Counseling Points - September 2007 - (Page 7)

Table 1. Comparison of Screening Tools Used to Assess Drug Dependence (Continued) Name MIDAS: Mentally Ill Drug & Alcohol Screening Download at: www.ohiosamiccoe.cwru.edu/library/media/clinicaltool_midas.pdf Each question refers to the past 6 months: 1. Do you feel that you have a problem with your use of drugs and/or alcohol? 2. Do you use drugs and alcohol even though your doctor or other treaters recommended that you do not? 3. Is your family concerned about your drug and alcohol use? 4. Are your treaters concerned about your drug and alcohol use? 5. Have you had legal problems or engaged in illegal activity (other than using drugs) due to drug and alcohol use? 6. Have you had medical problems related to, or worsened by, drug and alcohol use? 7. Do you use drugs and alcohol to relieve mental health symptoms? 8. Do you find that using drugs and alcohol worsens your mental health symptoms? 9. Do you have problems taking your psychiatric medication as prescribed because of drug or alcohol use? 10. Have you gotten in trouble, including getting in trouble at a mental health treatment program, because of drug or alcohol use? 11. Have you had ER visits or psychiatric hospitalizations that were connected to drug or alcohol use? 12. Do you ever feel guilty about your drug and alcohol use? 13. Have you experienced withdrawal symptoms or intense cravings to use drugs or alcohol? 14. Have you attended self-help (e.g., 12 step) meetings related to drug and alcohol addiction? 15. Have you received any addiction treatment, including detoxification? 16. Have you felt unable to control your use of any drug or alcohol? 17. Do you consider yourself to be an active alcoholic or drug addict? Developed by Kenneth Minkoff, MD. Administered to patient during office visit, eliciting yes or no answers. Scoring: Any yes answer on questions 1-12 indicates probable abuse; any yes answer on questions 13-17 indicates probable dependence. Sources: Ewing JA. Detecting alcoholism, the CAGE questionnaire. JAMA. 1984;252(14):905-1907; Gavin DR, Ross HE, Skinner HA. Diagnostic validity of the Drug Abuse Screening Test in the assessment of DSM-III drug disorders. Br J Addict. 1989;84(3):301-307; Minkoff K. Mentally ill drug and alcohol screening (MIDAS), accessed August 17, 2008 at www.ohiosamiccoe.cwru.edu/library/media/clinicaltool_midas.pdf. Description Administration screening questionnaires are used for this purpose, ranging from simple (four questions) to longer, more complex questionnaires (Table 1). Laborator y tests and onsite ur ine toxicology (UTOX) screens also help to identify physiologic dependency, although these measures are less effective for determining at-risk substance use and have the potential to breach the nurse-patient therapeutic relationship. Many patients feel an interview questionnaire shows that the health care provider is taking an interest in their health, whereas they view the laboratory tests as intrusive. When determining whether a patient uses, abuses, or is dependent on drugs, Doweiko states that it is important to remember that substance use occurs along a continuum: • Level 0: Total abstinence—no substance use/no risk for substance use problems. • Level 1: Rare/social use of legal substances and/or experimental use of other substances without a loss of control over use or any of the consequences to recreational use. • Level 2: Heavy social/early problem use above the norm for society, with the introduction of some consequences as a result of their pattern of use. Many individuals at this level begin to recognize that their use is problematic and are able to change their behavior to prevent the development of dependence. SEPTEMBER 2007 7 http://www.ohiosamiccoe.cwru.edu/library/media/clinicaltool_midas.pdf http://www.ohiosamiccoe.cwru.edu/library/media/clinicaltool_midas.pdf

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Welcome Office-Based Medication-Assisted Treatment of Opioid Dependence Summary Continuing Education Posttest Postest Answer and Program Evaluation Form

Counseling Points - September 2007

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