Alcohol/other drug problems screening and intervention by rehabilitation physicians

Rates of substance abuse by individuals with traumatically acquired disabilities such as spinal cord injury and traumatic brain injury have been reported to approach 50%, yet these individuals are not seen in treatment at proportions reflective of their population size. A possible factor promoting such low treatment participation could be a failure to identify and refer these individuals to treatment. Rehabilitation physicians are the primary care providers to such individuals after initial inpatient admission and in many cases remain in frequent contact with them on a long-term outpatient basis. This research was undertaken to determine the rates of substance abuse screening and intervention in a sample of 142 rehabilitation physicians. Despite indicating that substance abuse is a significant issue among such patients, the majority of responding physicians failed to routinely screen for substance abuse. Surprisingly, more than 40% of those who diagnosed patients with an active substance use disorder did not refer such patients to treatment. Given the extensive contact rehabilitation physicians have with patients with traumatically acquired disabilities, significant opportunities for intervention appear to be lost. Implications for practice and clinical training are provided