Persons with drug and alcohol problems are more costly consumers of health care services than those without such problems, and there is evidence that screening and brief interventions can lead to reduced consumption of these substances. Nevertheless, few health plans have screening and referral policies in place.
In 1999, the Kaiser Foundation Research Institute began a study examining the use of a computer-administered screening test in primary care clinics to identify substance abuse and behavioral health problems. The National Institute on Drug Abuse (NIDA) originally funded the study to determine whether the computer screen would identify more problems than medical personnel do.
In April 2000, RWJF funded an extension of the study to examine whether and how people screened for substance abuse problems pursued follow-up treatment, whether problems improved after the screening, what barriers impeded implementation of better screening at primary care clinics, and the medical conditions and costs of individuals who are hazardous drinkers and drug users.
Researchers found that:
- While computer-administered screening can detect more substance abuse problems than medical personnel, it may not induce more people to seek treatment for their problems.
- Subjects who sought treatment for alcohol problems reduced the severity of those problems.
- Administrators and providers report that time constraints and other organizational barriers account for the lack of screening.
- Hazardous drinkers and drug users had heightened prevalences for eight medical conditions, including costly conditions such as injury and hypertension, and psychiatric conditions; however, except for psychiatric conditions, medical costs were not higher.
Researchers published the findings in three journals focused on alcohol abuse. They are working with colleagues from South Africa to replicate the protocol in medical clinics serving low-income South Africans.