SUBSTANCE ABUSE: Many Doctors Fail to Diagnose Problems

      Ninety-four percent of physicians failed to include substance abuse as a possible diagnosis when presented with a case of symptoms typical of early-stage alcohol abuse, the AP/Baltimore Sun reports. Researchers at the National Center on Addiction and Substance Abuse at Columbia University presented national physicians with the following scenario: "A 38-year-old married patient has recurrent abdominal pain, intermittently elevated blood pressure, gastritis and irritability and wakes up frequently at night." Dr. Richard Corlin, a gastroenterologist in California, said that while the symptoms "are vague and common [and] can be related to a whole variety of conditions," they "clearly indicate alcohol abuse and doctors need to be made more aware of this possibility."

Teen Drug Use
      The survey also found that 41% of pediatricians did not diagnose illegal drug use in a "classic description of a drug-abusing teen." Twenty percent of respondents said they "felt very prepared to diagnose alcoholism," while 17% said they would feel prepared to diagnose illegal drug use. But the center said that 58% of doctors do not discuss substance abuse with their patients because they think patients "would lie about it." Another 35% said time constraints prevented them from discussing substance abuse with their patients and 11% "were concerned they wouldn't be reimbursed for screening and treating" substance-abusing patients. Center head Joseph Califano said doctors' failure to diagnose substance abuse is a "lost opportunity," calling upon doctors, medical schools and state licensing boards to focus more closely focus on substance abuse. Dr. Macaran Baird, a family physician in Minnesota, added that patients should come forward about their substance abuse problems. Baird said: "It's a tremendously courageous act by a patient ... to lay out that before their physician. We need for them to help the physician" (5/11).