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Detecting and Dealing With Substance Abuse Disorders in Primary Care

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Detecting and Dealing With Substance Abuse Disorders in Primary Care

Abstract and Introduction

Abstract


Substance abuse disorders (SADs) are prevalent, chronic, relapsing illnesses that, despite the availability of treatment, remain underdiagnosed. Patients with SADs frequently experience medical complications and initially present to their primary care providers for care. While patients rarely admit to SADs, they often display recognizable signs and symptoms. Through an understanding of SADs, primary care providers can facilitate early and comprehensive treatment of these complex illnesses and, in doing so, reduce complications.

Introduction


Substance abuse disorders (SADs) are common chronic relapsing illnesses that are characterized by drug-seeking and drug-taking behaviors that persist despite negative consequences. These diseases are similar to other primary care illnesses, such as hypertension and diabetes, in that they require consistent monitoring, treatment, and assistance with lifestyle changes. An estimated 20% of patients seen in family practice have SADs, and these disorders currently rank among the 10 leading preventable risk factors for years of life lost to death and disability. Despite this high incidence, one recent survey noted that substance abuse was diagnosed in only 9% of general and family practice visits, 8% of internal medicine visits, and 5.1% of psychiatric visits.

While patients seldom admit to drug problems, many display red flags that can alert practitioners to possible abuse issues. Early detection of SADs can facilitate treatment and, ultimately, a reduction in the significant disability and comorbidity that accompany these disorders. Despite the availability of effective treatments, most individuals with SADs have never been treated. Therefore, it is critical for primary care practitioners (PCPs) to recognize and effectively respond to patients who have substance abuse issues.

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