Substance use disorders (SUDs) impose enormous costs on individuals, families and public resources. Illegal drugs and alcohol are responsible for thousands of deaths each year, and contribute to the spread of communicable diseases such HIV and Hepatitis C, as well as some of the worst social problems in the United States, including child abuse, domestic violence and sexual assault. It is evident that in all areas of health care, untreated SUDs elevate the risk of complications and poor outcomes, and drive up the cost of health care.
Despite a general agreement that SUDs are a leading cause of death, disability and disease, front-line health professionals are not trained to identify individuals with SUDs, assess their condition, intervene on their behalf, or refer them to treatment. Numerous studies demonstrate the effectiveness and cost effectiveness of activities intended to detect and intervene early with individuals with SUDs in health care settings (Allen et al., 1997; Babor & Higgens-Biddle, 2001; Project Cork, 2004). Several forces either facilitate or inhibit efforts to detect and intervene with SUDs. This column focuses attention on a number of interdisciplinary efforts to support the training and education of health professionals and promote the development of transdisciplinary competencies for the early detection and intervention of SUDs.