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Screening and Intervention for Illicit Drug Abuse
A National Survey of Primary Care Physicians and Psychiatrists
Peter D. Friedmann, MD, MPH;
Deirdre McCullough, MS;
Richard Saitz, MD, MPH
Arch Intern Med. 2001;161:248-251.
Background Illicit drug abuse causes much morbidity and mortality, yet little is
known about physicians' screening and intervention practices regarding illicit
drug abuse.
Methods We mailed a survey to a national sample of 2000 practicing general internists,
family physicians, obstetricians and gynecologists, and psychiatrists to assess
their screening and intervention practices for illicit drug abuse.
Results Of 1082 respondents (adjusted response rate, 57%), 68% reported that
they regularly ask new outpatients about drug use. For diagnosed illicit drug
abuse, 55% reported that they routinely offer formal treatment referral, but
15% reported that they do not intervene. In multivariate logistic regression
models, more optimal screening and intervention practices were associated
with psychiatry specialty, confidence in obtaining the history of drug use,
optimism about the effectiveness of therapy, less concern that patients will
object, and fewer perceived time constraints.
Conclusions Most physicians reported that they ask patients about illicit drug use,
but a substantial minority inadequately intervene in diagnosed drug abuse.
Initiatives to promote physician involvement in illicit drug abuse should
include strategies to increase physicians' confidence in managing drug problems,
engender optimism about the benefits of treatment, dispel concerns about patients'
sensitivity regarding substance use, and address perceived time limitations.
From the Division of General Internal Medicine, Rhode Island Hospital,
Brown University School of Medicine, Providence (Dr Friedmann); the Pritzker
School of Medicine, University of Chicago, Chicago, Ill (Ms McCullough); and
the Clinical Addiction Research and Education Unit, Section of General Internal
Medicine, Department of Medicine, Boston Medical Center, Boston University
School of Medicine, Boston, Mass (Dr Saitz).
Corresponding author: Peter D. Friedmann, MD, MPH, Division of General
Internal Medicine, Rhode Island Hospital, 593 Eddy St, Providence, RI 02906
(e-mail: pfriedmann{at}lifespan.org).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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Pincus et al.
Am. J. Psychiatry 2007;164:712-719.
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