A The new ways to identify and treat people who use opioids and other drugs emerge, to an independent panel of experts, is to refer to their adult patients for illicit drug use. Preventive Services Task Force has determined, for the first time, that there is sufficient evidence to state with "moderate certainty".
"We have a very high prevalence of adults using illicit drugs and we're seeing harm every day from that, "said task force member. Carol Mangione, the chief of general internal medicine at the David Geffen School of Medicine at UCLA. "This is a big change that we really excited about. Advertisement
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The task force defines illicit drug use as well as taking illicit drugs and using prescription drugs for nonmedical purposes ̵
In 2008 , the task force, which advises the federal government and makes recommendations for primary care providers, concluded that there is not enough evidence to recommend for or against screening in adults or adolescents.
The availability of new studies, tools, and treatments is due in part to the recognition of the need for ways to address the opioid epidemic, Gary LeRoy, president-elect of the American Academy of Family Physicists (AAFP).
"As we move forward as a society, we are learning more," he said. Since 2008, opioid and substance use disorders have become a national epidemic. It's on everyone's mind right now as health care professionals. "
In 2017, more than 70,000 Americans died from drug overdoses.
Screening tools, which can detect illicit drug use and indicate who might need further assessment, according to the task force's findings. Naltrexone, buprenorphine, and methadone-can help adults with opioid use reduce relapses and stick with treatment. The task force also found that psychosocial interventions like behavioral therapy can help adults avoid or reduce their use of illicit drugs, especially cannabis.
The recommendation does not extend to adolescents aged 12 to 17 years. Mangione said this is not a recommendation against screening in this age group; screening tools and interventions are effective and safe for teenagers. Due to the effects of long-term buprenorphine use on the developing brain, this drug, for example, is approved for only 16 years or older.
The recommendation is not mandatory for clinicians, nor does it endorse one particular screening tool or intervention. Mangione said.
Some medical organizations, such as the American College of Physicians, and the AAFP have their own health care providers, hospital systems, and medical organizations own recommendations about clinical care. While neither would comment directly on the draft recommendations, LeRoy said many physicians are already on the lookout for signs of drug use, but may not always be using a particular tool.
LeRoy said continuity of care and understanding often help family physicians and other providers clue into changes that could indicate illicit drug use.
"For some of these folks, we've literally watched them grow up, "he said. "So we watched how they behaved and how they did in school as an adolescent. And then it's just like, OK, something's wrong. Let's have a discussion here. "
" Primary care providers are very, very busy individuals, "he says said. "It would be nice in a perfect world to sit down and do all the screens for everything under the sun on our patients. But you find what you are doing in your practice. "
Dr. Holly Biola, chief of family medicine at the Lincoln Community Health Center, Durham, NC, said there were some tools that make it difficult to understand the different languages in a single day.  "That is not to say we should not be screening all adults for illicit substances. I think we should, "Biola said.
The draft statement does not purport that screening is recommended "In some clinics and health centers, they say there is no help in diagnosing and treating patients."
LeRoy agreed, noting that access to resources, financial challenges, and transportation to health care services can all present hurdles. So hey said it's important to have care on site if possible because when people leave, "sometimes you do not see them back. They just disappear. "
Despite potential challenges in implementation, Mangione said.