Mass General to screen all patients for substance abuse

Massachusetts General Hospital in Boston will undertake an unusual new process in order to save money: screening all patients for potential drug abuse.

Starting this fall, the safety net provider will ask all patients four questions regarding their alcohol consumption and drug use, the Boston Globe reported. If clinicians suspect an addiction,  they can refer patients to special physicians and counseling.

"We make it incredibly hard for people to access care for addiction,'' Sarah Wakeman, medical director for Mass General's substance abuse disorders, told the Globe. "Part of our goal is shifting the culture.''

Altogether, the hospital, one of Boston's biggest safety net providers, will begin spending $1.4 million a year on addiction screening and treatment. Officials estimate that nearly 25 percent of patients hospitalized for routine medical problems have some substance abuse issue.

However, cost savings is also a factor in Mass General's decision. A study of more than 2,500 Mass General patients with addictions found they had longer stays and a greater chance of readmission, according to the Globe. The cost of their care was even higher than patients with chronic conditions such as congestive heart failure and pneumonia.

Providers discussed drug screening before, but more of the focus was on whether to screen certain healthcare workers, such as physicians and nurses, for drug use. And recent examinations of Medicare billings suggest that some independently practicing physicians rake in millions of dollars to monitor patients outside of the hospital to screen for potential abuse of prescription painkillers.

Yet Mass General is not alone. Beth Israel Deaconess Medical Center in Boston began screening all emergency room patients for drinking and illegal drug use earlier this year, according to the Globe, as did Boston's Brigham and Women's Hospital and other providers in the region. The College of American Surgeons recommends screening trauma patients for alcohol use on admission, and they will be queried on their drug use next year.

To learn more:
- read the Boston Globe article