Babor Thomas F, Kadden Ronald M
Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, CT 06030-6325, USA.
J Trauma. 2005 Sep;59(3 Suppl):S80-7; discussion S94-100. doi: 10.1097/01.ta.0000174664.88603.21.
This article summarizes current knowledge about the accuracy of screening tests and the efficacy of interventions for substance use disorders in different medical settings (including trauma centers) where the practitioners are not specialists in the management of substance use disorders. In the first section, we introduce basic screening approaches for psychoactive substance use disorders and issues of natural history, risk factors, and populations at risk. Next, we review recent scientific research on the development of screening tests and the evaluation of early intervention services for persons at risk. We conclude that reliable and valid screening tests are available to detect alcohol use disorders but that further work is needed before routine screening for drug use disorders is warranted. We found strong evidence to support the effectiveness of brief interventions in managing at-risk drinkers; however, the evidence is only suggestive for drug use disorders. Finally, we explore the implications of the findings for developing a public health approach to early intervention, particularly as it relates to the unique needs of trauma centers.
本文总结了在不同医疗环境（包括创伤中心）中，关于筛查测试准确性以及物质使用障碍干预措施有效性的现有知识，这些医疗环境中的从业者并非物质使用障碍管理方面的专家。在第一部分，我们介绍了精神活性物质使用障碍的基本筛查方法以及自然史、风险因素和高危人群等问题。接下来，我们回顾了关于筛查测试发展以及对高危人群早期干预服务评估的近期科学研究。我们得出结论，有可靠且有效的筛查测试可用于检测酒精使用障碍，但在有必要对药物使用障碍进行常规筛查之前，还需要进一步开展工作。我们发现有力证据支持简短干预在管理高危饮酒者方面的有效性；然而，关于药物使用障碍的证据仅具有启发性。最后，我们探讨了这些研究结果对于制定早期干预公共卫生方法的意义，特别是与创伤中心的独特需求相关的意义。
