Reaching Common Ground With Patients Having Drug/Alcohol Problems: Defining Problems and Planning Treatment

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Most clinicians encounter substance-abusing patients. Up to 20% of visits to primary care providers are related to drug and alcohol problems (Bradley, 1994). With these patients being twice as likely to consult them compared to patients without such problems, primary care physicians are in a unique position to identify and help patients with drug and alcohol problems (Rush, 1989). Although clinicians are at times reluctant to directly address this problem, brief interventions are feasible during primary care office visits (Bien et al., 1993). A recent review of brief patient interventions for alcohol and drug problems concluded that primary care physicians can help change the course of harmful drinking, reducing alcohol intake with both alcohol-abusing and alcohol-dependent patients (Fleming et al., 1997). Moreover, many primary care physicians maintain sustained patient relationships and thus have the opportunity over time to address concerns arising out of substance abuse.