New NIDA Drug Screening Tool Unveiled

New NIDA Drug Screening Tool Unveiled
April 23, 2009

News Summary

A new online tool and other resources will help primary-care physicians screen their patients for alcohol, tobacco and other drug problems, according to the National Institute on Drug Abuse (NIDA).

The NIDAMED physician outreach program includes the new Web-based screening tool -- based on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) -- as well as a companion quick-reference guide and a comprehensive screening resource guide for physicians. Waiting-room postcards urging patients to discuss their drug use with their doctors also are provided. "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. "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."

Primary-care physicians have great potential for screening patients with drug problems and referring them to treatment before they develop full-blown addictions or related health problems. However, many doctors say they lack the training and tools to conduct screenings for addictions.

COMMENTS ON THIS ARTICLE:

Posted by lisaf-breakingthecycles on 23 Apr 09 06:42 PM EDT

This is very encouraging and while this one is more for physicians, it mirrors NIAAA's new site, for the layperson, www.rethinkingdrinking.niaaa.nih.gov. In my view, we need to help people understand how one looses control of their alcohol (or substance) use before it becomes an addiction or causes the kinds of problems associated with binge drinking and alcohol abuse. Having these online, anonymous assessments and websites filled with FAQs and suggestions for what to do if there is a problem is great step in this direction.

Posted by Eileen on 24 Apr 09 10:45 AM EDT

This is VERY encouraging...I liken it to kindergarden screening where educators can see a student's challenge before they get lost in a system!

Posted by Reverendcrash on 24 Apr 09 12:09 PM EDT

What an amazing breakthrough. In kight of the Highest incidence of Substance abuse being in the Medical Proffession perhaps this will impact the 200,000 preventable deaths each year from Medical Malpractise

Posted by BSBIRTCO on 24 Apr 09 01:54 PM EDT

It is wonderful that NIDA has unveiled the ASSIST tool for use by healthcare providers as it assesses for both alcohol and other drugs. Patients should be asked about their substance use as a part of routine healthcare screening, as substance use affects a person's health. The idea is not to tell a person what to do or to stop using, but to improve their heatlh and quality of life.

Posted by Pfft on 24 Apr 09 02:09 PM EDT

What, are almost all of these comments being posted by NIDA people? You can't laud a system based on the limited amount of information displayed here. It's highly likely that within this system, substances do not receive the right degree of treatment. Someone that mentions that they enjoy LSD could be ranked with someone that says they enjoy cocaine, and both could be lectured similarly. Marijuana could be demonized here as it is elsewhere in government policy. Physicians aren't there to treat addictions. That's more of a psychological issue, usually. They can prescribe drugs to help, and monitor withdrawal, but theirs is not the science of addiction. The only point of this, as I see it, is to have doctors lecturing their patients. Since telling parents to talk to their kids about drugs isn't working, let's have people's general practitioners do it. That's not what I want to be paying for in health insurance, and this isn't what I want my tax money to go towards.

Posted by Jose on 24 Apr 09 09:11 PM EDT

Reply to comment posted by Pfft If you read between the lines, it appears that we have ourselves a pot head here. If so his agenda is: Hey I do not want my doctor to be able to evaluate my drug use. I just want him to write me a script for some medical marijuana. So, I do not want to use my tax money to have him deny me my script because he discovered that I had a problem with my use!

Posted by Donna on 26 Apr 09 11:59 PM EDT

I'm not a NIDA person and don't want to disappoint Pfft but I am glad to hear the medical profession is stepping up to the plate to be more proactive in addressing addiction and to screen for it. Training doctors in residency and while in medical school can only help make a complete treatment approach. What sounds like the challenge for Pfft is to understand the lack of training doctors have currently in their education on addiction, hence the high rate of prescription misuse by patients because doctors don't understand how to treat pain and recognize addiction.

Posted by Lisa on 27 Apr 09 10:34 AM EDT

re: Pfft Since physicians often control access to mental health professionals, it is appropriate that the primary medical provider screen for addiction more effectively. The idea is not to name one drug as better/worse than another, but to identify individuals who need to address their substance use with qualified personnel, and then open the gates to that care.

Posted by Shirley CD Professional on 27 Apr 09 12:27 PM EDT

At least it is a beginning, but I feel the doctors just need a little education about addiction that could help them refer someone to a professional for an evaluation. Just the type of drugs used does not say if there is a problem but things like "do you use more than you intend to" etc. would indicate a referral. Doctors, PO's Judges etc. need an understanding of what addiction is really about then they would know when to refer or not. If their patients used cocaine, herione etc. there is such a stigma still, they would probably not tell the truth.

Posted by Diane Kopperman on 27 Apr 09 01:55 PM EDT

I hate to say this in public, but Pfft, you are really out to lunch. Treating addictions is most definately a medical problem and should be included in a doctor's treatment portfolia. I particularly noticed your minimization of the use of LSD, pot, and cocaine. An occasional use (once of twice a year?) of any of these drugs isn't necessarily a problem. However, where is the cutoff between "occasional" and negative impacts of drug use? Anybody who uses all three, no matter how infrequently, has a drug problem. Furthermore, most people are not able to limit themselves to occasional use over the long haul and it is a slippery slope from there to "problem drug user" and then to "addict". Where do you draw the line? I agree with Donna and Lisa that physicians can and should be the first line of defense against problem drug use. They could intervene early when treatment is more likely to be successful, rather than waiting to prescribe drugs for withdrawal, which indicates an entrenched use of addictive drugs.

Posted by jay on 28 Apr 09 06:13 AM EDT

I think parts are true in all the above responses. A question y'all might want to consider is: is this a part of the process of integrating the phameceutical industry and "medicine" to perscribe away substance dependency? I know I have heard that the pills will be perscribed with some sort of recommendation to participate in traditional Tx however, isn't that how ADHD, depression and anxiety were going to be treated as well? How often are those conditions simply being medicated w/o any other care being provided?

Posted by Betty B on 13 Jul 09 09:10 AM EDT

As someone with ADHD, I can attest to how important the care is that goes along with my medications. I also work with many people with substance abuse issues and encourage them to make sure they are not just taking their "pills," but seeing their doctor or counselor on a regular basis. Suboxone, for example can NOT be prescribed in VT without a person being in a treatment program as well.

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