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SAMHSA’s Award-Winning Newsletter
November/December 2009, Volume 17, Number 6 

photo of doctor talking to a patient

Screening, Brief Intervention, and Referral to Treatment: New Populations, New Effectiveness Data

The idea behind SAMHSA’s Screening, Brief Intervention, and Referral to Treatment (SBIRT) program is deceptively simple: What if you could stop drinking and substance abuse problems before they became serious enough to destroy people’s lives?

Now SAMHSA’s grantees are providing SBIRT services in an ever-growing list of venues. To ensure that the approach endures long after the grants end, the program is expanding to include the next generation of service providers through a new medical residency grant program. (See “Creating a Curriculum: Educating the Next Generation.”) And the field is amassing even more evidence that the SBIRT approach is an effective way to reduce alcohol and illicit drug use—and save money.

“Promoting services like SBIRT to all parts of the Nation is a crucial part of SAMHSA’s mission to reach everyone struggling with substance abuse issues,” said H. Westley Clark, M.D., J.D., M.P.H., Director of SAMHSA’s Center for Substance Abuse Treatment (CSAT).

Reaching New Populations

The basics of SBIRT are the same no matter where the services are provided. All patients in participating emergency rooms, primary health clinics, campus health centers, or other health care venues automatically undergo a quick screening to assess their alcohol and drug use. If they’re at risk of developing a serious problem, they receive a brief intervention that focuses on raising their awareness of substance abuse and motivating them to change their behavior. Patients who need more extensive treatment receive referrals to specialty care. (See “Screening Works: Update from the Field,” SAMHSA News online, March/April 2008.)

CSAT’s goal is to help spread the approach throughout the entire health system. A grant program that ended last year, for instance, brought SBIRT to a dozen community college and university campuses around the country.

The nine state and tribal grantees currently providing SBIRT services are branching into new venues. In Colorado, for instance, a grantee is now bringing the SBIRT approach to HIV clinics (see “Normalizing Alcohol and Drug Screening in Colorado”). Another project with Alaska Natives involves taking SBIRT to areas so remote they can only be reached by boat or airplane (see “Reaching an Isolated Population”).

To help ensure SBIRT’s sustainability, CSAT also has launched a medical residency grant program (see “Creating a Curriculum: Educating the Next Generation.”). These grantees are developing a variety of tools for training medical residents, including lectures, Web-based programs with streaming video illustrations, and practice with standardized “patients.”

“These are the next generation of providers,” explained Project Director Walker Reed Forman, M.S.W., the Lead Public Health Advisor in CSAT’s Division of Services Improvement. “Research shows that when you learn something at an early point in your career, you’re more likely to adopt it once you’re out in the wider medical community.”

Proving SBIRT’s Effectiveness

A growing body of evidence about SBIRT’s effectiveness—and cost-effectiveness—could help SBIRT to expand even more. That research shows that SBIRT is an effective way to reduce drinking and substance abuse problems.

A 2009 article in the journal Drug and Alcohol Dependence, for example, found an almost 68-percent reduction in illicit drug use over a 6-month period among people who had received SBIRT services.

The report’s authors include Dr. Clark and other SAMHSA staff; Bertha Madras, Ph.D., former Deputy Director for Demand Reduction at the Office of National Drug Control Policy; and Wilson Compton, M.D., M.P.E., Director of the Division of Epidemiology, Services, and Prevention Research at the National Institute on Drug Abuse.

The researchers reviewed data on 459,599 patients screened at various medical settings in six states. Almost 23 percent had drinking or drug problems or a high risk of developing them. Of those patients, almost 16 percent received a brief intervention; 3 percent received brief treatment; and almost 4 percent received referrals for more specialized treatment.

In addition to significantly reducing illicit drug use, SBIRT also reduced individuals’ drinking. Among those who reported heavy drinking at baseline, the rate of heavy alcohol use was almost 39 percent lower at the 6-month followup.

Those who received brief interventions or referrals to specialty treatment also reported other improvements, including fewer arrests, more stable housing situations, improved employment status, fewer emotional problems, and improved overall health.



  News & Updates  
Pamela S. Hyde Sworn in as New Administrator

Pamela S. Hyde Sworn in as New Administrator

Read more, view Webcast, and see photos.

Parity Law: Lessons Learned from California

Parity Law: Lessons Learned from California

Study may help to highlight the need for public education about the Federal parity law.

Voice Awards Honor Consumer Leaders

Voice Awards Honor Consumer Leaders

Entertainment industry and consumer leaders honored in Hollywood. Photo gallery.


  Publications  
TIP 52:  Treatment Guide to Clinical Supervision

TIP 52: Treatment Guide to Clinical Supervision

Improving counselors’ skills takes coaching and mentoring.

Guidelines: Responding to Mental Health Crises

Report offers principles for safe interventions.

Substance-Exposed Infants: How States Help

Substance-Exposed Infants: How States Help

Cross-agency, unified approach is recommended.


  Grants  
Funding Opportunities

Funding Opportunities

Call for applications include Peer-to-Peer Recovery program.

Tribal Grants Awarded

In Montana, a tribal group recently accepted a “big check.”


  Homelessness  
New Research Available on Parenting

New Research on Parenting

SAMHSA staff recently guest-edited 11 articles that focus on parenting.

Web Site Update on Co-Occurring Disorders

Web Site Update on Co-Occurring Disorders

New, interactive Web site features a library of tools.


  Adolescents & Substance Use  
“Influencers” Prevent Prescription Drug Misuse

“Influencers” Prevent Prescription Drug Misuse

Online toolkit helps family, teachers, and doctors keep teens from abusing prescription drugs.

Youth Tobacco Trends Show Decline

Youth Tobacco Trends Show Decline

Fewer youth are using tobacco products.

Perceptions of Risk from Substance Use

Perceptions of Risk from Substance Use

Age relates to teens’ perception of the danger of substance use.


  Suicide Awareness  
Suicide Prevention Update

Suicide Prevention Update

Lifeline’s Twitter, Facebook numbers rise.


  Prevention Update  
Native American Center for Excellence

Native American Center for Excellence

Recent event included a hoop dancing demonstration.



  Also in this Issue  
Gender Differences in Adolescents

Gender Differences in Adolescents

State reports on behavioral health problems presented by gender.

New Wallet Cards for 1-800-662-HELP

New Wallet Cards for 1-800-662-HELP

Order free wallet cards in English and en español.



  


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