The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63580

Mike Hilton, PhD, Office of Collaborative Research, National Institute of Alcohol Abuse and Alcoholism, 6000 Executive Blvd., Suite 302, Rockville, MD 20852, 301 402-9402, mhilton@niaaa.nih.gov and Constance Weisner, DrPH, MSW, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave., San Francisco, CA 94143-0984.

Improved identification and intervention for AOD problems is an important health policy goal. In 1990, the Institute of Medicine recommended that individuals seen in medical and psychiatric settings be screened for alcohol problems, and in 1996 the U.S. Preventive Task Force recommended that all adults and adolescents be screened for problem drinking. Subsequent research has confirmed the importance of health and mental health providers addressing their patients’ AOD problems. The studies presented here focus on missed opportunities for addressing AOD problems in HMO settings. Each presents data from a large group-model HMO; two focus on adolescents with substance abuse problems and the remainder on adults. Medical comorbidity is a common theme across the papers; two (one in adolescents) describe the prevalence of medical conditions in treated substance abuse patients; two focus on behaviors which place substance abusers at risk of HIV, injury, and other health problems, and one examines treatment of hepatitic C patients’ substance abuse diagnoses. Results suggest that AOD problems are as prevalent as other chronic diseases (e.g., diabetes, hypertension) in primary care settings and that relatively few individuals with these problems are diagnosed or referred to specialty treatment. Moreover, actual and potential comorbid medical problems among these individuals are heightened, and their concerns about provider attitudes towards their health-related practices may prevent them from seeking medical care. Thus, private medical settings represent missed opportunities for screening and intervention, which could prevent worsening of substance abuse problems and related, costly medical conditions.

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Please contact Aggie Hinman axh@dor.kaiser.org or 510-891-3612 for further information

Learning Objectives:

• 1.Identify where and how adolescents are first identified as having substance abuse problems, and describe the process through which they successfully enter treatment.
• 2.Describe how substance use is related to HIV risk behaviors in adolescents.
• 3.Discuss relationships between patterns of alcohol consumption and health care use/avoidance.
• 4.List the medical conditions that are heightened in adolescents and adults with AOD problems.
• 5.Identify and compare at least two different intervention strategies that are likely to reduce harmful alcohol or drug use in a medical setting.

Keywords: Substance Abuse, Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.