Pubdate: Mon, 22 Jan 2001
Source: Los Angeles Times (CA)
Copyright: 2001 Los Angeles Times
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Author: Lindsey Tanner, AP Medical Writer

SURVEY: DOCS NEED TO HELP ADDICTS

CHICAGO--A national survey of primary care doctors suggests that many are 
doing little to help drug-addicted patients kick the habit.

About one-third of the 1,080 doctors surveyed said they do not routinely 
ask new patients if they use illicit drugs, and 15 percent said they do not 
routinely offer any intervention to drug-abusing patients.

Of the doctors who do offer intervention, 61 percent said they recommend 12 
- -step programs, which research has suggested may be less successful than 
formal addiction therapy, said Dr. Peter Friedmann, lead author and an 
assistant professor of medicine and community health at Brown University.

Only 55 percent said they routinely recommend formal addiction therapy, 
such as methadone treatment or residential treatment centers.

Results of the survey, mailed to doctors nationwide last year, appear in 
Monday's issue of Archives of Internal Medicine.

The findings suggest that many doctors don't consider drug abuse a medical 
problem akin to chronic diseases like diabetes or high blood pressure, 
Friedmann said.

National data from 1999 estimated that 14.8 million Americans were current 
users of illegal drugs.

Many abusers seek treatment for common disorders that may be linked to 
drugs, said Dr. H. Westley Clark, director of the Center for Substance 
Abuse Treatment at the U.S. Department of Health and Human Services. But if 
doctors don't inquire about the drug usage, they are not treating the 
problem, he said.

Reasons suggested for failing to do so include pessimism about being able 
to do anything to help and skepticism about the success of drug treatment 
programs, Friedmann said. Some also think talking about drug abuse with 
patients is taboo, or feel it is outside their role -findings that indicate 
better drug-abuse training is needed in medical schools, he said.

Friedmann said the problem "is pervasive enough in medical settings that 
all doctors should be trained and ready to identify patients with these 
problems and intervene."

"Primary care is supposed to embrace preventive medicine," said Dr. Terry 
Horton, medical director for Phoenix House, a national drug treatment 
program. "If you don't identify the people, there's not a chance you can 
get them toward help."

Family physicians, internists, obstetricians and gynecologists, and 
psychiatrists were questioned. Psychiatrists and OB/GYNs were the most 
likely to ask patients about drug abuse, but OB/GYNs were least likely to 
intervene.

Alan I. Leshner, director of the National Institute on Drug Abuse, which 
helped fund the study, says primary care physicians are in a prime position 
to help diagnose drug addiction and get abusers proper treatment.

And despite common misconceptions, "addiction is eminently treatable if the 
treatment is well-delivered and tailored" to the patient's own needs, 
Leshner wrote in a 1999 Journal of the American Medical Association essay.
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