toward identifying patients that could be at high risk of developing SUDs before they actually develop the disorder.
“[If high-risk patients are detected], we can do interventions even before addiction develops and help people minimize their alcohol and drug use,” she said. “The earliest way we can do that is through screenings in primary care settings or other settings where we can identify people who have unhealthy alcohol or drug use before they actually develop the disease of addiction. There are questions we can ask in primary care, just like we check for high blood pressure risk at every visit to try to identify people at risk before they develop hypertension.”
Although it is ideal for physicians to find out about a patient’s predisposition to drug addiction as early as possible, Wakeman said there are always major challenges present in the screening process. “I think there are lots of challenges because people aren’t always honest about their substance use,” she said. “People are often worried that they are going to be judged or punished if they admit to substance use. So, [it is about] building relationships with patients and making this just a part of their general health, so that people understand you’re asking [about substance use] not because you’re trying to judge them and that it won’t have bad consequences to them, but really because you want to take care of them.”
After the assessment is concluded, a diagnosis can be made by physicians who will normally use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Its latest version categorizes SUDs as mild, moderate, or severe – depending on the level of social impairment, risky use and pharmacological indicators.
“It’s important to send the message that people have a right to good health care, and that they know that doctors value their health and wouldn’t treat them differently because of drugs. It’s important for doctors to let people know what their intentions are, and I think the same is true for family members. You worry about someone because you want them to get well and because there’s treatment out there,” Wakeman concluded.