DOCTORS URGED TO WATCH FOR ALCOHOL AND DRUG ABUSE

WASHINGTON -- A leading substance-abuse center yesterday urged the
nation's doctors to focus more closely on alcohol and drug use by
their patients after finding that more than nine out of 10 physicians
didn't diagnose alcohol abuse when presented with its early symptoms.

A survey by the National Center on Addiction and Substance Abuse at
Columbia University, known as CASA, found that physicians felt
unprepared to diagnose substance abuse and lacked confidence in the
effectiveness of treatment.

When presented with an adult showing early signs of alcoholism, 94
percent of primary-care physicians failed to diagnose substance abuse,
the center reported.

And 41 percent of pediatricians didn't diagnose illegal drug abuse
when presented with a classic description of a drug-abusing teen-age
patient.

The center said that when the doctors were asked to suggest five
possible diagnoses for the symptoms, they failed to include substance
abuse.

The findings were reported in a study, "Missed Opportunity: The CASA
National Survey of Primary- Care Physicians and Patients," released
yesterday in Washington.

"Primary-care physicians must stop ignoring this elephant in their
examining rooms. Medical schools, residency programs and continuing
medical education courses have an obligation to provide the training
those physicians need to spot and deal with substance abuse," Joseph
A. Califano Jr., CASA president, said in a statement.

Barry R. McCaffrey, director of the White House office of national
drug control policy, said he supports the center's call for additional
training of physicians in substance abuse and addiction. "Families
have always relied on their doctors for health care advice. Drug abuse
rips families apart. Giving the right advice on drug prevention and
treatment can keep a family together," he said.

The survey found that only about 20 percent of doctors felt very
prepared to diagnose alcoholism and 17 percent felt prepared to
diagnose illegal drug use. In contrast, nearly 83 percent felt very
prepared to identify high blood pressure, 82 percent to diagnose
diabetes and 44 percent to identify depression.

In addition, 86 percent felt treatment for high blood pressure is very
effective.