November 11, 1996

Beyond CAGEA Brief Clinical Approach After Detection of Substance Abuse

Author Affiliations

From the Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Mass (Dr Samet); Department of General Practice, University of Wales College of Medicine, Cardiff (Dr Rollnick); and Department of Medicine, The Cambridge Hospital, Cambridge, Mass (Dr Barnes).

Arch Intern Med. 1996;156(20):2287-2293. doi:10.1001/archinte.1996.00440190027002

Generalist physicians should incorporate alcohol and drug abuse detection and brief intervention in the care of their patients. A suggestion of alcohol or drug abuse or a positive response to the CAGE questions deserves further assessment such as clarification about adverse consequences, inquiry about loss of control, determination of the patient's perception of the substance use, and an assessment of the patient's readiness to change behavior. Brief intervention with the patient in the clinical setting about alcohol or drug use can be effective. Motivational interviewing, a directive, patient-centered counseling style for enhancing motivation for change, can make brief interventions more effective by incorporating the patient's readiness to address alcohol or drug use. A useful clinical approach is presented that is tailored to the patient's stage of readiness to change alcohol or drug abuse behavior.

Arch Intern Med. 1996;156:2287-2293