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Taking a Substance Abuse History (Large then Small Groups) - |
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November 11, 2009 3:00 PM - 5:00 PM |
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James Thayer M.D. |
| Assignment Due Today: |
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| Student Readings: |
| Mosby |
17-18 |
An Approach to Sensitive Issues—Alcohol (note CAGE Questions on p. 18) |
| Syllabus |
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Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse |
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Helping Patients Who Drink Too Much (Steps 1-4) |
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Lecture PowerPoint |
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| Faculty Only: |
| Syllabus |
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Faculty Guide for Substance Abuse Scenarios |
| Syllabus |
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Substance Abuse Scenarios for student use in class(to be distributed) |
| Syllabus |
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Copy of Mosby Reading |
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| Internet Sites: |
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| Session Goal: |
To stress the importance of taking a substance abuse history with every patient.
To develop effective questions to obtain an accurate substance abuse history.
To provide an opportunity to practice taking a substance-abuse history.
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| Student Objectives: |
Define hazardous and harmful, drinking.
Define and distinguish between alcohol abuse and dependence.
Describe the maximum safe drinking limits by age and sex.
Describe signs and symptoms that should trigger an early suspicion of substance abuse.
Describe and demonstrate the CAGE questions and the AUDIT tool.
Describe the standard drink equivalents for the various forms of alcoholic drinks.
Demonstrate asking effective questions to obtain an accurate substance abuse history:
Which substances?
How much?
How often?
What route?
What consequences?
Demonstrate screening strategies for alcohol and substance abuse.
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| Small Group Activities: |
- Using the scenarios provided, students may take turns role-playing doctor-patient interactions in front of the group, in each case taking time to discuss the doctor's approach—what was done well, and what might be more effective. Rotate patient and doctor roles so as many students as possible get a chance to be the "doctor."
- What did students learn from their roles as interviewers and as "patients"? (e.g., Did they feel that asking about substance abuse was awkward or would threaten the doctor-patient relationship? Did they feel it was appropriate for physicians to be asking patients specific questions about substance abuse?)
- What have students learned about when to ask screening questions about substance abuse, when it is appropriate to take a more detailed substance abuse history, and what the next step might be in assisting a patient with a substance abuse problem?
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