Social History R.I.P.

Training to use the Epic electronic medical record a couple weeks ago I did a double take when I saw the archaic heading in the initial evaluation template, a throwback to the days when physicians thought of drinking and smoking as social problems rather than illnesses, addictive disorders.

I long ago substituted “Substance Use History.” Under this heading I document use, abuse and dependence related to each category of drug, along with episodes of treatment, use of 12 Step programs, periods of abstinence and adverse consequences.

Will you validate the importance of substance use disorders by giving them a heading of their own? What about work, military, leisure, sexual, legal, and educational?

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