Referral practices of Portland-area family practice providers for alcohol and illicit drug abuse: A survey

Background: Drug and alcohol abuse is a persistent and serious problem in Oregon. Screening and referral for these problems by primary care providers has been shown to be generally inadequate nationwide, with inconsistency among various types of practitioners1. Purpose: This primary mission of this project is to provide the Oregon Office of Alcohol and Drug Abuse Programs (OADAP) with data regarding the screening and referral practices of Oregon primary care providers (PCPs) for substance abuse treatment. Methods: A survey instrument was developed by OADAP and mailed to 228 randomly-selected family practice doctors and physician assistants in the Portland area. The survey consisted of three sections: general demographics, practice patterns, and open-ended questions. Results: twenty-six (11.4%) of the surveys were completed and returned. Despite the small number of responses, a statistically significant correlation was found between self-reported screening rates for illicit drug use and the difficulty providers experienced discussing illicit drug use. A correlation approaching statistical significance was also found between self-reported referral rates for alcohol problems and perceived ease of referring for such problems. Although the open-ended responses could not be analyzed quantitatively, they nonetheless contained interesting observations and recommendations. Conclusions: The low response rate limited the usefulness of this study, and it is difficult to assess the actual or perceived rates of screening and referral based on our study. However, some of our findings were strongly suggestive of relationships between screening or referral practices and certain barriers or contributors to doing so, e.g., the aforementioned correlations. It may be hypothesized that measures could be designed and implemented, e.g., educational efforts to increase provider comfort in discussing substance abuse issues with patients, or streamlining the referral process, that would have favorable effects on how Oregon patients are cared for with regard to these issues