The substance-related disorders are underdiagnosed and frequently misdiagnosed in the clinical practice of psychiatry; however, the magnitude of their influence cannot be overstated. Substance use can complicate the diagnostic process as well as the recommended course of treatment for patients. It is common among patients with mental health problems, and symptoms of substance use disorders are often mistaken for other psychiatric conditions. Given the importance of accurate diagnosis to the success of treatment, many factors should be considered when evaluating patients for substance use and related disorders. The present review highlights key issues in the assessment and treatment of psychiatric patients with comorbid substance use.

The world of primary care can be complex and challenging. With an ever increasing body of medical knowledge, primary care physicians must make it a priority to think outside the box when diagnosing patients. This is especially true when it comes to the consideration of substance abuse as a diagnosis. Managing common medical problems such as hypertension and diabetes are familiarities of care, but substance abuse can be easily dismissed or overlooked. It is proposed that 20% of patients encountered for a primary care visit have a problem with substance abuse. Primary care providers should add substance abuse to differential diagnosis, treat when trained and refer when appropriate. Automatically discharging patients who are found to carry this diagnosis is inappropriate, as this patient population deserves and needs to be treated as much as any other patient population. This article will provide tips for the primary care physician to aid in the diagnosis of substance abuse and provide recommendations by which these patients can receive treatment.

Addiction Medicine and Emergency Medicine have much in common. Their greatest similarity is in the overlap of the patient population that they each serve. The substance abusing population is over-represented in the emergency room (ER), placing increasing demands upon financial and staff resources. Identification and proper intervention in the ER has been a focus of most joint research in the past, but other areas of investigation are open. Additionally, emergency medicine as a relatively new specialty has much in its history to share with addiction medicine as it strives for recognition. Emergency physicians are also finding themselves to be over-represented among the patients of the addiction medicine specialist.

This study examined the utility of the Theory of Planned Behavior (TPB) in predicting alcohol consumption on game day among college students. Data were collected from a random sample of 740 college students who completed an anonymous online survey. Survey items assessed participants’ motivations for consuming alcohol and the total number of drinks consumed on game day. With the exception of Perceived Behavioral Control (PBC), each of the TPB constructs was statistically significant in predicting alcohol consumption. Behavioral Intentions to drink alcohol on game day predicted behavior. Intentions, in turn, were predicted by Attitude Toward the Behavior and Subjective Norm constructs. The TPB proved useful in explaining alcohol use on game day with college students. However, the applicability of the PBC construct within the TPB model remains in question. Additional research with more effective PBC measures is needed before more definitive statements can be made concerning the TPB’s efficacy in predicting college student alcohol consumption on game day.

Medical Research
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International Drug Policy
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