Section of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA.
Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Box G-BH, 700 Butler Drive, Providence, RI 02906, USA; Department of Family Medicine, Brown University, Memorial Hospital of RI, 111 Brewster Street, Pawtucket, RI 02860, USA; Psychosocial Research, Butler Hospital, 345 Blackstone Boulevard Providence, RI 02906, USA.
Med Clin North Am. 2018 Jul;102(4):567-586. doi: 10.1016/j.mcna.2018.02.004.
Unhealthy substance use is common in primary care populations and is a major contributor to morbidity and mortality. Two key strategies to address unhealthy substance use in primary care are the process of screening, brief intervention, and referral to treatment (SBIRT), and integration of treatment for substance use disorders into primary care. Implementation of SBIRT requires buy-in from practice leaders, careful planning, and staff and primary care provider training. Primary care-based treatment of opioid and alcohol use disorders can be effective; more data are needed to better understand the benefits of these models and identify means of treating other substance use disorders in primary care.
在初级保健人群中，不健康的物质使用很常见，是发病率和死亡率的主要原因。解决初级保健中不健康物质使用的两个关键策略是进行筛查、简短干预和转介治疗（SBIRT），以及将物质使用障碍的治疗纳入初级保健。SBIRT 的实施需要得到实践领导者的认可、精心的规划以及员工和初级保健提供者的培训。基于初级保健的阿片类药物和酒精使用障碍治疗可能是有效的；需要更多的数据来更好地了解这些模式的益处，并确定在初级保健中治疗其他物质使用障碍的方法。
