Screening and prevention of alcohol and drug use disorders in women.

Today a variety of treatments are available for women with SUDs. They range from psychosocial interventions such as motivational enhancement therapy, cognitive-behavioral therapy, and 12-step recovery to pharmacotherapies such as buprenorphine, methadone, and naltrexone. Although the general public remains skeptical of SUD treatment, national studies consistently find it to be both clinically and economically efficacious. In Oregon, for example, researchers found that every dollar invested in drug treatment saved taxpayers dollars 5.60. By the time a woman walks through the door of a drug treatment program, however, her disorder is likely to be firmly engrained. The medical practitioner's office provides an ideal setting for screening and early identification of high-risk alcohol and other drug use and abuse. A variety of reliable and valid self-report measures are available. Sadly, however, the majority of health providers still do not routinely screen patients for alcohol or drug problems. The consequences can be severe, particularly for women. Although efforts have focused on practitioner education and strategies to address practical barriers to implementation (eg, time, resources), much less attention has focused on the pessimistic views of practitioners about SUDs and treatment efficacy. New strategies are needed to enhance practitioner feelings of self-efficacy about their ability to identify and intervene early in the progression from alcohol use to abuse to dependence.