One Question from Primary Care Doctors Can Reveal Risky Alcohol or Drug Patterns

With a few distinct questions, primary care physicians can make a tremendous impact on identifying which patients may have a drug or substance abuse problem, says the American Society of Addiction Medicine (ASAM). The impact can even prevent lifelong addictions or loss of life if teens are screened about their habits separate from their parents’ view during doctor’s office visits – although many primary care doctors may not yet be adequately or consistently screening patients for substance abuse.

Groups like the U.S. Preventative Services Task Force are encouraging doctors to talk more with patients about substance abuse, especially primary care doctors, as they may be the start of a patient’s overall treatment plan. According to the Veterans Health Administration, around 66 percent of patients battling a drug or alcohol addiction receive treatment from their primary care doctor or in a general behavioral health setting.

The patient history form captures some information about a patient’s health, but critical information about alcohol or drug use may need to be captured from an in-person, private conversation, says ASAM. Patients may be reluctant to specify on a form if they’re experiencing a problem with a substance, and may be more open to honest answers when asked directly by their physician. Many times, say some physicians, the patient is relieved to be addressing the problem.

Encouraging patients to talk about a drug or alcohol problem early is also a way to help ensure proper treatment before the problem escalates further.The screen can be made more simple using tools like the Alcohol Use Disorders Identification Test (AUDIT-C), which guides the physician through a set of interview questions with the patient over areas such as number of times they drink, how much they consume and if they participate in activities like excessive drinking.

Researchers from Boston University School of Medicine have explored the inconsistent levels of primary care patient screenings, finding in a study that a few simple questions from a physician can help lessen dangerous levels of alcohol consumption among patients. Sometimes, only one specific question related to alcohol use quantities and frequency can identify which patients may need further treatment, says the National Institute on Alcohol Abuse and Alcoholism, a conclusion demonstrated in the Boston University study.

Experts believe some doctors may not perform the patient screening because they are uninformed of what steps to take next if a substance abuse problem emerges with a patient. They also struggle with the extra time a patient screening may require when faced with overbooked and busy offices.

Despite these challenges, experts hope more primary care doctors will address drug use or alcohol with their patients, because many times, the screening kick starts the treatment and recovery process.