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LEADER 00000cam a2200457Ma 4500 
003    OCoLC 
005    20180804040352.7 
006    m     o  d         
007    cr |n||||||||| 
008    981118s1997    mdua    obt  f000 0 eng d 
019    NCBIBSocn855713583 
049    MAIN 
060 00 W1|bTR33LG v.24 1997 
060 10 WM 270 
082 00 616.86|221 
100 1  Sullivan, Eleanor J.,|d1938- 
245 12 A guide to substance abuse services for primary care 
       clinicians /|cEleanor Sullivan, Michael Fleming. 
260    Rockville, MD :|bU.S. Dept. of Health and Human Services, 
       Public Health Service, Substance Abuse and Mental Health 
       Services Administration, Center for Substance Abuse 
300    1 online resource (xvii, 168 pages) :|billustrations. 
336    text|btxt|2rdacontent 
337    computer|bc|2rdamedia 
338    online resource|bcr|2rdacarrier 
490 1  Treatment improvement protocol (TIP) series ;|v24 
490 1  DHHS Publication ;|vno. (SMA) 97-3139 
500    PHS contract no. ADM 270-95-0013. 
504    Includes bibliographical references. 
       TIP is to recommend guidelines for primary care clinicians
       to follow in caring for patients with alcohol and other 
       drug use disorders. These guidelines were developed by a 
       Consensus Panel of clinicians, researchers, and educators 
       who work on the prevention and treatment of substance use 
       disorders. Protocols are based partly on research evidence,
       partly on Panel members' clinical experience. The 
       algorithm to the left follows a patient with substance use
       problems who presents in a primary care setting. The chart
       will serve as a guide or road map through screening, brief
       assessment, brief intervention, assessment, referral, 
       specialized treatment, and followup care as they are 
       detailed in the TIP. Since substance use disorders are 
       often chronic conditions that progress slowly over time, 
       primary care clinicians, through their regular, long-term 
       contact with patients, are in an ideal position to screen 
       for alcohol and drug problems and monitor each patient's 
       status. Futhermore, studies have found that primary care 
       clinicians can actually help many patients decrease 
       alcohol consumption and its harmful consequences through 
       office-based interventions that take only 10 to 15 minutes
       (Kahan et al., 1995; Wallace et al., 1988). This potential,
       however, is largely untapped: Saitz and colleagues found 
       that of a sample of patients seeking substance abuse 
       treatment, 45 percent reported that their primary care 
       physician was unaware of their substance abuse (Saitz et 
       al., in press). Yet even though screening and limited 
       treatment of substance use disorders do not require a 
       large time investment, the Consensus Panel that developed 
       this TIP recognized that many primary care clinicians are 
       already overwhelmed by the demands imposed by expanded 
       gatekeeper functions. The Panel realized that a practical 
       approach to addressing patients' substance abuse problems 
       was needed: one that recognized the time and resource 
       limitations inherent in primary care practice and offered 
       a series of graduates approaches that could be 
       incorporated into a normal clinic or office routine. 
       Biological, medical, and genetic factors as well as 
       psychological, social, familial, cultural, and other 
       environmental features all bear on substance abuse. 
       Addressing the condition effectively requires a team 
       effort, especially when it has progressed beyond the early
       stage. For this reason, in addition to screening and 
       intervention treatment options, these guidelines include 
       information about viable referral for assessment and 
       treatment, as well as followup. Readers will notice that 
       the TIP contains more information on alcohol use and abuse
       than on use of illicit drugs. This reflects both the scope
       of the problems and the research literature available 
       about them. It is estimated that about 18 million people 
       with alcohol use problems and 5 million users of illicit 
       drugs need treatment. Although the Panel recognizes that 
       tobacco is an addictive substance with a major public 
       health impact, it is not included in this TIP because the 
       topic falls outside CSAT's purview. Readers are referred 
       to "Smoking Cessation: a Guide for Primary Care Clinicians,
       " published by the Agency for Health Care Policy and 
       Research (Agency for Health Care Policy and Research, 
       1996). The Consensus Panel's recommendations are based on 
       a combination of clinical experience and research-based 
       evidence. In the list below, the summary guidelines 
       supported by the research literature are followed by (1); 
       clinically based recommendations are marked (2). Citations
       supporting the former are referenced in the body of the 
       document. Screening and assessment instruments mentioned 
       below are reproduced and discussed in Chapters 2 and 4 and
       Appendix C. The guidelines are presented in more detail in
       Chapter 6. 
650  0 Substance abuse. 
650  0 Primary care (Medicine) 
655  2 Practice Guideline. 
655  2 Technical Report. 
700 1  Fleming, Michael F.,|d1948- 
710 2  Center for Substance Abuse Treatment (U.S.) 
710 2  National Library of Medicine|eissuing body. 
830  0 Treatment improvement protocol (TIP) series ;|vno. 24. 
830  0 DHHS publication ;|vno. (SMA) 97-3139. 
830  0 NCBI BookShelf 
856 40 |u|zConnect to 
       ebook (University of Melbourne only) 
990    National Center for Biotechnology Information 
990    Batch Ebook load (bud2) - do not edit, delete or attach 
       any records. 
991    |zNEW New collection NLM.bookshelf 2018-08-03 
Location Call No. Status