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Many Doctors Overlook —- Or Ignore -— Their Patients' Drug Abuse
A nationwide survey of primary care doctors that appears in the current
issue of The Archives of Internal Medicine suggests that many are doing little
to help their drug-addicted patients conquer addiction. Nearly one-third
of the 1,080 doctors surveyed said that they did not routinely ask new patients
if they used illicit drugs, and 15% stated that they did not routinely offer
any intervention to those patients who said they used drugs. Family physicians,
internists, obstetricians, gynecologists, and psychiatrists were questioned.
The survey results indicate that the psychiatrists and obstetricians were
the most likely to ask their patients about drug abuse, however the obstetricians
were the least likely to intervene.
Dr. Peter Friedmann, the lead author of the survey and an assistant professor
of medicine and community health at Brown University, said that of the doctors
who do offer intervention, 61% routinely recommend 12-step programs (which
some research suggests may be less successful than formal addiction therapy,
such as methadone treatment or treatment in residential care centers). According
to Dr. Friedmann and his team of researchers, this finding suggests that many
doctors do not yet consider drug abuse a medical problem akin to other chronic
diseases like diabetes, asthma, or high blood pressure.
The national data from 1999 estimated that as many as 14.8 million Americans
were users of illegal drugs. Many drug abusers seek treatment for common disorders
that can often be linked to drugs. However, as Dr. H. Westley Clark, the director
of the Center For Abuse Treatment at the U.S. Department of Health and Human
Services, points out, if doctors neglect to ask their patients about drug usage,
they are neglecting to treat the problem.
“Primary care is supposed to embrace preventative medicine,” said Dr. Terry Norton,
medical director for Phoenix House, a national drug treatment program. “If you
don't identify the people, there's not a chance you can get them toward help.”
Dr. Friedmann offered suggested reasons for doctors failing to address their
patients' drug abuse, including pessimism about being able to do anything to
help and skepticism about the efficacy of drug treatment programs. Some doctors,
he added, could also think that it's taboo to discuss drug abuse with patients,
or they may feel it is outside their role as primary care physician. All of
which, said Dr. Friedmann, indicate the need for better drug-abuse training
in medical schools. “The problem,” he said, “is pervasive enough in medical
settings that all doctors should be trained and ready to identify patients
with these problems and intervene.”
Responding to the findings of the survey, the Director of The National Institute
on Drug Abuse, Dr. Alan I. Leshner, said, that despite common misconceptions, “addiction
is imminently treatable if the treatment is well delivered and tailored” to
the patient's own needs. Primary care physicians, emphasized Dr. Leshner, are
in a key position to help diagnose drug addiction and get abusers proper treatment.
Articles
- What to Look For in a Rehab
- What We All Need to Know About Drug Addiction
- Facts about Alcohol, from Social Drinking to Serious Dependence
- OxyContin ® Diversion and Abuse
- Harsh Truths About Cocaine
- Methamphetamine: Highly Addictive and Highly Dangerous
