This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (17)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Substance Abuse/ Alcoholism  • Diagnosis  • Alert me on articles by topic  Social Bookmarking   What's this?

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).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Can Psychiatry Cross the Quality Chasm? Improving the Quality of Health Care For Mental and Substance Use Conditions
Pincus et al.
Am. J. Psychiatry 2007;164:712-719.
ABSTRACT | FULL TEXT