Washington, D.C. -- Recognizing the devastating toll substance use conditions take on our nation's health, the National Quality Forum (NQF) today, for the first time ever, released a groundbreaking set of endorsed national voluntary consensus standards on evidence-based practices to treat substance use conditions. The standards were developed with support from the Robert Wood Johnson Foundation.

Substance use problems and illnesses have substantial impact on health and societal costs, and often are linked to catastrophic personal consequences. Data from the 2005 National Survey on Drug Use and Health reveal that an estimated 22.2 million persons aged 12 or older met diagnostic criteria for substance dependence or abuse with alcohol or illicit drugs in the past year, and an estimated 71.5 million used a tobacco product within the previous month.

"We cannot effectively address the disturbing effects of excessive drug and alcohol use without quality treatment for people with substance use conditions," said Janet Corrigan, PhD, NQF President and CEO. "NQF believes these standards will accelerate the use of effective, evidence-based treatments."

During the past 15 years, scientific knowledge about evidence-based therapies to treat people with substance use conditions has increased substantially. The NQF consensus standards provide clear guidance to the field on evidence-based practices that if adopted in all health care settings would substantially improve patient outcomes. The NQF report also identifies areas where further research is needed to identify preferred treatment practices and provides recommendations for the development of quality measures to evaluate and improve performance.

The endorsement of these practices by NQF's over 365 member organizations, which include healthcare providers, consumer groups, professional associations, purchasers, federal and state agencies, research and quality improvement organizations and suppliers, is the first time formal consensus has been achieved in the field about the treatment of substance use conditions. The standards were vetted through NQF's formal Consensus Development Process, with multiple stakeholder input, to achieve special legal standing as voluntary consensus standards.

"These consensus standards represent a defining leap forward in the effort to improve treatment of substance use conditions," said Elaine Cassidy, PhD, MSEd, program officer at the Robert Wood Johnson Foundation. "They give visibility and credibility to evidence-based treatment practices and create momentum for further advances."

The eleven newly endorsed treatment practices are organized into four domains and subdomains as follows:

Identification of Substance Use Conditions

Screening and Case Finding

1. During new patient encounters and at least annually, patients in general and mental healthcare settings should be screened for at-risk drinking, alcohol use problems and illnesses, and any tobacco use.

2. Healthcare providers should employ a systematic method to identify patients who use drugs that considers epidemiologic and community factors and the potential health consequences of drug use for their specific population.

Diagnosis and Assessment

3. Patients who have a positive screen for -- or an indication of -- a substance use problem or illness should receive further assessment to confirm that a problem exists and determine a diagnosis. Patients diagnosed with a substance use illness should receive a multidimensional, biopsychosocial assessment to guide patient-centered treatment planning for substance use illness and any coexisting conditions.

Initiation and Engagement in Treatment

Brief Intervention

4. All patients identified with alcohol use in excess of National Institute on Alcohol Abuse and Alcoholism guidelines and/or any tobacco use should receive a brief motivational counseling intervention by a healthcare worker trained in this technique.

Promoting Engagement in Treatment for Substance Use Illness

5. Healthcare providers should systematically promote patient initiation of care and engagement in ongoing treatment for substance use illness. Patients with substance use illness should receive supportive services to facilitate their participation in ongoing treatment.

Withdrawal Management

6. Supportive pharmacotherapy should be available and provided to manage the symptoms and adverse consequences of withdrawal, based on a systematic assessment of the symptoms and risk of serious adverse consequences related to the withdrawal process. Withdrawal management alone does not constitute treatment for dependence and should be linked with ongoing treatment for substance use illness.

Therapeutic Interventions to Treat Substance Use Illness

Psychosocial Interventions

7. Empirically validated psychosocial treatment interventions should be initiated for all patients with substance use illnesses.

Pharmacotherapy

8. Pharmacotherapy should be recommended and available to all adult patients diagnosed with opioid dependence and without medical contraindications. Pharmacotherapy, if prescribed, should be provided in addition to and directly linked with psychosocial treatment/support.

9. Pharmacotherapy should be offered and available to all adult patients diagnosed with alcohol dependence and without medical contraindications. Pharmacotherapy, if prescribed, should be provided in addition to and directly linked with psychosocial treatment/support.

10. Pharmacotherapy should be recommended and available to all adult patients diagnosed with nicotine dependence (including those with other substance use conditions) and without medical contraindications. Pharmacotherapy, if prescribed, should be provided in addition to and directly linked with brief motivational counseling.

Continuing Care Management of Substance Use Illness

11. Patients with substance use illness should be offered long-term, coordinated management of their care for substance use illness and any coexisting conditions, and this care management should be adapted based on ongoing monitoring of their progress.

Seven new recommendations to accompany the practice set were likewise endorsed. The recommendations pertain to the following areas:

• Improving the NQF-endorsed Practices
• Additional Research
• Measure Development
• Implementation
• Finance
• Legal and Regulatory
• Management in Primary Care

For more information and to order the report please visit: http://www.qualityforum.org/.