A majority of general internists are not prepared to screen, diagnose, provide a brief intervention, refer to treatment, or discuss treatment options with patients with substance use disorder (SUD), a recent study found. Very few internists prescribe medications to treat SUD on a frequent basis and some view substance use as a crime and a choice, according to researchers who evaluated a cross-sectional survey of 290 inpatient and outpatient general internists in an academic medical center. They found:

• Of the 149 general internists who responded (51%), 46% frequently cared for patients with SUD.

• 16% frequently referred patients to treatment and 6% frequently prescribed a medication to treat SUD.

• 20% felt very prepared to screen for SUD, 9% to provide a brief intervention, 7% to discuss behavioral treatments, and 9% to discuss medical treatments.

• 31% felt that SUD is different from other chronic diseases because they believe using substances is a choice.

• 14% felt treatment with opioid agonists was replacing one addiction with another.

• 12% of hospitalists and 6% of PCPs believe that someone who uses drugs is committing a crime and deserves punishment.

Citation: Wakeman SE, Pham-Kanter G, Donelan K. Attitudes, practices, and preparedness to care for patients with substance use disorder; Results from a survey of general internists. [Published online ahead of print May 10, 2016]. Subst Abus. doi:10.1080/08897077.2016.1187240.