NIDA Unveils New Drug Use Screening Tools for Physicians

Research shows that screening, brief intervention, and referral to treatment by doctors in primary care settings can help reduce drug and alcohol use. However, few physicians are currently doing this as part of their practice. New tools unveiled by the National Institute on Drug Abuse (NIDA) on Monday hope to change that.

NIDAMED, NIDA’s first comprehensive Physicians' Outreach Initiative, gives medical professionals tools and resources to screen their patients for tobacco, alcohol, illicit, and nonmedical prescription drug use. The NIDAMED resources include an online screening tool, a companion quick reference guide, and a comprehensive resource guide for clinicians. In an interview with CADCA’s Coalitions Online, NIDA Director Dr. Nora Volkow said the new tools will help eliminate one of the barriers that keep many physicians from screening their patients for substance abuse.

“Many doctors aren’t properly trained on screening for substance abuse and how to intervene, so they feel very uncomfortable asking patients about drug and alcohol use,” Dr. Volkow explained. “These tools will make it much more accessible for primary care physicians to do screening and interventions of their patients. Not only do the tools help physicians go through the screening, they guide them on the appropriate interventions.”

The online screening tool is an interactive Web site that guides clinicians through a short series of questions and, based on the patient's responses, generates a substance involvement score that suggests the level of intervention needed. A physician can use this interactive tool during routine office visits. NIDAMED also includes an online resource guide with detailed instructions on how to implement the screening tool, discuss screening results, offer a brief intervention and make necessary referrals.

In 2007, an estimated 19.9 million Americans aged 12 or older were current users of illegal drugs—nearly 1 in 5 of those 18 to 25 years old—and many more are current tobacco or binge alcohol users. The consequences of this drug use can impact the cause and progression of many medical conditions and diseases—everything from diabetes to asthma. Yet only a fraction of people who need addiction treatment receive it.

Dr. Volkow said by regularly screening patients, doctors can intervene before substance abuse becomes a full-blown addiction, making them the “first line of defense against substance abuse and addiction.” Doing so can also help ensure more people receive the necessary treatment.

The NIDAMED tools were developed because doctors are in a unique position to discuss drug-taking behaviors with their patients before they lead to serious medical problems. “Physicians really have a lot of influence on their patients. We tell our doctor a lot of things that we wouldn’t tell our relatives or spouses because there is something about the physician-patient relationship that is very unique,” Dr. Volkow noted.

During a news conference in Washington, D.C., Dr. Westley Clark, Director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration (SAMHSA), echoed that sentiment.

“A lot of people who have a substance abuse problem don’t think they need treatment. An important role for practitioners is to help people realize that in fact they do have a problem,” Dr. Clark said, adding that NIDAMED would broaden and strengthen SAMHSA’s SBIRT (Screening, Brief Intervention and Referral to Treatment) initiative.

NIDA is partnering with various national organizations to disseminate the tools, including the American Medical Association and the American Society of Addiction Medicine.

NIDAMED's screening tool was adapted from the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), developed, validated, and published by the World Health Organization (WHO) as an effective screening tool for identifying substance use. NIDA-modified ASSIST tools are specifically designed to fit into today's busy clinical practices. Doctors can access the new tools at www.drugabuse.gov by clicking on the NIDAMED icon.