Alcohol Abuse, Other Drug Abuse, and Mental Disorders in Medical Practice

Abstract

Millions of Americans suffer and die of alcohol abuse, other drug abuse, and mental disorders that go undiagnosed and untreated. Studies showing that up to 19% of the US adult population have these disorders also have found that only one fifth of those affected have sought help for them in the previous six months. Many of these persons have disorders that are treatable with modern medications and therapy. Because more than half of all persons with these disorders obtain all of their care from the general medical sector, a great potential exists in primary care for prevention, detection, treatment, and referral of these patients. Primary care physicians, however, have not been very successful at diagnosing and treating substance abuse and mental disorders because of inadequate training, patients' attitudes, and the constraints of the health care system. Recommendations to improve this situation include continued research, improved physician education, and increased emphasis on care of these disorders by organized medicine. Although tobacco use is also a major health problem, data relating to nicotine addiction were not included in this report.

Effect of a primary care based brief intervention trial among risky drug users on health-related quality of life

“…Primary care clinics have regular contact with large, multi-ethnic groups. In primary care, routines and guidelines regarding screening, brief intervention, and referral to treatment (SBIRT) can be implemented (Kamerow et al, 1986; Saitz et al, 2010). There is evidence that reduction in illicit drug use can be achieved using behavior change theories and techniques (Babor et al, 2007; Bernstein et al, 2005; Goldstein et al, 2004; Humeniuk et al, 2012, 2008b; Humphreys and McLellan, 2010).…”

Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

“…Chronic pain is commonly encountered in primary care [1], where the majority of patients with substance use disorders (SUDs) receive health care [2]. Patients with SUDs are at significant risk of pain [3, 4] and are likely to be undertreated for pain.…”

Psychiatric education improves internistsʼ knowledge: a three-year randomized, controlled evaluation.

“…Only 20% of these patients are seen by mental health specialists for their psychiatric problems; 74% of the mentally ill receive their only mental health care in the general health sector (2). Approximately 25% of general medical patients have significant psychiatric illnesses (3,4) and between one third to one half of these psychiatric problems among medical patients are missed by primary physicians (5,6).…”