Behavioral health conditions

Substance abuse

For those who are addicted to drugs, alcohol or tobacco, it’s nearly impossible to recover without outside assistance. Substance use can significantly impact successful outcomes as you treat medical disorders as well.

If you believe your patient has a problem with substance abuse, we strongly urge you to coordinate medical care with behavioral health treatment. The tools below can help.

CAGE-AID is a commonly used, five-question tool used to screen for drug and alcohol use. If a person answers yes to two or more questions, a complete assessment is advised.

The American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Substance Use Disorders, Second Edition (May 2006)

The American Psychiatric Association (APA) Treating Substance Use Disorders: A Quick Reference Guide (2006), and Guideline Watch (April 2007): Practice Guideline for the Treatment of Patients With Substance Use Disorders, 2nd Edition.

The American Psychiatric Association (APA) Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder (2018) (PDF)

Department of Veterans Affairs / Department of Defense Clinical Practice Guideline for the Management of Substance Use Disorders (2015) (PDF)

National Institute on Drug Abuse Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide (2014) (PDF)

The American Society of Addiction Medicine (ASAM) Clinical Practice Guideline on Alcohol Withdrawal Management (2020)

The New England Journal of Medicine Treatment of Opioid Use Disorders (2016)

Washington State Agency Medical Directors’ Group Interagency Guideline on Prescribing Opioids for Pain (2015) (PDF)

The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder 2020: Focused Update (PDF)

Substance Abuse and Mental Health Services Administration Medications for Opioid Use Disorder, Treatment Improvement Protocol (TIP) Series 63 (2020)

Magellan Tip Sheet – Substance Use Disorders Identification (PDF)

Magellan's Opioid Use Resources for Providers

National Council for Behavioral Health – Improving Adolescent Health: Facilitating Change for Excellence in SBIRT (Screening, Brief Intervention, and Referral to Treatment) 

  • An appearance of unusual behavior, which is getting worse
  • Being argumentative, isolated, irritable and/or irresponsible
  • Demonstrating poor judgment, risky or reckless behavior
  • Breaking rules
  • Sudden mood changes
  • Withdrawing from activities that involve others
  • Decreased interest in activities
  • Absenteeism and/or tardiness, particularly on Mondays
  • Decreased productivity and ability to focus
  • Changes in appearance, or a lack of attention to appearance 

Physical symptoms will vary depending upon the substance that is being used. They may include any of the following:

  • Tendency to nod off or appear to be extremely drowsy
  • Eye pupil constriction, red and/or glassy eyes
  • Changes in sleeping habits
  • Frequent sniffy or runny nose
  • Increased constipation
  • Complaints of nausea and/or vomiting