By Melissa Cheng, MD, MPH, MSPH
In light of the current opioid epidemic and increasing heroin and synthetic opioid problem plaguing our youth, many are asking, “What can we do about this growing problem?” One potential answer is the Screening, Brief Intervention and Referral to Treatment (SBIRT), a comprehensive evidence-based public health approach to early intervention and treatment for people at risk of developing or currently experiencing a substance abuse disorder. SBIRT allows for substance abuse screening in any healthcare setting using free validated questionnaires. The vast majority of patients will not have an issue with alcohol, illicit drug use, or prescription medication misuse. However, when a problem is detected we can provide the appropriate intervention. Patients that are at moderate or high risk for abusing substances can be given brief interventions such as motivational interviewing (MI), which can raise awareness about the patient’s substance use and its consequences in order to motivate a positive behavior change. For many providers, a quick 5-10-minute conversation using MI can be a very important one. Also, when an existing substance use disorder is detected we can make appropriate referrals to treatment. In Utah, only 6% of substance use disorder treatment referrals are from health care providers, whereas 56% originate from the criminal justice system. If we can turn those numbers around, we can make significant impacts on reducing crime and societal costs. SBIRT has been proven to be effective in reducing substance use, such as alcohol, heroin, cocaine and opioids; reduction in risky behaviors, such as intravenous drug use and unprotected sex; improvement in quality-of-life measures, such as decreased criminal justice rates and improved employment status; and is also cost-effective. Further, SBIRT is reimbursable by many insurance companies, including Medicare.
The Rocky Mountain Center for Occupational and Environmental Health at the University of Utah was awarded a 3-year grant to teach health professional students about SBIRT and increase community utilization of SBIRT. If you are interested in learning more about SBIRT, please email me at Melissa.firstname.lastname@example.org.
Melissa Cheng, MD, MOH, MSPH is an Assistant Professor(Clinical) in the Department of Family & Preventive Medicine in the Division of Occupational and Environmental Health at the University of Utah School of Medicine.