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According to a New York Times article, "although doctors and nurses have the best opportunity to intervene with alcoholics and substance abusers, our research indicates they are woefully inadequate of even diagnosing someone with this disease," This was a quote from Joseph Califano Jr., the chairman and president of Columbia University's National Center on Addiction and Substance Abuse.
Researchers at the Center conducted surveys and found that 9 of 10 primary care doctors fail to diagnose substance abuse in patients who display classic symptoms of the problem. This was attributed to insufficient training in the treatment of addiction, doctors' frustration in dealing with these patients, the common perception among doctors that treatment for substance abuse does not work, and inadequate insurance reimbursement treatment.
This is a complex set of issues that require solutions on multiple fronts - including increased training during medical education and financial as well as legislative solutions. A number of recommendations were made by the Columbia group from increasing formal education to some punitive measures for primary care doctors who fail to diagnose substance abuse or addiction.
One recommendation that was not offered but seems to make sense is the idea of including substance abuse/addiction training as part of the medical licensure process - just as there are required child abuse and pain management courses. These are part of state requirements and vary from state to state.
There are however two terrific organizations that have taken the lead in educating clinicians in the diagnosis and treatment of substance abuse and addiction. These are the American Society for Addiction Medicine (ASAM) and the American Academy of Addiction Psychiatry (AAAP) They offer courses and have great meetings each year.
Next week ASAM is offering a confernece in Washington, DC on "The State of the Art in Addiction Medicine" October 30 - November 1, 2003. Also the annual meeting of AAAP is in December.
Here are the links to AAAP and ASAM and for those who are interested, here is a link to all of the state requirements for licensure.
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