Although substance abuse problems have a profound impact on individual
health and well-being, family functioning, injury, work performance,
and medical costs, these problems remain underdiagnosed and under-trea
ted by physicians. The generalist has an important opportunity to inte
rvene in this pervasive problem. The methods for screening, diagnosis,
and intervention for substance abuse problems, as well as treatment a
pproaches for full-fledged chemical dependence, are well established a
nd empirically supported. Internal medicine can and should, therefore,
play a greater role in caring for the substance-abusing patient.