Addressing Substance Abuse

This module will help practices screen, intervene, and appropriately refer patients with substance use disorders.

Why is this important?

According to the 2012 National Survey on Drug Use and Health, about 22 million Americans over the age of 11 abused or were dependent on alcohol or illicit drugs, but only 10.8 percent received treatment. [1]  (Substance use disorder (SUD) is routinely underdiagnosed by healthcare providers who lack the training or resources to screen patients effectively and link them to appropriate treatment. [2])

Frequently, patients with SUD have comorbid medical conditions (e.g., cardiovascular disease, cancer, liver disease, pulmonary disease) and psychiatric disorders (e.g., depression, generalized anxiety disorder). [3, 4] In addition, SUD can cause, worsen, and complicate treatment of many medical conditions. For example, risky alcohol use complicates management of hypertension, diabetes, and smoking cessation, and alcohol interacts with prescribed medications such as opioids or benzodiazepines, which increases patients’ risk for overdose or death. For adolescents, alcohol and substance use can affect brain development, resulting in problems with attention, learning, visuospatial abilities, and executive function. [5,6,7] Alcohol and substance use also increase risk-taking behaviors that place adolescents at risk for injury and sexually transmitted infections. 

The high rates of undertreated patients with an SUD result in staggering health, social, and financial costs. [8,9] Primary care providers need accurate information about their patients’ substance use to help patients decrease or stop using the substance(s) and to effectively manage their medical conditions. [1,10,11,12] Because patients with risky substance use behaviors most often present in primary care practices, there is much that you can do to identify and help them. 

How will these tools help?

Office policies and standardized screening tools can help quickly identify patients with an SUD or at-risk use. With this information, you can make an appropriate diagnosis and assess the effect of substance use on your patient’s other medical conditions. [13] Implementation of routine screening, BI/counseling, and referral practices can also reduce stigma, improve patient outcomes, and improve the clinician–patient relationship for individuals with a SUD or at-risk use.

Note: Because this module is intended for a broad clinical audience, it includes information and case studies about screening and referring both adults and adolescents to SUD treatment. 


Target Audience

This module is intended to be used by the following practice staff:

  • Physicians
  • Physician Assistants
  • Nurse Practitioners
  • Registered Nurses
  • Medical Assistants
  • Practice Managers

Learning Objectives

How complete is the picture you get of the factors that influence your patients’ health? Prescription drug abuse, alcohol abuse, and other substance use affect health outcomes. This module provides tools and strategies to help your practice screen patients for substance use and risky alcohol use, counsel them appropriately, and provide referrals to care when necessary, so you can provide patients with the best possible care.

Course summary
Available credit: 
  • 1.00 Attendance
Course opens: 
Course expires: 
Parent activity set: 

This module was funded by the National Institute on Drug Abuse (NIDA).

Available Credit

  • 1.00 Attendance


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