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Screening for addictive disorders within a workers' compensation clinic: an exploratory study.

Iman Parhami¹, Mark Hyman, Aaron Siani

¹Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California 90095, USA. iparhami@mednet.ucla.edu

Substance Use & Misuse

|November 10, 2011

Summary

Workers' compensation patients show high rates of substance use disorders, with 46% needing intervention. Brief screening for alcohol, smoking, and substance use (WHO-ASSIST) and opioid misuse (COMM) is feasible and accepted.

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Area of Science:

Occupational Medicine
Addiction Psychiatry
Public Health

Background:

Workers' compensation (WC) clinics manage injuries and associated health issues.
Substance use disorders (SUDs) can complicate injury recovery and treatment.
Screening for SUDs in WC settings is not widely established.

Purpose of the Study:

To determine the prevalence of addictive disorders among patients in a WC clinic.
To assess the feasibility of implementing substance abuse screening in this setting.

Main Methods:

A cross-sectional study was conducted in 2009.
100 WC patients completed the Alcohol, Smoking, Substance Involvement Screening Test (WHO-ASSIST) and the Current Opioid Misuse Measure (COMM).

Main Results:

46% of patients required intervention for at least one substance-related disorder (25% tobacco, 23% sedatives, 8% opioids).
46% screened positive for prescription opioid misuse using the COMM.
Screening was brief, economical, and well-accepted by patients.

Conclusions:

A significant proportion of WC patients have substance-related disorders requiring intervention.
Integrating SUD screening into WC clinics is feasible and well-tolerated.
Further research on the cost-effectiveness of SUD detection and intervention in WC settings is warranted.