Normalizing Alcohol and Drug Screening in Colorado
By Rebecca A. Clay
José Esquibel has a dream: to make screening for alcohol and substance abuse problems as routine as diabetes screening in every health care facility in Colorado. And the Screening, Brief Intervention, and Referral to Treatment (SBIRT) grant the state received from SAMHSA in 2006 is helping to make that dream a reality.
“We really want to see SBIRT become standard practice in our state’s health care system,” said Mr. Esquibel, SBIRT Project Director and Director of Interagency Prevention Systems in Colorado’s Department of Public Health and Environment. Eight hospitals, six primary care settings, and eight HIV clinics across the state are already using the SBIRT approach. Funding for serving the HIV clinics comes from the state’s Ryan White CARE Act funding.
A project partner called the Colorado Clinical Guidelines Collaborative is helping to spread the word even more. This group of clinicians condenses best practices in various subject areas into two-page guides distributed to its network of physicians. “Doctors can see at a glance what they can be doing,” said Mr. Esquibel.
To further ensure sustainability, the project is also targeting health care payers. The state recently passed a law requiring that insurance companies in Colorado pay for alcohol screenings beginning in January 2010. And Mr. Esquibel is hopeful that the state legislature will agree to activate Medicaid billing codes in the next legislative session.
Now the project is taking the message to the public. The project’s Web site includes information about substance abuse plus an ask-the-expert feature. “We want to communicate to the public that someone should be asking them questions about how alcohol and drugs affect their health whenever they’re in a health care setting,” said Mr. Esquibel.

SBIRT Colorado health educators at a recent training and team-building retreat in Breckenridge, CO. SAMHSA funds the program, which is administered by the Colorado Department of Human Services/Division of Behavioral Health and managed by Peer Assistance Services, Inc.