Doctors Cannot Reliably Detect Substance Use Disorder

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Substance Use Disorder rates are fairly well known, and SUD rates amongst people seeking general medical help from a doctor are similar to those of the overall population. Around 7% of people seeking help from a General Practitioner will have substance use disorder that involves opioids or other “hard” drugs. A slightly higher percentage of people will have an alcohol use disorder when seeking treatment. The highest percentage of patients, around 30%, will have a nicotine addiction from smoking regularly. People that work for the best drug and alcohol rehabs in Florida, including people who work at Florida Springs in Panama City, will always tell patients that self-assessment for alcohol or drug addiction is incredibly important. That statement is backed up by this research, as general practitioners are not able to accurately assess these issues for the patient without cooperation. It is always up to the patient to choose to seek treatment at the best drug and alcohol rehabs in Florida. Therefore, people working around addiction are always looking for patients to self-assess for substance use disorder, because only a patient’s willingness to seek help will ultimately lead to recovery. People in Alcoholics Anonymous often talk about “powerlessness”, but that powerlessness can also simply be described as a willingness to ask for help from others, because the vast majority of people in recovery have needed help from other people to get to that place.

The research I used for today was published in the Journal of Internal Medicine. The authors of the study state that,

“The prevalence of substance use disorders is higher among medical inpatients than in the general population, placing inpatient providers in a prime position to detect these patients and intervene.”

Importance of Self-Assessment

I totally agree with that statement, but General Practitioners should be aware of the challenges they face when it comes to patients of other races and genders. The study points out that doctors have most trouble when it comes to assessing patients of other races from their own and other genders from their own. If we assume that most doctors in the United States are still white and male, which is still backed up by research even though more and more women and people of other ethnic backgrounds are becoming doctors every day. Provider detection rates are only high when it comes to smoking, with General Practitioners able to tell when a patient is a smoker over 72% of the time. That number is cut in half, around 32%, when GPs are asked to assess a patient for cannabis use disorder. The numbers drop quickly when doctors try to assess women rather than men, and drop even more when they are asked to assess African-American patients.

This research can only serve to add to the importance of self-assessment for addiction or substance use disorder. Patients are always incredibly unlikely to have success getting sober if they do not self-identify as addicts, alcoholics, or as a person with substance use disorder. At meetings of people with substance use disorder, a key component of recovery for many sober people, it is most common for everyone at a “closed” meeting to self-identify as an alcohol, addict, or both. People are not asked to use those terms, as anyone with a substance problem is welcomed at “closed meetings”, but people who self-identify as not having any substance problem are asked to only attend “open meetings” which are much more uncommon. Many AA clubs have as little as one open meeting a week, while most AA clubs will have dozens of closed meetings on a weekly basis.

Many of the best drug and alcohol rehabs in Florida will seek to get patients comfortable with the idea of self-identifying as people with substance use disorder. This is partly because of the importance of meetings, and partly because 12-step programs have become foundational to many people’s recovery, amongst other important reasons. Although it is interesting to look at the ability of doctors and assessment of substance use disorder, people who work at the best drug and alcohol rehabs will always push for patients to self-assess. Until other modes of recovery show success for patients, self-assessment will remain foundational to the recovery process. It is important to tell people that the exact wording does not matter, as many people have struggled with calling themselves “addicts or “alcoholics” on a permanent basis. Nobody must call themselves anything at any time, and that remains true even at closed meetings of Alcoholics Anonymous. Simply state that you are a person with substance use disorder, or a person who struggles with drinking, and you will be fine. I have never attended a meeting where everyone said things exactly the same way.

Alcoholics Anonymous was founded on a principle of anonymity, so closed meetings were originally just a safeguard of that principle. If journalists or people reporting on AA wanted to attend a meeting, they were pushed to attend open meetings. This was to make it impossible for anyone reporting on a meeting to assume everyone at an open meeting was a person with a drinking problem. Luckily, reporting people for seeking help from AA has never been a newsworthy subject, except in some very unfortunate cases where celebrities have been followed to meetings or treatment. Closed meetings and anonymity are still an amazing thing for people who feel protected by those things, so I do not expect AA to change from the ”open” or “closed” meeting system any time soon, even if downsides exist when the reasons for those types of meetings are not well understood by everyone.

By T.A. Cannon (Contact me at

Serowik, K.L., Yonkers, K.A., Gilstad-Hayden, K. et al. Substance Use Disorder Detection Rates Among Providers of General Medical Inpatients. J GEN INTERN MED 36, 668–675 (2021).