Are you feeling a little overwhelmed by opening the “can of worms” when it comes to substance abuse?
Many of us feel uncomfortable discussing these issues with patients for a variety of reasons. One common area of concern is our ability to make the “right” diagnosis and choose the “right” treatment for the patient. Another concern is that addressing such issues will take far more time than you have in your clinic.
We are not trained or expected to be experts in the diagnosis of substance use disorders. But using a non-judgmental and concerned approach and after a few screening and follow-up questions, you will often be able to tell whether the patient has a problem with their substance use or not. Offering expert help from other treatment team members in the form of a mental health or, even better, a specially-trained substance use professional is the next step in the process. And they will take it from there.
Patients may jump at the chance to get more help or they may take some time to even consider that step. In fact, most patients who enter and complete a substance use program do so from self-referral. Retrospectively, they are surprised that their physicians didn’t discuss the problem with them. But because of the high prevalence of substance use disorders in the general medical population, we still have a very important role to play in helping patients get to the next step in care.
What services a patient needs and will accept depends on a variety of factors such as severity of dependence, willingness or ability to engage in intensive treatment, insurance, and many others.