Physicians Concerned About Missing Signs of Addiction

More than two-thirds of physicians polled say they worry they’ve missed signs of drug misuse and substance use disorders, and 75% say telehealth visits have limited the ability to determine if patients are at risk for or are already misusing prescription drugs.

The findings were part of a report published on Monday by Quest Diagnostics.

>> READ the full Quest Diagnostics Health Trends report

The report combined an analysis of nearly 5 million de-identified aggregated Quest test results (including 475,000 from 2020) and a Harris Poll survey of 500 primary care physicians. Among the report’s other notable findings:

• In addition to 67% of physicians saying they worry they’ve missed signs of drug misuse or SUD by at least 1 patient, 94% of PCPs report seeing more patients experiencing stress, anxiety, and/or other mental health issues related to the pandemic.
• 91% of physicians are confident they can recognize signs of prescription drug misuse during in-office visits by patients, but only 50% say they have the same confidence with telehealth visits.
• 78% of physicians fear patients will turn to illicit fentanyl if they cannot get a prescription medication, and 86% worry that illicit fentanyl will cause more deaths than prescribed opioids. Meanwhile, Quest data shows positivity for non-prescribed fentanyl has increased by 35% (from 4.3% to 5.8%) during the pandemic.
• While 88% of physicians report feeling confident they can identify patients at risk for drug use and misuse, Quest data showed that 48% of patients tested in 2020 showed signs of drug misuse and 50% were engaged in polysubstance use.

“COVID-19 exacerbated longstanding public health issues, including mental health, drug misuse and social disparities, while supercharging telehealth, at-home care and other consumer-centric approaches," Jay G. Wohlgemuth, MD, senior vice president, R&D and Medical, and chief medical officer, Quest Diagnostics, said in a news release. “Our latest Health Trends findings reveal the need to arm physicians with comprehensive resources to identify and combat drug misuse amid this shifting landscape.

Wohlgemuth said such resources may include clearer guidelines for implementing drug monitoring, including presumptive and definitive testing, as well as guidance on using telehealth to care for patients who are taking controlled prescription medications or are struggling with SUD.