March 22, 2018
WASHINGTON, D.C. – Substance use disorder (SUD) has reached crisis proportions in the United States, affecting 20.2 million people over the age of 18. Excessive alcohol consumption accounts for one in 10 deaths among working-age adults, and the opioid epidemic claims 115 lives every day. Despite these harsh realities, only 10.6 percent of individuals with SUDs receive treatment for drug or alcohol addiction.
Screening and Brief Intervention (SBI) is a proven, evidence-based practice for unhealthy alcohol use. Behavioral health care providers use both SBI and Referral to Treatment (SBIRT) to identify or intervene with individuals who are at risk for SUDs. However, to date SBIRT adoption by primary care providers has been sporadic, with varying success rates.
Recognizing that SBIRT can help to save lives, the National Council for Mental Wellbeing, with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), launched the Achieving SBIRT Practice Transformation project. The project, designed to understand the barriers to increased use of SBIRT in primary care, confirmed that widespread adoption has been hindered by a lack of clear, uniform implementation guidelines.
In response to these findings, the National Council, with guidance from a panel of esteemed experts, developed “Implementing Care for Alcohol and Other Drug Use in Medical Settings: An Extension of SBIRT,” a guide for primary care. This builds on the successful management of depression and anxiety in primary care using collaborative care principles and measurement-based care, moving toward more comprehensive care of people with SUD.
“’Implementing Care for Alcohol & Other Drug Use in Medical Settings: An Extension of SBIRT’ gives primary care clinicians a step-by-step guide to assessing alcohol and other drug use as part of standard practice, and can be used by any primary care organization or office”, said Linda Rosenberg, president and CEO of the National Council.
“Historically, SUDs have been managed outside health care systems in the U.S., but many forces are leading to an appropriate shift to identifying and managing SUDs in medical settings, beginning in primary care. This guide’s enhancement of the SBIRT model is intended to help primary care practices deliver improved, comprehensive, coordinated care for patients with SUDs, thereby improving patient outcomes,” noted Katharine Bradley, who is the practice transformation team chair and a senior investigator at the Kaiser Permanente Washington Health Research Institute
Expert Panel Contributors
Katharine Bradley, M.D., MPH, *Chair
Senior Investigator, Kaiser Permanente Washington Health Research Institute
Henry Chung, M.D., *Advisor
Senior Medical Director, Behavioral Health Integration Strategy, Montefiore Care Management Organization
Professor of Psychiatry at the Albert Einstein College of Medicine
Richard L. Brown, M.D., MPH
Professor, University of Wisconsin Department of Family Medicine and Community Health
Tillman Farley, M.D.
Chief Medical Officer, Salud Family Health Centers
Leigh Fischer, MPH
Associate, Abt Associates
Eric Goplerud, Ph.D.
Vice President and Senior Fellow, National Opinion Research Center (NORC) at the University of Chicago
Senior Fellow, NORC at the University of Chicago
Sandeep Kapoor, M.D.
Director, SBIRT, Division of General Internal Medicine, Department of Emergency Medicine, Department of Psychiatry/Behavioral Health, Northwell Health
Hillary Kunins, M.D., MPH, M.S.
Assistant Commissioner, Bureau of Alcohol and Drug Use, New York City Department of Health and Mental Hygiene
Clinical Professor, Departments of Medicine, Psychiatry and Behavioral Sciences, Family and Social Medicine, Albert Einstein College of Medicine
Richard Saitz, M.D., MPH
Chair and Professor of Community Health Sciences (CHS), Boston University School of Public Health
Professor of Medicine, Boston University School of Medicine
Mary Velasquez, Ph.D.
Professor and Director, Health Behavior Research and Training Institute, University of Texas at Austin School of Social Work
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The National Council for Mental Wellbeing is the unifying voice of America’s health care organizations that deliver mental health and addictions treatment and services. Together with our 2,900 member organizations serving over 10 million adults, children and families living with mental illnesses and addictions, the National Council is committed to all Americans having access to comprehensive, high-quality care that affords every opportunity for recovery. The National Council introduced Mental Health First Aid USA and more than 1 million Americans have been trained. For more information about the National Council, please visit www.TheNationalCouncil.org.