Chapter IV
Screening and Early Intervention
Nearly one-third (31.7 percent) of the U.S.
population (80.4 million people ages 12 and
older) engages in substance use that threatens
their own health or safety or the health and
safety of others, but does not meet clinical
diagnostic criteria for addiction.^1 Few of these
individuals, however, are routinely screened for
risky use of addictive substances or receive any
services designed to reduce such use such as
brief interventions.^2 Of those who do receive
some form of screening, in most cases it
involves only one type of substance use--
tobacco or alcohol--which fails to identify risky
use of other substances or recognize that 30.6
percent of risky users who are not addicted
engage in risky use of more than one substance.^3
In order to reduce risky use and its far-reaching
health and social consequences, which may
include the development of addiction, health
care practitioners must:^4 Understand the risk factors,* how these risks
vary across the lifespan and how risky use--
whether or not it progresses to addiction--
can have devastating outcomes for
individuals, families and communities; Educate patients, and their families if
relevant, about these risks and the adverse
consequences of risky use; Screen for risky use of addictive substances
and related problems using tools that have
been proven to be effective; and Provide brief intervention when appropriate.Health care practitioners also should conduct
further assessment if the patient presents with
signs or symptoms of addiction and treat the
patient or provide referrals to specialty care if
needed, as discussed in Chapters V and VI.* See Chapter II.