Tuesday, May 5, 2009

NIDA Alcohol Smoking and Substance Involvement Screening NIDAMED

The National Institute on Drug Abuse (NIDA) has released a new program designed to help physicians be more proactive and more proficient at asking patients about and screening for alcohol and other substance abuse problems. Overall, we as physicians have not been very good about screening for these disorders despite taking care of the many medical and surgical/trauma complications from substance abuse that we see everyday. It has never really been clear to me why this is the case as we know that those with substance abuse use an inordinate share of medical resources. It has been somewhat of a mystery to me why we have been so poor at this. There are signs of changes. For instance the American College of Obstetrics and Gynecology has recommended substance abuse screening for all patients. Trauma centers must screen for substance abuse in order to maintain accreditation.

One problem maybe is that physicians as a group don't really know how to ask about alcohol and drug abuse problems. The National Institute on Drug Abuse has now provided a way to make that task easier. Through their NIDAMED resource center there is now an interactive web based program, the NIDA Alcohol Smoking and Substance Involvement Screening (NIDA-Modified ASSIST) which guides the physician through initial screening questions and then with follow-up questions. If the initial screening questions are negative the program ends but if there is an initial yes answer the program moves forward. Not only are the follow-up questions computer program driven but it also provides recommendations for what interventions may be appropriate. The questions and recommendations also can be used in a printed form. I have looked at these and they look pretty good. Another feature is that this program can be integrated into the electronic medical record (EMR) which is becoming increasingly necessary today.

So I recommend that physicians take a look at the NIDA Alcohol Smoking and Substance Involvement Screening which can be found through NIDAMED at www.drugabuse.gov

Thought for the day

The web is amazing.

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