Screening tests for alcohol use disorders

Improving substance abuse screening and intervention in a primary care clinic

Despite recent efforts to educate primary care providers in the identification and management of patients presenting with substance abuse problems, many opportunities to identify and intervene with these patients are overlooked. This project was designed to identify factors that interfere with rates of screening and brief intervention (SBI) of substance abuse problems in a primary care clinic in a major academic medical center in New York City. Six informants representing the disciplines of medicine, nursing, and social work in the primary care clinic provided information regarding SBI. Analysis was focused on substantiation of the need for enhanced diffusion of knowledge related to screening for substance abuse problems to improve rates of SBI in primary care. Recommendations for improvement included continued promotion of SBI by influential role models and opinion leaders, improvement in primary care providers' perceptions of the perceived characteristics of SBI to improve rates of adoption, implementation of interdisciplinary educational initiatives toward the goal of improving rates of SBI in the primary care clinic, and initiation of translational research at the clinic supporting SBI in primary care.

Screening and brief interventions for alcohol use disorders in managed care settings

This chapter will focus on the identification and treatment of alcohol use disorders in general medical care settings in the context of managed care systems. The chapter will include the best data available on the prevalence of problem drinking, screening procedures, brief intervention ("talk therapy"), and implementation in managed care environments. The clinical protocols presented were designed for primary care clinicians working with patients seeking routine medical care. The protocol was developed for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Physicians' Guide. The four steps were designed to help clinicians to screen, to conduct a brief assessment, to provide advice and or referral and to establish follow-up procedures.