Talking to Patients About Referral to an Addiction Specialist

Some patients will resist or flatly deny substance abuse. However, if you suspect substance abuse and referral to addiction treatment is warranted, then you must discuss the issues with the patient. Explain to patients and their significant others that:

  • Addiction is a treatable chronic disease
  • You want to give them the best treatment and so you are referring them to a specialist much like you would do for other chronic diseases
  • When stabilized, patients may return to the primary care provider for on-going care, while the addiction specialist can continue to provide the buprenorphine treatment

Skillful, empathetic interviewing is key and specific approaches should be followed when discussing substance abuse with patients.

Try these sensitive interviewing techniques when recommending a referral:

  • Use the "Ask-Tell-Ask" approach:
    1. Ask permission to discuss something with them
    2. Tell them your concerns
    3. Ask what they thought about what you said
  • Remember your role as a health provider - explain that you need to discuss drug use because you are concerned about their health and explain why you are recommending a referral. Point out the direct relationship between their drug use and any health or social consequences they might have experienced.
  • Provide as much information as possible about the provider/clinic where you are referring the patient; if you speak with confidence and knowledge about the treatment center, patients are more likely to respond more positively.
  • Maintain the patient's privacy - conduct the interview in private and do not bring up the substance abuse or referral around other staff members, family, or friends without the patient's permission.
Related Resources: 
Description: 
A guide for using non-stigmatizing language when working with patients who have substance use disorders.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Physician stage in practice: 
Description: 
Guide on using motivation to effect substance abuse treatment. Includes information on motivational interviewing, integrating motivational approaches into treatment, and measuring patient motivation.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Description: 
Provides physicians with information on how to work with a patient who has co-occurring disorders, including how to engage the patient in treatment and how to develop a successful therapeutic relationship.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
field_vote: 
Physician stage in practice: