1. 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
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

2. 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

3. For the dependent drinker….

4. 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: