Primary care visits provide a vital opportunity for providers to screen patients for unhealthy alcohol or substance use and identify those who could benefit from a brief intervention.
Unhealthy use of alcohol or other drugs can lead to a host of harmful health conditions, from injuries such as motor vehicle accidents to high blood pressure, heart disease, stroke, mental health issues such as depression and anxiety, and social problems such as family or job-related issues. However, brief interventions from primary care physicians (PCPs), including making a recommendation to cut back on drinking, have been shown to be effective in improving clinical outcomes.
Conducting a screening and screening tools
In conjunction with National Alcohol Screening Day on April 11, and consistent with the US Preventive Services Task Force (USPSTF) recommendation on this topic, please consider screening for unhealthy alcohol and substance use in your adolescent and adult patients, if you don’t do so already.
The CAGE questionnaire for adults is a four-question screening tool that helps to identify alcohol usage patterns that may reflect problems with alcohol:
- Have you ever felt you should Cut down on your drinking or substance use?
- Have people Annoyed you by criticizing your drinking or substance use?
- Have you ever felt bad or Guilty about your drinking or substance use?
- Have you ever had a drink or used substances first thing in the morning to steady your nerves or get rid of a hangover?
One “yes” answer suggests a possible substance use disorder. If there is a “yes” answer to two or more questions, it is highly likely that a problem exists and referral to a substance use disorder specialist may be the next step.
For screening adolescents for alcohol and drugs, consider utilizing the CRAFFT screening tool, which was developed at Children’s Hospital in Boston.
For more information
A variety of resources are available to assist your patients including:
- Substance Abuse and Mental Health Services Administration
- National Council on Alcoholism and Drug Dependence, Inc.
- Alcoholic Anonymous World Service Office: 212-870-3400
- Smart Recovery
- Narcotics Anonymous (NA)
- Al-Anon/Alateen Family Groups
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