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A Government Task Force Recommends Screening All Adults for Illicit Drugs.
A U.S. Government-sponsored task force this week released a report recommending that primary care physicians routinely screen their patients for illicit drug use. The recommendation is similar to the task force’s now-followed recommendation that primary care physicians routinely query their patients about drinking and smoking habits.
The U.S. Preventative Services Task Force, a panel of health care experts who provide disease prevention advice to the federal government, based their recommendations in large part because of the recent spike in opioid addiction rates and because drug overdoses have become the primary cause of injury-related deaths in the country. The most recent (2017) nationwide survey of drug abuse determined that 30.5 million Americans—about 11.5% of the adult population—had used illicit drugs within the past month. Latest statistical data from the Centers for Disease Control and Prevention concluded that drug overdoses resulted in more than 70,000 deaths in 2017.
If the recommendation is adopted, it might mean that primary care physicians would regularly query their patients on illicit drug use, both recreational street drugs and potential abuse of prescription medications. While the panel did not recommend screening of adolescents and teenagers, the American Academy of Pediatrics recommended such screening in a 2016 update to their policy on adolescent substance abuse.
The task force’s report—“Screening for Illicit Drug Use, Including Nonmedical Use of Prescription Drugs: an Updated Systematic Review for the U.S. Preventative Services Task Force”—represents a turn-around from the last time the panel debated the idea in 2008, when it concluded that such national screening by doctors might not be effective. The new recommendation only represents a starting point for effective screening, as the report notes that primary care physicians’ resources for treating substance abuse, when uncovered, remain limited. In conclusion, the report states that “more research is needed on approaches to identify and effectively intervene with patients exhibiting risky patterns of drug use in primary care.”
Task force member Dr. Carol Mangione told the Los Angeles times that part of the reason the panel agreed on patient screening is that there are now more treatments for drug abuse and addiction than there were in 2008. “We don’t want to screen for something unless we know there’s an effective treatment,” she told the newspaper. “If you don’t have a treatment that’s effective for people who screen positive, you haven’t really helped.”
Another task force member, Dr. Karina Davidson, noted that the new recommendation will help spur physician interest in coming up with appropriate treatments for their patients with drug abuse problems. If asking patients about illicit drug use becomes routine, doctors will have to do the necessary work to come up treatments, whether anti-addiction drugs, therapy, or at the least knowing who they can refer their patients to for further help. Dr. Davidson also said she believed that bringing illegal drug use into the physicians’ fold might take some of the stigma out of drug abuse and help make patients more likely to accept help for their problem earlier in the addiction process.
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Sources
Healy, Melissa. “With opioid abuse surging, expert panel recommends drug screening for all U.S. adults.” August 1, 2019. The Los Angeles Times. Retrieved from
Patnode, Carrie D. PhD, MPH; Perdue, Leslie A. MPH; Rushkin, Megan MPH; O’Connor, Elizabeth A. PHD. “Screening for Illicit Drug Use, Including Nonmedical Use of Prescription Drugs: an Updated Systematic Review for the U.S. Preventative Services Task Force” August 2019. U.S. Preventative Task Force. Retrieved from
American Academy of Pediatrics. “Substance Use Screening, Brief Intervention, and Referral to Treatment (Revised). July 2016. Retrieved from