title: Detection of alcohol and drug problems in an urban gynecology clinic.
abstract: OBJECTIVE
  To compare screening instruments for their utility to detect substance use problems in women seeking gynecologic care, to assess the likelihood that alcohol/drug problems will be detected by physicians during a routine office visit and to examine the relationship between regular alcohol and/or drug use and the patient's presenting gynecologic complaints.
  
  
  METHODS
  Women (N = 360) attending a hospital-based gynecology clinic were screened prior to physician visit using the Michigan Alcoholism Screening Test, CAGE and T-ACE. After the visit, information on presenting complaint and physician's documentation of the patient's tobacco, alcohol and other drug use was abstracted from the medical record.
  
  
  RESULTS
  The rates of alcohol and illicit drug use varied across assessment instruments; physician documentation, however, yielded the lowest prevalence estimates. Regular alcohol and drug users were more likely to present with chronic and acute medical problems than patients who were not regular users of these substances.
  
  
  CONCLUSIONS
  The gynecology clinic offers an opportunity for early identification of women with substance problems, and alternative strategies are needed to encourage gynecologists to routinely screen for such problems at each medical visit.
authors.affiliation: National Institute on Drug Abuse, Intramural Research Program, Departments of Psychiatry and Behavioral Sciences and of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. agupman@intra.nida.nih.gov
authors.forename: Anne E
authors.initials: AE
authors.lastname: Gupman
authors.forename: Dace
authors.initials: D
authors.lastname: Svikis
authors.forename: Mary E
authors.initials: ME
authors.lastname: McCaul
authors.forename: Jean
authors.initials: J
authors.lastname: Anderson
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Santora
mesh_terms: D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D010044:Outpatient Clinics, Hospital; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014504:Urban Health