Screening for Alcohol and Cannabis Use in Primary Care: A Brief Report on Patient Perspectives

Abstract

Background: Substance use disorders (SUDs) pose significant public health challenges in the U.S., contributing to increased morbidity and mortality. Despite the prevalence of SUDs, underdiagnosis remains common due to inconsistent screening practices and patient reluctance to disclose substance use, often driven by stigma and misunderstanding of screening purposes. Objectives: This study aimed to explore adult primary care patients' experiences with substance use screenings implemented by Kaiser Permanente Washington (KPWA) as part of a mental health integration initiative. Methods: Through semi-structured qualitative interviews, participants shared their perspectives on the effectiveness of the screening process and their feelings about answering questions related to alcohol, cannabis, and other drug use. Results: Key themes emerged around concerns of privacy, perceived judgment, and the need for clearer communication regarding how screening data is utilized. Participants expressed a desire for a more supportive and transparent approach from healthcare providers, suggesting that reassurance and contextual information could enhance their willingness to disclose substance use. Conclusion: The study highlights the importance of fostering open dialogue between patients and providers to improve the accuracy of substance use reporting and overall patient care. Next steps include seeking funding for further data collection to analyze experiences across diverse demographic groups, aiming to inform more effective screening and intervention strategies in primary care settings. By addressing these critical issues, healthcare systems can better engage patients and optimize SUD identification and treatment in primary care.