 | SUBSTANCE ABUSE
Audio-Digest Psychiatry
Volume 36, Issue 24
December 21, 2007
Screening for substance abuse – S. Pirzada Sattar, MD
Is there a role for medications in treating addiction disorders? – Marc A. Schuckit, MD
 Click here to read an abstracted written summary of this program.
Points of Care– Why health care providers do not address alcohol and drug use disorders: .. 1) they do not identify it, .. if physicians think problem not significant enough, they will not identify it; 2) they do not have enough time to identify..; patients may have significant other medical problems that must be addressed in brief visit; 3) physicians often believe that available treatments do not work and therefore do not refer ..; data from National Institute on Drug Abuse show treatment does work; 4) question not framed correctly, and all too often judgmental;.. "You don't have a problem with alcohol or drugs, do you?" or "Are you an alcoholic?" when question should be, "how much alcohol do you drink?" or "do you ever use drugs?" 5) .. provider does not seek collateral information; MEDICATIONS ..? .. alcohol and drug dependence chronic relapsing disorders and must be treated as such; patients must be motivated to change and to comply long-term with treatment; cognitive behavioral, interpersonal, and psychologic aspects key to care; medications may be helpful as adjuncts to psychotherapy ..; alcohol problems cost $300 billion and cause 22,000 deaths per year; .. people in alcohol and drug treatment programs do well, especially those with "a lot to lose" (eg, career), "a lot of assets," and social support system; among people who complete private treatment programs, 1-yr abstinence rate ≈70%, and 1-yr abstinence rate predicts ≈70% 5-yr abstinence rate; .. even in treatment programs for the "have-nots," 1-yr abstinence rate 52%; 12-step groups: use cognitive and behavioral techniques to help patient get, and stay, clean and sober.
Dr. Sattar at the Third Annual: The Body and Its Brain–Clinical Perspectives, Mar 31, 2007, in Omaha, NE, by Creighton Univ Med Ctr. Dr. Schuckit at Advances in Psychopharmacology Throughout the Life Span, Apr 12-14, 2007, in San Diego, CA, by the Univ of Calif, San Diego, Sch of Med.
| |
