From the Administrator: The Value of Screening and Brief Intervention

We at SAMHSA are often asked about the best ways to treat addiction. This issue of SAMHSA News highlights one of the most promising: preventing addiction before it starts by screening individuals who use drugs and alcohol but have not developed serious dependence-related problems, and then providing education and intervention.

Findings from SAMHSA's 2004 National Survey on Drug Use and Health showed that users of drugs and alcohol often do not perceive themselves as having a problem. Of the 21.1 million people who needed but did not receive treatment in 2004, 94 percent did not think they needed treatment for their alcohol or drug use problem.

Unfortunately, their doctors may not perceive a problem either, or if they do, may not know how best to help. Yet, the health care setting provides one of the most advantageous opportunities for intervention.

People are surprisingly receptive to information and instructions about their health when they are in a health care setting. They came for help, and they view this as part of the treatment.

Primary care settings, community clinics, and hospital emergency rooms provide ready-made screening settings. Depending on the results, an array of options is available: (1) a brief intervention, which is typically a short-duration counseling session delivered within the context of the medical visit to raise awareness and motivate change; (2) brief treatment of approximately two to nine sessions focusing on rapid implementation of strategies for change; and (3) referral to more intensive treatment.

In this way, the paradigm of health care becomes a seamless continuum with help available at every juncture.

Let us be clear: The purpose of screening is not diagnosis. A screening instrument does not enable a clinical diagnosis to be made, but rather indicates whether there is probability that key features of the target problem are present in an individual.

Used intelligently and sensitively, with respect for privacy and confidentiality, screening can provide vital information and can enable people to lead longer, healthier, and ultimately more rewarding lives.

Charles G. Curie, M.A., A.C.S.W.
Administrator, SAMHSA

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