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Leaders step up the call for more screening by physicians

April 9, 2009
by Gary A. Enos, Editor
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A Texas study shows a staggering number of ER visits by some illegal drug users

The federal government is calling generalist physicians the “first line of defense” against substance abuse and addiction, if they can begin to screen the individuals they see in a more systematic fashion. A recent report from a nonprofit coalition of safety-net providers in Texas shows what can happen when physicians are not fully engaged in the process of assisting persons with substance use problems.

The report from the Integrated Care Collaboration, a group of providers in the Austin area that work together to improve health access and quality and to affect financing policies, found that nine individuals in the region accounted for a staggering 2,678 emergency-room visits from 2003-2008. Eight of the nine individuals had drug abuse problems, and seven had mental health diagnoses.

With the average ER visit costing about $1,000, the coalition is seeking to highlight this issue and look for less costly interventions that will also benefit patients. It is recommending more referral of these frequent ER visitors to both primary care physicians and specialty behavioral health programs.

Now the federal government is getting more involved with this subject as well, announcing that later this month it will unveil a physicians’ outreach initiative designed to give doctors convenient tools for screening patients for substance use. The National Institute on Drug Abuse (NIDA) initiative, to be called NIDAMED, will include the availability of an online screening tool and a quick reference guide.

Federal officials hope NIDAMED will help increase awareness of the detrimental impact of problem levels of substance use on overall health. NIDA will introduce the initiative at an April 20 press event in Washington, D.C., with groups such as the American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA) represented at the unveiling.