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Substance and Alcohol Abuse and Addiction
To better care for patients with such disorders and to effectively collaborate with substance abuse and addiction treatment professionals in the prevention, early recognition, and treatment of substance abuse and addiction, physicians should:
- recognize the gravity, extent, and broad-based nature of substance abuse and addiction in our society;
- include substance abuse prevention in patient education;
- diagnose substance abuse and addiction in the earliest stage possible, and treat or refer for treatment;
- be aware of the criteria for outpatient, intensive outpatient, partial hospitalization, and in-patient treatment in order to recommend the appropriate level of treatment for each patient;
- recognize the effects of addiction on family members, especially children, offer support and treatment for family members, and include them in treatment for the addicted member whenever possible; and
- partner with community resources in prevention, education and treatment of substance abuse and addiction.
The Academy recommends that hospitals not discriminate against the admission and treatment of patients with alcohol-related illness or injury. The Academy encourages its members to document alcohol abuse in the medical record. It should also be recorded on the death certificates when implicated as a contributing cause of illness, injury or death.
Alcohol Abuse in Adolescents
Drinking and Driving
The AAFP urges strong support of the following four recommendations:
- Reduction of the legal blood alcohol concentration (BAC) for drivers to 0.04 gm/dl.,
- State legislation to fund comprehensive alcohol-impaired driving prevention and treatment programs,
- State legislation to immediately confiscate drivers' licenses for those found to be above the legal BAC (this is known as administrative license revocation),
- Increased enforcement of drinking and driving laws and expansion of the use of sobriety checkpoints.
Standardized Drinking Age
The AAFP publicly favors age 21 as the minimum legal age to purchase or consume alcohol.
- Strong support for increased taxes on alcoholic beverages and tax on beer, wine, and distilled spirits equally based on alcohol content.
- Support for designating a portion of the increased revenues to match the level of alcoholic beverage advertising with an equal number of pro-health and pro-safety messages.
Pregnant Women, Substance Use and Abuse by
The AAFP opposes imprisonment or other criminal sanctions of pregnant woman solely for substance abuse during pregnancy, but encourages facilitated access to an established drug and alcohol rehabilitation program for such women.
Syringe Exchange Programs
The ability to establish effective SEPs may require the modification or repeal of existing drug paraphernalia/syringe possession and syringe prescription laws. SEPs should not be subject to regulations that diminish their overall effectiveness.
Local discretion should be permitted in the decision to establish SEPs and should take into consideration prevalence of injection drug use and disease, overall safety to the community, neighborhood, children, and SEP participants along with the overall risks and benefits of allocating funds to SEPs.
Components of SEPs may include but are not be limited to:
- Drug abuse and addiction referral,
- HIV testing and counseling,
- Hepatitis B testing and immunization,
- Referral for social services, health care and reproductive health services,
- Referral for mental health services,
- Proper training of involved staff of SEPs,
- Health education, including alcohol and other substance abuse,
- Education regarding prevention of sexual and injectable disease transmission,
- Education regarding methods of further reduction of harm associated with drug use,
- Processes to assure the safe disposal of exchanged syringes and needles
- Funding adequate for continuity and consistency of syringe exchange services.