Narconon PSA  

Wisconsinites can take pride in so many of our state's achievements, but our drinking status is not among them. The Badger state regularly lands at or near the top of national rankings on high-risk or heavy drinking, according to the Centers for Disease Control and Prevention.

And it's not just college students.

One in four Wisconsin adults engage in illegal drug use or alcohol use that is medically defined as risky. Diseases and injuries related to drinking and drug use make it the fourth leading cause of death in our state and the fourth leading cause of hospitalization.

Pregnant women in Wisconsin drink more than expectant mothers elsewhere in the United States. Such drinking puts their babies at risk for facial deformities and development disabilities.

Drug use is one of several common causes of premature birth and is likely contributing to the high neonatal mortality rates -- recently reported as the highest in the nation -- among disadvantaged African-Americans in the southeastern part of our state.

Everyone in Wisconsin is touched by alcohol and drug problems, either as users or through problems in our families and communities.

The cost to us as taxpayers is considerable. The economic toll of substance abuse in our state is estimated at more than $5 billion each year to our health care and criminal justice systems, according to the state health report, "Healthiest Wisconsin 2010 (2000). "

As tragic as these statistics are, citizens can find some comfort in knowing the state is not sitting on its hands.

A federally funded, state-administered screening and assistance program to fight alcohol and drug problems is now being piloted at 20 clinics around Wisconsin in settings as varied as inner-city Milwaukee, Madison, the rural northwest, and two tribal health clinics. The program, called the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL), is being coordinated by the Department of Family Medicine at the UW School of Medicine and Public Health.

The program is simple and effective in early detection of at-risk or harmful substance abuse, numerous studies show.

Four key questions to be included in any routine health care visit indicate which patients are at risk. Those patients then meet with on-site, trained health educators to discuss their drinking and drug use and agree together upon options for change.

Patients who have serious addictions -- about 6 percent -- are referred for specialized treatment. Currently only a small portion of these patients have ever received such treatment.

For the many more patients who are not addicted but engage in risky or harmful drinking or drug use -- about 20 percent -- just a brief discussion and perhaps one or two follow-up sessions are enough to help them significantly decrease their alcohol and drug use, studies show.

Not only are people's lives improved through this assistance, a Wisconsin study showed that nearly $1,000 is saved in health care and criminal justice costs for every patient receiving screening and brief intervention services.

Over the next five years, the 20 clinics are expected to provide an initial screening to some 100,000 patients ages 18 and older. Of these initial screenings, some 25,000 people will be in need of brief intervention or additional treatment. Over time, we expect to add more clinics and extend services to adolescents.

The time to provide such assistance is long overdue. For 12 years, government agencies and professional organizations from federal to local levels have recommended that health care settings routinely provide alcohol and drug screening, intervention, and referral services to all patients. So far, few settings in the United States are doing so.

Not long ago, doctors didn't even ask patients whether they smoked, an omission that seems unbelievable to us now.

Wisconsin researchers helped lead the way in ensuring that health care providers asked about smoking and provided options for quitting as part of any health care visit.

We now have the opportunity to do much the same thing for drinking and drug use.

How fitting it is for the state most afflicted by risky drinking to help lead our nation in finding effective solutions.

The Wisconsin Initiative to Promote Healthy Lifestyles is seeking input on how to implement screening and assistance services in your areas. We welcome your comments at info@wiphl.org.

Dr. Brown is an associate professor of family medicine at the UW School of Medicine and Public Health and clinical director of the Wisconsin Initiative to Promote Healthy Lifestyles.

Editor's Note: This commentary was originally published in the Wisconsin State Journal.