Developing and Using a Referral Network Patient Referral Slides Developing and Using a Referral Network Methods for negotiating change Provider expectations: setting realistic goals for change in a chronic disease http://findtreatment.samhsa.gov First clip 19:45 What do you think you can do to prevent this sort of thing from happening again?... 22:00 …support services and follow-up as needed. Second clip 8:43 In the preparation stage… 9:48 …Today’s referral will also bring positive benefits

For the non-dependent high risk drinker…. You have the opportunity to address an acute problem and have a big effect on health outcomes Sobell: Many high risk drinkers will cut back and quit on their own Provider feedback can play an influential role

For the dependent drinker….

Alcohol abuse resembles other chronic illnesses… <30% of patients with asthma, HTN, diabetes adhere to prescribed diet and/or behavioral changes and 50% experience yearly recurrence requiring medical care 50-60% of patients discharged from substance abuse treatment are abstinent at 1 year As in other chronic diseases, poor adherence and relapse is predicted by low SES, co-morbid psych conditions and lack of family and social supports Substance abuse should be insured, monitored, treated and evaluated like other chronic diseases McClellan AT, Lewis DC, et al. JAMA 2000; 284:1689-1695.