Addiction Medicine: Closing the Gap between Science and Practice

brief intervention disappeared at three and six-
month post-partum follow-ups,^144 indicating a
need for more intensive treatment services.

Screening and brief interventions in prenatal
care settings have been found to reduce alcohol
use significantly,^145 as well as the chances of
low birth-weight deliveries.^146 Brief
interventions for alcohol use among pregnant
women are effective even when provided in a
community setting by non-medical
professionals.^147 Programs that include spouses
and partners are particularly effective.^148

Mental Health Care ......................................................................................................

Despite the high rate of co-occurring addiction
and mental health disorders,^149 screening and
brief interventions for risky substance use are
not common practice in mental health settings
and are not standard practice in the field of
psychiatry.^150

There are effective tools for screening patients
with mental health conditions in mental health
settings for risky use of addictive substances^151
and there is evidence that interventions can be
effective in addressing such use among those
with psychiatric conditions.^152 For example, a
study evaluating the effectiveness of a screening
and brief intervention program in a primary
health and mental health care setting at a
university found that six weeks after receiving
the intervention, participants decreased their
alcohol use.* 153

Dental Care ..................................................................................................................

Dental professionals can play a unique role in
detecting substance use among their patients,
providing brief interventions and referring
patients to treatment.^154 Risky use and addiction
have a significant impact on multiple
components of dentistry including patients’ oral

• Including the average number of drinks consumed

per week over the past 30 days, the highest number of
drinks consumed on one occasion in the past 30 days
and the number of times in the preceding two weeks
participants had consumed five or more drinks on one
occasion.

health^155 and the safety of common treatments

and interventions including the prescription of

controlled medications such as opioid pain

relievers.^156 The fact that dental health

maintenance and treatment require routine and

often repeated visits makes dental professionals

a consistent and potentially influential presence

in the lives of people who engage in risky use of

addictive substances.^157 Dental patients are

receptive to their dentists’ involvement in the

prevention and treatment of risky use and

addiction. A 2005 survey of patients visiting an

emergency dental clinic found that 80 percent

believed dentists should ask their patients how

much alcohol they drink; 90 percent believed

that dentists should warn patients to drink less

or quit if it is affecting their oral health.^158

Pharmacies ...................................................................................................................

The responsibilities of pharmacists with regard

to the prevention and early intervention of risky

use and addiction extend to administering

prescription medications; pharmacists are the

best source of information regarding the safe and

effective use of medications and the adverse

effects that arise from their misuse. They also

can be instrumental in controlling the diversion

of prescription medications for misuse by

monitoring the number of prescriptions filled by

a patient, looking for false or altered prescription

forms^159 and recognizing when a patient is

“doctor shopping”† or in need of treatment.^160

High School, College and University Settings ............................................................

Screening and brief intervention programs

reduce risky use of addictive substances among

students by changing their attitudes, beliefs and

expectations regarding tobacco, alcohol and

other drug use.^161

School health programs, in collaboration with

primary care providers, are important

opportunities for screening adolescents and

young adults for substance use, primarily

† The practice of patients visiting various health care

providers to obtain multiple prescriptions for the

drugs they misuse.