Efforts by government agencies to promote
physician education and training in
addiction science and addiction treatment
and upgrade health care professionals’ skills
through the development and dissemination
of screening tools and evidence-based
clinical guidelines.^275 Notable examples
include:^
The National Institute on Drug Abuse’s
NIDAMED, a physician outreach
initiative aimed at encouraging doctors
to screen patients for risky substance
use, including tobacco, alcohol and
other drugs. NIDAMED offers free
screening tools and prevention and
treatment research and information that
physicians can share with their patients.
It also offers curriculum resources to
provide scientifically accurate
information to medical students,
residents and faculty^ about substance
use, addiction and its consequences.^276 The Substance Abuse and Mental Health
Services Administration’s SBIRT*
Medical Residency Program, which
seeks to develop and implement training
programs for medical residents in
evidence-based screening, brief
intervention, brief treatment and referral
to specialty treatment for risky
substance use and addiction involving
alcohol and other drugs, and to promote
more broadly the adoption of these
practices in the medical field.^277 The Health Resources and Services
Administration’s Project
MAINSTREAM, which provides
resources for educating a broad range of
health care professionals† in screening,
brief intervention, referral to treatment,- Screening, Brief Intervention, Referral and
Treatment.
† Including audiologists, dentists, dieticians, nurse
midwives, nurse practitioners, nurses, occupational
therapists, pharmacists, physical therapists, physician
assistants, physicians, psychologists, public health
professionals, social workers and speech pathologists.
identifying and assisting children of
parents with addiction and helping
communities implement effective
prevention programs related to addiction
involving all substances.^278 Smaller-scale efforts to provide brief
training to health professionals‡ in addiction
science in order to improve the attitudes,
proficiency and practices of all health
professionals^279 --not just those who choose
to specialize in addiction medicine or
addiction psychiatry. Such brief trainings
have proven effective in improving health
professionals’ knowledge, attitudes,
confidence, motivation and practices with
regard to providing smoking cessation
services;^280 conducting screening and brief
interventions for risky alcohol use in
emergency departments^281 and for risky
alcohol and other drug use in primary care
facilities;^282 and for prescribing
pharmaceutical medications such as
methadone and buprenorphine for patients
with addiction involving opioids.^283 The emergence of Patient-Centered Medical
Homes^284 --in which a team of health
professionals provides comprehensive and
continuous medical care--is proving to be a
strong model for addiction treatment to be
integrated into the primary medical care
system.^285 Recent research within the
Medicaid and Veterans Health
Administration systems demonstrates the
success of this approach^286 and the potential
to incorporate addiction care into this
integrated system. Efforts by quality assurance organizations to
encourage services that address risky
substance use and addiction within
mainstream health care. For example, in
2012, the Joint Commission announced new,
voluntary measures for hospitals that choose
to provide screening, brief intervention and
referral to treatment for tobacco, alcohol and‡ Including but not limited to physicians, physician
assistants, nurses, nurse practitioners, dental
professionals, pharmacists, social workers.