screening

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Opioid analgesics must be prescribed with discernment and their appropriate use should be periodically assessed. Urine drug testing, although not designed specifically for this role, is a widely available and familiar method for monitoring opioid use in chronic pain patients. Urine drug testing can help track patient compliance and expose possible drug misuse and abuse. We sought to evaluate current attitudes and practices regarding the use of urine drug testing among chronic pain patients taking opioids. To the best of our knowledge, this is one of the first such attempts in the literature to examine and document the practice patterns of urine drug testing in this context. A total of 99 attendees at the American Congress of Pain Medicine were surveyed in 2008 about their urine testing practices for patients on opioid therapy. Surprisingly, more urine testing was motivated by a desire to detect undisclosed substances than to evaluate appropriate opioid use. Some respondents never urine-tested their opioid patients, and about two-thirds of respondents had no formal training in urine testing of patients on opioid therapy. The literature does not thoroughly address the role of urine drug testing in this patient population. Most respondents did random rather than scheduled testing; few had any urine testing protocol. The study found motivations for urine testing and testing practices varied widely, and urine testing, despite its clinical utility, is not used consistently.
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The Joint Commission provides downloads and release notes on the latest quality measures here, including measures for tobacco, alcohol, or drug use.
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Joint Commission
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A website that explains the 5 A's for tobacco cessation.
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US Department of Health and Human Services
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Alex's NIDA Modified Assist Screening Results

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Alex's NIDA Modified Assist Screening Results

Alex's NIDA Modified Assist Screening Results- For case Alex in Screening and Assessment

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NIDA created a "clinician's screening tool for drug use in general medical settings"
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The NIAAA's pocket guide on how to screen for heavy drinking
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A brief interventions manual for use by primary care physicians. Details the "FRAMES" method.
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Department of Mental Health and Substance Dependence
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Adolescent Screen for Tobacco Dependence: The Hooked on Nicotine Checklist

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This checklist was first described in the Development and Assessment of Nicotine Dependence in Youth study, and was designed to screen adolescents for symptoms of tobacco dependence (DiFranza et al. 2002a). An adolescent answering yes to any of these questions is said to have some dependence on tobacco.

Name: _______________________ Date: _____________________

1. Have you ever tried to quit but couldn’t?   YES   NO

2. Do you smoke now because it’s really hard to quit?   YES   NO

3. Have you ever felt like you were addicted to tobacco?   YES   NO

4. Do you ever have strong cravings to smoke?   YES   NO

5. Have you ever felt like you really needed a cigarette?   YES   NO

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Conducted during 2003, this survey of almost 70,000 people in the United States addressed current illegal drug use, alcohol, and tobacco habits. The results were broken down based on a number of factors, including age, gender, race, employment, education, etc. (From Their Website)
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SAMHSA
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Routinely screen all patients over the age of 14 for alcohol use problems. Learn how to conduct and implement brief interventions and motivational interviewing. Establish close relationships with other alcohol treatment services and alcohol treatment specialists. Integrate alcohol and drug treatment programs into routine clinical practice where feasible. (From Their Website)
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Council on Scientific Affairs, American Medical Association; 1999
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