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Minnesota Health Technology Advisory Committee SAMHSA/CSAT Treatment Improvement Protocols 6 . TIP 6: Screening for Infectious Diseases Among Substance Abusers Title Page Screening for Infectious Diseases Among Substance Abusers Treatment Improvement Protocol (TIP) Series 6
Andrea G. Barthwell, M.D. Consensus Panel Chair Cynthia L. Gibert, M.D. Medical Consultant and Writer U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. Table 2 in the chapter on syphilis, which is cited in the text as copyrighted, is reproduced herein with permission of the copyright holder. The copyright holder's permission is required for reproduction or copying. All other material appearing in this volume except quoted passages from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Center for Substance Abuse Treatment or the authors. Citation of the source is appreciated. This publication was written under contract number ADM270-90-0001 from the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration (SAMHSA). Richard Bast served as the Government project officer. Stuart M. Berman, M.D.; Bernard Branson, M.D., Beth A. Dillon, M.S.W.; Samuel W. Dooley, Jr., M.D.; Dorothy C. Gunter, M.P.H.; Christopher H. Hayden; Robert Johnson, M.D., M.P.H.; T. Stephen Jones, M.D.; Bess Miller, M.D., M.Sc.; Louis B. Polish, M.D.; William O. Schalla, M.S.; George Schmid, M.D.; and Ronald O. Valdiserri, M.D., M.P.H., of the Centers for Disease Control and Prevention, served as technical experts. Text development was provided by Mollie Sayers, Patricia Kassebaum, and Dixie McGough. The opinions expressed herein are those of the Consensus Panel members and do not reflect the official position of SAMHSA or any other part of the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of SAMHSA or DHHS is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized patient care and treatment decisions. The U.S. Government does not endorse or favor any specific commercial product or company.
Trade, proprietary, or company names appearing in this publication are used only because they are considered essential in the context of this Treatment Improvement Protocol.
Care has been taken to make the information in this Treatment Improvement Protocol current. However, the user of this document should realize that regimens for treating infectious diseases do change, especially in the treatment of HIV/AIDS and multidrug-resistant tuberculosis. If there is any question about the appropriateness of nay information contained in this protocol, or question about whether the information is current with the latest advances in treatment, the reader is encouraged to consult a specialist in infectious diseases. What Is a TIP?CSAT Treatment Improvement Protocols (TIPs) are prepared by the Quality Assurance and Evaluation Branch to facilitate the transfer of state-of-the-art protocols and guidelines for the treatment of alcohol and other drug (AOD) abuse from acknowledged clinical, research, and administrative experts to the Nation's AOD abuse treatment resources. The dissemination of a TIP is the last step in a process that begins with the recommendation of an AOD abuse problem area for consideration by a panel of experts. These include clinicians, researchers, and program managers, as well as professionals in such related fields as social services or criminal justice. Once a topic has been selected, CSAT creates a Federal Resource Panel, with members from pertinent Federal agencies and national organizations, to review the state of the art in treatment and program management in the area selected. Recommendations from this Federal Panel are then transmitted to the members of a second group, which consists of non-Federal experts who are intimately familiar with the topic. This group, known as a non-Federal Consensus Panel, meets for about three days, makes recommendations, defines protocols, and arrives at agreement on protocols. Its members represent AOD abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Chair for the Panel is charged with responsibility for ensuring that the resulting protocol reflects true group consensus. The next step is a review of the proposed guidelines and protocol by a third group whose members serve as expert field reviewers. Once their recommendations and responses have been reviewed, the Chair approves the document for publication. The result is a TIP reflecting the actual state of the art of AOD abuse treatment in public and private programs recognized for their provision of high-quality and innovative AOD abuse treatment. This TIP on guidelines to screening for infectious diseases among substance abusers is the sixth published by CSAT since a treatment improvement initiative began. It represents another step by CSAT toward its goal of bringing national leadership to bear in the effort to improve AOD abuse treatment. Consensus Panel Members
The Treatment Improvement Protocol Series (TIPs) fulfills CSAT's mission to improve alcohol and other drug (AOD) abuse and dependency treatment by providing best practices guidance to clinicians, program administrators, and payers. This guidance, in the form of a protocol, results from a careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non-Federal clinical researchers, clinicians, program administrators, and patient advocates employs a consensus process to produce the product. This panel's work is reviewed and critiqued by field reviewers as it evolves. The talent, dedication, and hard work that TIPs panelists and reviewers bring to this highly participatory process have bridged the gap between the promise of research and the needs of practicing clinicians and administrators.
We are grateful to all who have joined with us to contribute to advance our substance abuse treatment field.
The term "drug use" as used in this Treatment Improvement Protocol (TIP) encompasses the following categories of drugs:
Tobacco, considered to be a drug, is excluded from this discussion because it is only marginally relevant to the topic of this TIP. |