Section: Module 4: Lesson 1: Ability to Screen Effectively and Quickly for Substance Use Disorders | Substance Use Disorders in Primary Care | NextGenU.org

  • Learning Objectives:

    Upon completion of the first lesson of Module 4, students should be able to:

    • Demonstrate the skills necessary to screen for substance disorders using the ASSIST Screening Tool.
    • Recognize the skills required for addiction prevention counseling.
    • Demonstrate the skills that help set respectful limits on patient requests for prescription medication.
    • Demonstrate how to clearly and supportively recommend treatment to patients with substance use disorders.
    • Demonstrate the skills for evaluating a patient’s stage of change, readiness to accept the diagnosis, and readiness to undertake behavior change.
    Approximate time required for the readings for this lesson (at 144 words/minute): 2 hours.

    Click here to start this lesson

    • Required Learning Resources and Activities
    • url icon
      The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) (40 mins) URL
      Students must
      View

      In "The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Manual for Use in Primary Care" read sections 1 - 7 (pp. 1 - 10). This should give you a sufficient understanding of how and why the ASSIST and the ASSIST-Linked Brief Intervention are used in primary health care. Next, read sections 9 - 15 (pp. 19 - 36). This should provide you with a basic understanding of how to screen using the ASSIST and how to categorize a patient using an ASSIST Scorecard.

    • url icon
      Brief Intervention: The ASSIST-linked brief intervention for hazardous and harmful substance use: manual for use in primary care (80 mins) URL
      Students must
      View

      You will be reading this entire manual titled "Brief Intervention," therefore you may wish to download it (for your own personal use only). The first 3 sections review concepts that are similar to those covered in the ASSIST screening manual, so you do not need to spend a lot of time reviewing those sections. Read sections 4 - 6 that will provide you with new theories and skills for brief interventions. You need to thoroughly understand these sections before continuing on to read section 7. Read section 8 on high risk and injecting clients that will help you understand and apply what you have read in the mhGAP. Section 9 will provide you with case examples of brief interventions. Section 10 to 12 provide further techniques to deliver longer interventions as well as how to include the ASSIST-linked brief intervention in practice.

    • forum icon
      Substance Use Assessment Simulation Forum
      Students must
      View
      Start discussions: 1
      Post replies: 1
      Make forum posts: 2

      After you have read the required resources provided in this module, you should feel comfortable participating in this simulation assessment activity about tobacco, alcohol, and other substance use. 

      Step 1: Select two local peers with whom you can role-play. Using the sample case scenarios from the WHO (Appendix 1, p. 41), perform the following simulation: 

        • You, as the NextGenU trainee, play the role of the ‘doctor’ in the scenario (which we will refer to as ‘practitioner’, since those types of brief interventions can be successfully delivered by nurses, clinical officers, counselors, and other care providers, as well as doctors). 
        • One peer simulates the patient. 
        • The other peer observes you practicing the skills of assessment and brief intervention for substance abuse, specifically applied to tobacco use. This peer should evaluate you using the scale in Appendix 2 (pp. 42 - 45).
      Step 2: As a group, discuss how the ‘practitioner’ performed on all the elements mentioned in the evaluation scale in Appendix 2. Here are some extra questions to help the ‘practitioner’ learn from this experience: 
        • How do you rate the performance of the ‘practitioner’? 
        • Did s/he give adequate advice to the patient? 
        • In which areas has s/he excelled? 
        • In which areas does s/he need improvement? 
        • If you were the one playing the role of the ‘practitioner’ what could you have done better? 
      Step 3: Repeat this role-playing activity with each participant playing a different role. Playing the various roles will help you (the NextGenU.org trainee) to deepen your learning and become even more competent at assessing substance use and performing the brief intervention. Repeat this activity until you, the NextGenU.org trainee, and your peers agree that you can perform the assessment and intervention adequately for tobacco, using the criteria outlined in step two, and certify this by clicking "true" in response to the quiz question below.

    • quiz icon
      Quiz: Module 4: Lesson 1
      Students must
      View
      Receive a grade
      To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.
    • Additional Learning Options
    • url icon
      Primary Care Addiction Toolkit: Motivation and Change (26 mins) URL

      Click on the links titled "Influencing motivation to change", "Negotiating a change plan", "Setting goals and finding solutions", and "Preventing and managing relapse".  Read the content of those links for additional information about change and motivation and well as how to ask solution-focused questions to help assess and improve a patient's ability to change.

    • url icon
      The Clinical Assessment of Substance Use Disorders (40 mins) URL

      From the menu on the left-hand side of the document titled "The Clinical Assessment of Substance Use Disorders," read the sections titled 'Key Concepts' and 'Learning Goals' and then read the 'Questions' section. Answer the 'Questions' and post them online (within the resource - there is no need to submit anything to NextGenU).

      Continue reading the 'Introduction' section, 'Medical Model', and all the materials under 'Clinical Evaluation', from 'Red Flags' to 'Initial Visit'. While watching the 'Initial Visit' video, take note of the blue icons and comments on the right. At appropriate times during the video, these comments will be highlighted in yellow. At this time, you can click on the blue icon and another smaller video will pop up. This smaller video will share thoughts and comments running through the minds of the doctors and patients during the interview.