The Baltimore County Health Department has launched a program to help doctors identify patients with drug abuse problems so they can get treatment.
The department's Bureau of Substance Abuse is mailing to 4,000 doctors in the county a packet containing information to help them recognize symptoms of substance abuse. It also includes questions to ask when trying to diagnose patients who might be abusing drugs.
"Physicians are a critical player in getting people into treatment," said Michael M. Gimbel, director of the bureau.
The program is called Physicians Reaching Out to Understand Drugs, or PROUD. It is the latest attempt by the bureau to combat the abuse of illegal drugs and prescription medications, such as the popular painkillers Vicodin and OxyContin. The program is being paid for with a state grant.
The PROUD mailing also includes literature on drugs - both legal and illegal - in fashion among teen-agers and adults, and tips on safe use of prescription medications.
"This program is not an attack on doctors," said Gimbel. "We want them to be our partners."
Gimbel said he is concerned that doctors don't always have adequate training to recognize substance-abusing patients.
The chairman of the Maryland State Medical Association's Addiction Committee agrees.
"Tradition in medicine is that addiction is not viewed as an illness," said Dr. David R. McDuff. "Addiction is always a moral or legal issue."
PROUD emphasizes the importance of recognizing physical and mental symptoms of drug abuse so that doctors can make precise diagnoses and offer the most effective treatment.
McDuff and Gimbel say that diagnosing substance abuse is sometimes made difficult by a pessimism among physicians about whether addiction can effectively be treated.
McDuff, in a telephone interview, noted a recent study by the National Center on Addiction and Substance Abuse at Columbia University in which primary-care physicians and their substance-abusing patients were surveyed.
The study, published in May 2000, concluded that physicians are more likely to view treatments for illnesses such as hypertension, diabetes and depression to be "very effective" than they are treatments for smoking, alcoholism and drug abuse.
The PROUD packet includes cards that doctors can return requesting more information on the program. The effectiveness of the program will be measured by the number of cards that are returned, and by whether treatment centers see an increase in physician referrals for drug abuse, Gimbel said.
