Q: What are the consequences of not intervening in drug use?
Ms. Waters: Among a number of others, the consequences include increased cost, morbidity and mortality, disrupted family and social systems, comorbid medical disorders, exacerbation of current medical problems, and potentially dangerous drug interactions (see “Patients’ fatal mistakes soar 3,000%“).

Q: What cautionary advice do you have for PCPs with regard to the diagnosis and treatment of illicit drug use?
Ms. Becker: Providers need to make an effort to overcome personal stereotypes and avoid overlooking the nonmedical use of prescription drugs. The white, middle-class patient is often not interviewed but could be abusing prescription drugs, while the urban minority patient is often assumed to be a crack or heroin addict. These stereotypes influence the care the patient receives. Also, PCPs need to be sure they are able to recognize drug-seeking behavior.
Ms. Waters: Many health-care providers mistakenly believe treatment is not effective. Evidence proves otherwise.


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Ms. Lippert is a medical writer and editor in the New York City area.

References
1. Substance Abuse & Mental Health Services Administration. National Survey on Drug Use & Health. Available at www.oas.samhsa.gov/nhsda.htm.
2. Miller NS, Sheppard LM, Colenda CC, Magen J. Why physicians are unprepared to treat patients who have alcohol-and-drug-related disorders. Acad Med. 2001;76:410-418.
3. Substance Abuse & Mental Health Services Administration. Screening, Brief Intervention, and Referral to Treatment. Available at sbirt.samhsa.gov.

All electronic documents accessed October 6, 2008.