Drug screening tools for Doctors.

National Institute on Drug Abuse (NIDA)
Embargoed for Release
Monday, April 20, 2009
10:00 a.m. EST

Contact:
Stephanie Older
301-443-6245
NIDA Launches Drug Use Screening Tools for Physicians
NIDAMED Helps Doctors Provide the Best in Medical Care
Washington, D.C. – The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, today unveiled its first comprehensive Physicians’ Outreach Initiative, NIDAMED, which gives medical professionals tools and resources to screen their patients for tobacco, alcohol, illicit, and nonmedical prescription drug use. The NIDAMED resources include an online screening tool, a companion quick reference guide, and a comprehensive resource guide for clinicians. The initiative stresses the importance of the patient-doctor relationship in identifying unhealthy behaviors before they evolve into life threatening conditions.

The NIDAMED tools — targeting primary care clinicians — were launched at a news conference at the National Press Club that featured NIDA Director Dr. Nora D. Volkow, Acting Director of the Office of National Drug Control Policy Ed Jurith, J.D., Sen. Carl Levin of Michigan, Acting Surgeon General Steven K. Galson, M.D., and representatives from the World Health Organization, the American Medical Association, and other organizations committed to helping patients who struggle with drug-related medical issues.

"Many patients do not discuss their drug use with their physicians, and do not receive treatment even when their drug abuse escalates," said Dr. 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."

In 2007, an estimated 19.9 million Americans aged 12 or older (around 8 percent of the population) were current (past month) users of illegal drugs—nearly 1 in 5 of those 18 to 25 years old—and many more are current tobacco or binge alcohol users. The consequences of this drug use can be far-reaching—playing a role in the cause and progression of many medical disorders, including addiction. Yet only a fraction of people who need addiction treatment receive it.

"I have long worked with NIDA to increase access to effective treatment in the battle against addiction," said Sen. Levin. "By encouraging physicians to consult with, screen and refer their patients who are in need of treatment, the NIDAMED initiative is a critical step towards achieving that goal. We must find ways to disseminate these important clinical tools, that can aid in mending lives and families, once torn asunder due to the scourge of addiction."

The NIDAMED tools were developed because doctors are in a unique position to discuss drug-taking behaviors with their patients before they lead to serious medical problems. Research shows that screening, brief intervention, and referral to treatment by clinicians in general medical settings, can promote significant reductions in alcohol and tobacco use.

A growing body of literature also suggests potential reductions in illegal and nonmedical prescription drug use. Yet many primary care physicians express concern that they do not have the experience or diagnostic tools to identify drug use in their patients.

"Not only will these tools potentially help clinicians identify the use of drugs such as cocaine and heroin, they can also identify patients who are misusing prescription medications," said Dr. Galson, a rear admiral in the U.S. Public Health Service. "In 2007, 16.3 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the past year — behaviors that can lead to serious health problems, including addiction.”

"My doctor literally saved my life," said Mink Rockmoore, a former Boston-area radio announcer who is a recovering heroin addict. "He worked hard to build my trust; he listened to my fears in a non-judgmental way; and he arranged for me to get both detox and treatment."

NIDAMED’s screening tool was adapted from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), developed, validated, and published by the World Health Organization (WHO) as an effective screening tool for identifying substance use. NIDA-modified ASSIST tools are specifically designed to fit into today’s busy clinical practices. Doctors can access the new tools at www.drugabuse.gov by clicking on the NIDAMED icon.

The online screening tool is an interactive Web site that guides clinicians through a short series of questions and, based on the patient’s responses, generates a substance involvement score that suggests the level of intervention needed. A physician can use this interactive tool during routine office visits. NIDAMED also includes an online resource guide with detailed instructions on how to implement the screening tool, discuss screening results, offer a brief intervention and make necessary referrals. In addition, a quick reference guide has been developed to serve as a prompt to medical professionals to initiate screening. This abbreviated guide provides a snapshot of the NIDA-modified ASSIST, briefly summarizing the questions, scoring and next steps.

Also included in the NIDAMED physician toolkit is a patient-tested postcard that encourages patients to ”Tell Your Doctors About All the Drugs You Use” and offers Web links for further information. Doctors are encouraged to put the cards in their waiting rooms to be read by patients before their appointments.

NIDAMED was unveiled in conjunction with NIDA’s recently updated Principles of Drug Abuse Treatment: A Research Based Guide. This publication summarizes the 13 evidence-based principles of effective treatment, answers common questions, and describes types of treatment, providing examples of scientifically based and tested treatment components. The principles are based on three decades of scientific research and clinical practice that have yielded a variety of effective approaches to drug addiction treatment.

More information on all NIDAMED products and the Principles of Drug Abuse Treatment: A Research Based Guide can be found at www.drugabuse.gov.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at www.drugabuse.gov. To order publications in English or Spanish, call NIDA’s new DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests to 240-645-0227 or drugpubs@nida.nih.gov. Online ordering is available at http://drugpubs.drugabuse.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.





I don't like this.

Just turn your doctor into a DRUG COP!

When are we going to stop this insanity and get rid of that expensive and futile proposition known as a war on drugs?

This is not what I wanted with change in our medical care.

I don't smoke, drink, or use drugs; and this scares me. Now people will feel that they can't trust their doctors. People who have a problem with addiction aren't going to seek help just because some doctor accuses them of having a problem.

And will this prompt Doctors to become over-vigilant? Will they leap to the "drug abuser" conclusion too quickly?

But, what I would like to know is: are they going to put this in some sort of government drug data base? And, do they have to have your permission to do the test?

And another question, would someone who had once had a problem with alcohol only, let's say, be tagged in that database 10 years later as someone not permitted to have necessary pain medications in the event of an accident or surgery? Would a person carry that stigma and even the potential for lack of proper medical care with them forever in the medical world?

Can of worms.

The drug warriors are psychopaths, in my non medical opinion.

"By encouraging physicians to consult with, screen and refer their patients who are in need of treatment, the NIDAMED initiative is a critical step towards achieving that goal. We must find ways to disseminate these important clinical tools, that can aid in mending lives and families, once torn asunder due to the scourge of addiction."

Refer to whom? Forced treatment? Never works. The "torn" family is going to be the indicator, not some sneaky diagnostic tool.

"In 2007, 16.3 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the past year — behaviors that can lead to serious health problems, including addiction.”

So, taking a non-prescribed drug once a year can lead to "addiction"? What's a "non medical" purpose? Is there a list of 'approved medical' indications? Someone wanted to calm down, but it's not medically approved to do so? :shrug:

One heroine addict is cited. Most heroine addicts don't make doctor visits. I've heard there are weekend crack users. Do they need to be "Referred"?

This sounds like a great tool for doctors to cut their patient loads. :sarcasm:

I'll have to pass this on!

I was stunned. I thought I would post it on DU to see what others thought about this madness.

I don't think that putting out cards with that message is going to increase the number of people discussing their drug use wtih their doctors. Infact, I don't see any of these strategies as being effective. I understand that this could help doctors determine the level of care needed and make the right referrals for patients that are completely honest about their drug use. If patients lie to the doctor, none of these tools are useful. People will avoid going to doctors if the doctor asks them to do this interactive survey on their drug use. People will be running out of there wearing their ugly gowns.

Besides, people will just lie anyway. What's next, secret hair tests??