From the Administrator: The Value of Screening and Brief Intervention
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| Charles G. Curie
SAMHSA Administrator
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We at SAMHSA are often asked about the best ways to
treat addiction. This issue of SAMHSA News highlights
one of the most promising: preventing addiction before
it starts by screening individuals who use drugs and
alcohol but have not developed serious dependence-related
problems, and then providing education and intervention.
Findings from SAMHSA's 2004 National Survey on Drug
Use and Health showed that users of drugs and alcohol
often do not perceive themselves as having a problem.
Of the 21.1 million people who needed but did not receive
treatment in 2004, 94 percent did not think they needed
treatment for their alcohol or drug use problem.
Unfortunately, their doctors may not perceive a problem
either, or if they do, may not know how best to help.
Yet, the health care setting provides one of the most
advantageous opportunities for intervention.
People are surprisingly receptive to information and
instructions about their health when they are in a health
care setting. They came for help, and they view this
as part of the treatment.
Primary care settings, community clinics, and hospital
emergency
rooms provide ready-made screening settings. Depending
on the results,
an array of options is available:
(1) a brief intervention, which is
typically a short-duration counseling session delivered
within the context of the medical visit to raise awareness
and motivate change; (2) brief treatment of approximately
two to nine sessions focusing on rapid implementation
of strategies for change; and (3) referral to more intensive
treatment.
In this way, the paradigm of health care becomes a seamless
continuum with help available at every juncture.
Let us be clear: The purpose of screening is not diagnosis.
A screening instrument does not enable a clinical diagnosis
to be made, but rather indicates whether there is probability
that key features of the target problem are present in
an individual.
Used intelligently and sensitively, with respect for
privacy and confidentiality, screening can provide vital
information and can enable people to lead longer, healthier,
and ultimately more rewarding lives. 
Charles G. Curie, M.A., A.C.S.W.
Administrator, SAMHSA
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