SCREENING FOR SUBSTANCE USE DISORDERS INDICATIONS, RATIONALE, AND METHODS

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SCREENING FOR SUBSTANCE USE DISORDERSINDICATIONS,
RATIONALE, AND METHODS

• 1. INDICATIONS AT EVERY OPPORTUNITY!
• .
• 2. RATIONALE THE EARLIER THE DIAGNOSIS OF
  SUBSATANCE USE DISORDERS-THE
• BETTER THE OUTCOME.
• 3. METHODS
• NIAAA SCREENING AND BRIEF INTERVENTION
  GUIDELINES.
• ADULTS
• ASK ABOUT DRUG AND ALCOHOL USE.
• CAGE QUESTIONAIRE-SIMPLE AND
  RELIABLE.
• AUDIT-SLIGHTLY LONGER, ALSO RELIABLE.
  
• MAST-LONGER, LESS ACCURATE BUT GOOD
  FOR IDENTIFICATION OF LIFETIME ALCOHOL-
• RELATED PROBLEMS.
• ADOLESCENTS AND SPECIAL POPULATIONS
• ASK ABOUT DRUG AND ALCOHOL USE.
• YOUNG MALE-SPECIFIC YOUNG
  FEMALE-SPECIFIC SCREENING TOOLS AND

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ASSESSMENT

• COMPLETE BIOPSYCHOSOCIAL HISTORY AND PHYSICAL
  EXAM.
• LABORATORY TESTING
• ADDICTION SEVERITY INDEX (ASI)
• CLINICAL INSTITUTE WITHDRAWAL ASSESSMENT OF
  ALCOHOL-REVISED (CIWA-AR)

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TREATMENT

• OFFICE BASED
• BRIEF INTERVENTIONS IN PROBLEM AND AT RISK
  PATIENTS.
• MOTIVATED PATIENTS WITH ADDICTION.
• ADDICTION THERAPY REFERRAL
• 12 STEP REFERRAL
• OUT-PATIENT DETOXIFICATION WHEN APPROPRIATE.
• MEDICATIONS
• AGONIST DRUGS
• ANTAGONIST DRUGS
• AVERSION DRUGS
• PSYCHOTROPIC DRUGS FOR DUAL-DIAGNOSIS
• ADDRESS PSYCHOSOCIAL ISSUES.
• ADDRESS COMORBID MEDICAL DISORDERS
• URINE DRUG SCREENING

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Treatment (continued)

• ASAM PATIENT PLACEMENT CRITERIA-SECOND EDITION
  REVISED
• HOSPITAL DETOXIFIACTION
• FOLLOW CIWA-2R CRITERIA
• INTENSIVE OUT-PATIENT
• INDIVIDUAL THERAPY COGNITIVE BEHABIORAL THERAPY
  (CBT), MOTIVATIONAL ENHANCEMENT THERAPY (MET),
  TWELVE STEP FACILITATION (TSF)
• MULTIDIMENSIONAL FAMILY THERAPY
• BEHAVIORAL COUPLES THERAPY
• GROUP THERAPY
• RESIDENTIAL TREATMENT