Teaching about substance abuse in medical school.

Physicians often fail to diagnose and treat (or treat properly) alcoholism and other chemical dependence in patients. This failure may result from inadequate training, a sense of futility about effectiveness of treatment, belief that this is a social problem rather than disease or denial because the physician him/herself is from a family with substance abuse. A survey of 81 first year medical students identified six (7%) with past or present patterns suggesting abuse of alcohol or other drugs, five (6%) reporting both personal and immediate family abuse patterns, and 25 (31%) who reported such patterns in parents, grandparents or siblings. Students who are adult children of alcoholics (ACOAs) often need emotional support while learning about alcoholism and its treatment. Medical school training about substance abuse must take these needs into consideration and provide services approved by, but insulated from, the dean's office to help students cope with effects of personal or family substance abuse.