Drug and alcohol use is a public health problem, and as a professional in the health care field you can alleviate its devastating effects and make the future brighter for your patients. Make the most of your interaction with patients and the community at large by using your authority and expertise to advance the prevention and treatment of substance use disorders.

Action Steps

• Incorporate screenings and brief interventions into your routine practice.
  
  
• No matter what health care field you are in (primary care, emergency or hospital, mental health, dental, etc.), become familiar with local treatment agencies so you can make referrals if needed.
  
  
• Insist that treatment providers to whom you refer patients send you a progress report. This will help coordinate care across sectors.
  
  
• If you are a physician, get certified to prescribe buprenorphine, a medication used to treat opiate addictions.
  
  
• Become aware of the health issues that may be exacerbated by or indicative of substance use problems.
  
  
• If your state has a UPPL law, which allows health insurers to deny coverage to patients whose injuries are the result of being under the influence of alcohol and other drugs, become an advocate to repeal this law.
  
  
• Voice your concerns about addiction and treatment, UPPL or the need for equal coverage for substance abuse treatment to your legislators. Health care professionals have powerful stories to tell about the impact addiction has on patients and their families and the large cost to society.

Resources

Helping Patients with Alcohol Problems: A Health Practitioner's Guide

Quick Guide for Clinicians Based on TIPS 31 and 32: Screening, Assessing, and Treating Adolescents for Substance Use Disorders

Alcohol Screening and Brief Intervention in the ED

TIP 40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction

TIP 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs

What others have done

A team of community leaders in Rochester, NY are creating links between physicians and treatment providers, and improve public health through early recognition of alcohol abuse and dependency.

The theory driving Rochester's project is that physicians not only are unfamiliar with screening techniques, they are uncomfortable making referrals because they don't have relationships with the specialized treatment community. Therefore, the Rochester team will start by training physicians to identify risky drinkers and use brief intervention techniques to reduce consumption levels using a model called Cutting Back.

Additionally, some physicians will form partnerships with community treatment providers for personalized feedback and follow-up. Others will get patient education posters and brochures for their waiting rooms to increase consumer comfort with screening.

The Rochester team worked with Excellus BlueCross/Blue Shield and the Monroe County Medical Society to recruit physicians. The medical society invited its members to an event hosted by Excellus at its headquarters in downtown Rochester. Excellus also invited providers and arranged for CME credits.

The Rochester team is now working one-on-one with physicians to get them trained and partnerships established. The team is also working with representatives from the area's major hospital systems to establish screening and brief intervention in the emergency rooms.