'DOCTORS IN US IGNORE DRUG ADDICT PATIENTS'

CHICAGO A national survey of primary care doctors suggests that many are
doing little to help drug-addicted patients kick the habit. About one-third
of the 1,080 doctors surveyed said they do not routinely ask new patients if
they use illicit drugs, and 15 percent said they do not routinely offer any
intervention to drug-abusing patients.

Of the doctors who do offer intervention, 61 percent said they recommend
12-step programs, which research has suggested may be less successful than
formal addiction therapy, said Dr Peter Friedmann, lead author and an
assistant professor of medicine and community health at Brown University.

Only 55 percent said they routinely recommend formal addiction therapy, such
as methadone treatment or residential treatment centres.

Results of the survey, mailed to doctors nationwide last year, appear in
Monday's issue of Archives of Internal Medicine.

The findings suggest that many doctors don't consider drug abuse a medical
problem akin to chronic diseases like diabetes or high blood pressure,
Friedmann said.

National data from 1999 estimated that 14.8 million Americans were current
users of illegal drugs.

Many abusers seek treatment for common disorders that may be linked to
drugs, said Dr H Westley Clark, director of the Centre for Substance Abuse
Treatment at the US Department of Health and Human Services. But if doctors
don't inquire about the drug usage, they are not treating the problem, he
said.

Reasons suggested for failing to do so include pessimism about being able to
do anything to help and skepticism about the success of drug treatment
programs, Friedmann said. Some also think talking about drug abuse with
patients is taboo, or feel it is outside their role findings that indicate
better drug-abuse training is needed in medical schools, he said.

Friedmann said the problem "is pervasive enough in medical settings that all
doctors should be trained and ready to identify patients with these problems
and intervene."

"Primary care is supposed to embrace preventive medicine," said Dr Terry
Horton, medical director for Phoenix House, a national drug treatment
programme. "If you don't identify the people, there's not a chance you can
get them toward help."

Family physicians, internists, obstetricians and gynecologists, and
psychiatrists were questioned. Psychiatrists and OB/GYNs were the most
likely to ask patients about drug abuse, but OB/GYNs were least likely to
intervene.

Alan I Leshner, director of the National Institute on Drug Abuse, which
helped fund the study, says primary care physicians are in a prime position
to help diagnose drug addiction and get abusers proper treatment.

And despite common misconceptions, "addiction is eminently treatable if the
treatment is well-delivered and tailored" to the patient's own needs,
Leshner wrote in a 1999 Journal of the American Medical Association essay.