Physician Beliefs About Substance Misuse and Its Treatment: Findings from a U.S. Survey of Primary Care Practitioners

Abstract

Primary care physicians are in a unique position to detect patients with substance use related problems and initiate treatment at an early stage when it may be more successful. To evaluate current knowledge, attitudes, and practices of primary care physicians in the United States regarding the detection of substance use related problems, a national telephone survey of practicing primary care physicians was conducted in 1999. A total of 648 randomly selected family and general practitioners, internists, pediatricians, and OB-GYNs were interviewed regarding their perceived preparation to diagnose selected health conditions, their perceived difficulty discussing selected health conditions with patients, and their perceptions of the effectiveness of available treatments for selected health conditions. Findings suggest that primary care physicians in the United States perceive themselves as being less prepared to diagnose substance “abuse” than other chronic conditions. They additionally find it more difficult to discuss this topic with their patients, and are more skeptical about the effectiveness of available treatments. Because the social, economic, and health consequences of untreated substance misuse negatively affect the quality of life for so many patients and their families, developing new approaches to improving the attitudes and screening behaviors of primary care providers vis-à-vis substance use disorders should continue to be an important priority.

Keywords:

• primary care
• survey data
• physician beliefs
• treatment effectiveness
• physician training

Additional information

Notes on contributors

Timothy P. Johnson

Timothy Johnson is Director of the Survey Research Laboratory, Professor of Public Administration, and Research Professor of Epidemiology and Biostatistics at the University of Illinois at Chicago. Dr. Johnson teaches courses in sample design, research methodology, and multivariate statistical analysis. His main areas of research interest include cross-cultural sources of measurement error in survey research and the social epidemiology of substance “abuse.” He has previously received funding from the National Center for Health Statistics, the National Cancer Institute, and the National Institute on Drug Abuse. He has also served on the Editorial Board of Substance Use & Misuse for the past 7 years.

Alyse L. Booth

Alyse Lynn Booth is currently president of ABA INTERNATIONAL, a strategic marketing communications and public relations firm in New York City, specializing in positioning nonprofits and strategic issues/ideas in the marketplace. Ms. Booth served as vice president and director of communications of The National Center on Addiction and Substance Abuse at Columbia University (CASA) for nearly 8 years. She managed all strategic communications initiatives for this organization headed by former Health, Education and Welfare Secretary Joseph A. Califano, Jr., including public opinion research. Ms. Booth conceived, implemented, and raised financial support for six annual CASA National Surveys of Teens, Their Parents, Teachers and Principals, which became the media's most noted survey in 1996. The surveys were covered by all television networks, the subject of a Time cover, editorial cartoons, and a USA Today “Cover Story,” on the front page of newspapers across the country and the top story on talk radio for a “week”. Survey findings were noted in major speeches by former President Bill Clinton and House Speaker Newt Gingrich and by Senator Hillary Rodham Clinton in her book, It Takes a Village.

Patrick Johnson

Patrick Johnson received his doctorate from the University of Wisconsin-Madison in Educational Policy Studies with a specialization in the social psychology of education. Dr. Johnson is currently a research scholar at the Institute for Social and Economic Research and Policy at Columbia University and Professor in the School of Human Development and Learning at Dowling College. Previously, Dr. Johnson was a Fellow at the National Center on Addiction and Substance Abuse at Columbia University. His research has focused primarily on gender and racial/ethnic differences in the development of drug-related cognitions and their role in the initiation and maintenance of drug use and abuse.