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Comment & Response
December 2015

Appropriate Screening for Substance Use vs Disorder—Reply

Author Affiliations
  • 1Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California
  • 2National Center for PTSD, Dissemination and Training Division, Veterans Affairs Palo Alto Health Care System, Menlo Park, California
  • 3Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
  • 4Clinical Psychology PhD Program, California School of Professional Psychology Alliant International University, San Francisco
  • 5Department of Medicine, Stanford University School of Medicine, Stanford, California
JAMA Intern Med. 2015;175(12):1998-1999. doi:10.1001/jamainternmed.2015.6550

In Reply We thank McNeely and Saitz for their thoughtful letter. The Screen of Drug Use (SoDU)1 is able to identify negative consequences of drug use and drug use disorders in primary care (PC) patients. The criterion of negative consequences of drug use includes domains of impulse control (eg, driving under the influence, risky sexual behaviors), social responsibility, as well as physical and interpersonal determinants.2 As McNeely and Saitz point out, it is important to specify the purpose of screening, such as to determine whether a PC patient engages in low levels of drug misuse, risky drug use, or whether he or she meets the criteria for a specific diagnosis. Identification of patients with low levels of drug misuse enables PC physicians to manage and prevent potential drug-medication interactions and risk of overdose and to recommend or deliver preventive interventions for individuals who have the potential to progress to more frequent drug use and to experience negative consequences.

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