Screening tools are an important part of population based health. The information on the Drug Abuse Screening Test (DAST) was particularly interesting and helpful. However, what struck me most was the recognition that it is not useful for pain patients. This is a growing area of concern in the country. Firstly, as many individuals have already struggled with an addictive behavior, these patients are often difficult to manage for pain. The pain may be an acute situation, such as a kidney stone or a fracture. However, they deserve adequate pain relief and must be treated appropriately (National Institute on Drug Abuse, n.d.).

Furthermore, many chronic pain patients may then develop an addictive behavior as a result of their chronic pain. This is a more difficult area. The issue needs to focus on whether or not the patients are actually abusing the drugs in the traditional viewpoint, or are merely attempting to alleviate their pain. Of course, pain is subjective and this makes it difficult. However, more research is clearly needed in this area since chronic pain is a significant public health problem (American Academy of Pain Medicine, n.d.).

The CAGE drinking assessment tool is standard for a reason: it works. It is, however, not the only one. Other screening tools include the TWEAK test. The discussion is correct when it discusses what one of the greatest difficulties are concerning these tests: denial. Individuals who abuse alcohol and drugs often live in significant denial about their problems. For this reason, interventions are often held by family and friends. It may be useful if the assessment tools encourage the person to complete it with a family member or friend. This would not require a full intervention, but it may help push the person past denial. The reality remains however, that an individual will not seek help until he or she admits there is a problem. Denial, of course, often prevents this.