I've written more than once about my belief in not creating more problems for than they have already. To that end, one of the easiest way to avoid labeling patients with additional problems is to refrain from screening them for things that they don't need to be screened for. To review some basic principles, we screen patients for conditions that are:
a) asymptomatic
AND
b) conditions for which intervention at an earlier stage of the disease improves morbidity and/or mortality
Therefore, we should not be in the habit of screening for things like drug abuse because drug abuse is a condition that fails to meet our first criterion. Drug abuse is not asymptomatic. Calling up your dealer, paying him for drugs and then using those drugs to get high are all symptoms of drug abuse.
Even though to the common wisdom is that we should screen, in practice I don't think anyone really does. We may ask more in depth questions regarding drug and alcohol use of patients whom we have a reason to suspect of having a drug/alcohol problem or in patients who come in with a different problem which we suspect might be caused or exaccerbated by drug or alcohol use. And this is perfectly appropriate. But, sweet lord, there is no need to screen every patient.
On an unrelated note, I'm reading Watchmen in anticipation of the movie. This is my first graphic novel experience and so far Watchmen has not disappointed. I'll give a final review when I'm done.
2 Comments
Looking forward to the review, Doctor!
Hee the verification word is "blood"
I saw the movie last night. Interesting..