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With opioid abuse surging, expert panel recommends drug screening for all US adults

Melissa Healy, Los Angeles Times on

Published in News & Features

It's time for doctors to start asking every patient, every time: Have you engaged in any illicit drug use?

That's the new advice from a panel of public health experts who examined whether a primary care physician's time is well spent -- and whether patients' interests are served -- by routine screening for drug abuse.

A draft report issued this week by the U.S. Preventive Services Task Force recommends that all U.S. adults be screened for illicit drug use as long as their doctors can do so accurately and, when abuse is detected, offer their patients effective treatment or refer them to someone who can.

Questions about drug use should not only cover the possibility that a patient is taking illegal street drugs such as cocaine or heroin, the task force said. They should also explore whether a patient might be sneaking pills from a family member's pain medication or getting a boost from stimulants prescribed for a child with attention-deficit/hyperactivity disorder.

An acknowledgment of drug use should prompt a physician to warn patients about the dangers they are courting, offer medication-assisted therapy for addiction if appropriate, and refer patients to counseling and further treatment.

The task force has long advised doctors to query American adults -- and in some cases adolescents -- about their drinking and smoking habits. If the new recommendation is adopted, drug abuse would join the list of risky behaviors to be diagnosed and often treated by primary care doctors.

 

At a time when addiction has become a leading cause of disability in the U.S. and drug poisonings have become the No. 1 cause of injury-related deaths, some say the panel's advice is long overdue.

"We've been doing this for almost a decade in my office," said Dr. Gary LeRoy, a staff physician at the East Dayton Health Clinic in Dayton, Ohio, and president-elect of the American Academy of Family Physicians.

The draft recommendation, released Tuesday, leaves no doubt about the extent of drug abuse in America, he said. A nationwide survey conducted in 2017 by the Substance Abuse and Mental Health Services Administration found that 30.5 million people -- roughly 11.5% of American adults -- said they had used illicit drugs in the past month.

"All of us should be keenly aware that on average, one in 10 of our patients are doing drugs -- whether we ask them or not -- and we're not going to cause someone to use illicit drugs because we ask the question," LeRoy said. "When you create an atmosphere of trust where you have safe conversations, they appreciate that you ask."

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