concerned party), the next step is finding the drug or alcohol treatment program that is most likely to prepare the addicted individual to pursue long-term recovery.

Effective drug and alcohol treatment may consist of participation in a 12-step recovery support group, outpatient therapy, enrollment in a residential treatment facility, or a combination of these options. For example, to increase the likelihood that they can achieve and maintain long-term sobriety, many individuals complete an extended stay in a residential rehabilitation program, then follow up with continued outpatient therapy, family therapy, and involvement in a 12-step or similar support program.

But none of this can be accomplished without the step that NIDA hopes to make much easier and much more common: identifying a drug or alcohol problem before permanent damage has been done.