How to Identify and Treat Patients With Substance Use Disorders

It's all too common to see patients with a substance use disorder in today's primary care population. Yet, identifying the substance use disorders then treating or referring patients for them is a complex problem. MedTwitter

and addiction cost society more than $740 billion annually in workplace productivity, healthcare, and crime-related expenses.

are filled with stories like that of user"Cyralek," who say that the two doctors they've seen since quitting drinking didn't show much interest in the problem beyond ordering liver function tests.by researchers at Washington University School of Medicine in St. Louis, 80% of patients who met the diagnostic criteria for substance use disorder visited a doctor, hospital, or clinic for some reason over the past year.

Doctors aren't necessarily rewarded for the time it takes to develop a rapport with patients and to have a conversation that leads to asking, How much are you drinking?"The system in primary care isn't set up that way," said Lucy McBride, MD, an internist in Washington, DC.In a perfect world, patients struggling with a substance use disorder would present with a request to discontinue using drugs or alcohol, as Gordon did.

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