Project MAINSTREAM trains health providers skilled in detecting substance abuse
Alcohol, tobacco, marijuana, cocaine and other drugs impair the lives of millions of users and their families. A federal survey1 reveals the startling trends — an estimated 14 million Americans used illicit drugs such as cocaine during 2000, including 10 percent of young people aged 12-17. About 2 million youths used inhalants. Heavy drinking was reported in 12.6 million people. An estimated 6.6 million were binge drinkers. More than 22 million Americans drove under the influence of alcohol. A whopping 65.5 million adults reported current use of a tobacco product. About 2 million Americans used marijuana for the first time.
Seeking to stem the tide, a new curriculum at The University of Texas Health Science Center at San Antonio is giving health professionals across the board the skills to detect their patients' substance abuse problems and start them on the road to recovery.
The U.S. Health Resources and Service Administration (HRSA) and the Substance Abuse and Mental Health Services Administration are funding "Project MAINSTREAM" at only five institutions nationwide, including the Health Science Center. Both federal agencies are components of the U.S. Department of Health and Human Services. The Association for Medical Education and Research in Substance Abuse is administering the project.
What does it mean for South Texas? "Physicians, dentists, nurses and allied health professionals graduating from the Health Science Center and returning to the region will be more aggressive in screening for substance abuse and understanding how it affects a host of problems, from lung cancer, oral cancer and liver deterioration to high-risk pregnancies, motor vehicle accidents and domestic violence," said Janet F. Williams, M.D., associate professor of pediatrics.
Dr. Williams was selected as a national mentor for Project MAINSTREAM and became the Health Science Center team mentor when the project was funded in San Antonio. Marden E. Alder, D.D.S., professor of dental diagnostic science; Margaret H. Brackley, Ph.D., professor of chronic nursing care; and Joe E. Thornton, M.D., assistant professor of psychiatry, worked together to submit the team proposal for the Dental, Nursing and Medical schools.
"Our campus is recognized among those having the highest-quality research for substance abuse treatment," Dr. Brackley said. "Now we hope to ensure that clinicians know how to translate that research into clinical practice."
The Health Science Center team already has worked to enhance substance abuse education in the training of undergraduate dental students and forensic dentistry fellows. Sheryl L. Kane, D.D.S., clinical assistant professor of restorative dentistry and fellow in forensic dentistry, has joined the Project MAINSTREAM team's educational activities. Efforts in the School of Medicine, School of Nursing and School of Allied Health Sciences are in progress.
A simple reminder from a health provider that smoking is unhealthy can deter the habit. "Studies have shown that even a very short intervention decreases the amount of substance abuse," Dr. Alder said. "By intervention, I mean a less-than-10-minute interaction between clinician and patient."
Patients see a variety of health providers, and all of the providers should ask questions about substance abuse and give constructive counsel. "We're teaching health professionals from 15 different fields how to screen for substance abuse," Dr. Williams said. "The idea is that someone will reach the user, no matter how he enters the health care system."