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Doctors Are in the House

May 30, 2008
by Gary Enos
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For better or worse, physicians and their governing bodies are coming to the forefront on the need to address substance use problems in primary care settings. The Physician Consortium for Performance Improvement, a group convened by the American Medical Association, announced today its adoption of clinical performance measures for the treatment of patients with known substance use disorders. The consortium has never before enacted measures related to substance use, and its push for integrated care goes beyond that. The new measures also are intended to facilitate early identification of depression in individuals with substance use problems. A growing number of addiction treatment experts are viewing these kinds of developments as partnership opportunities for the specialty addiction treatment community. Look for a leading medical director's perspective on this issue in the July/August Addiction Professional, and let us know what you think about primary care's interest in addiction issues.



I hope the lack of published responses on this vital topic does not reflect the typical apathy of physicians who are working in the behavioral health field. Having managed a medical detox in NJ for 5 years, admitting 20+ clients a day, most days, I know there are very few substance abuse clients who do not have a psychiatric component. depression, anxiety, and PTSD (usually from sexual abuse) are so common, they are almost a given. Yet, the physicians "fail to see or hear the symptoms" which usually include apathy, hopelessness, helplessness, and recidivism. Because there is usually a lack of genuine concern (aka compassion) for these clients, care plans are "cookie cutter" style, seldom individualized. Doctors brush past the complaints and symptoms, focusing on detox and discharge. 12-step, rehabilitation programs are usually meaningless entities to these physicians. As reimbursement agencies threaten to cut back or cut out monies, more agencies are scrambling to develop performance improvement markers for their programs. Too bad and so sad that these changes are not patient motivated, but instead are money-driven. For years, if an addict with any psychiatric symptoms tried to get medical help for detox or rehab, they were turned away or placed inappropriately into a behavioral health setting. The medical people did absolutely nothing to resolve this dilemma.
Phyllis Prekopa, MS, CARN-AP, LCADC

Gary Enos


Gary Enos

Gary A. Enos has been the editor of Addiction Professional since its inception. He also...

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