Alcohol screening and brief interventions in medical settings can significantly reduce
alcohol use. Corresponding data for illicit drug use is sparse. A Federally funded
screening, brief interventions, referral to treatment (SBIRT) service program, the
largest of its kind to date, was initiated by the Substance Abuse and Mental Health
Services Administration (SAMHSA) in a wide variety of medical settings. We compared
illicit drug use at intake and 6 months after drug screening and interventions were
administered.
SBIRT services were implemented in a range of medical settings across six states.
A diverse patient population (Alaska Natives, American Indians, African-Americans,
Caucasians, Hispanics), was screened and offered score-based progressive levels of
intervention (brief intervention, brief treatment, referral to specialty treatment).
In this secondary analysis of the SBIRT service program, drug use data was compared
at intake and at a 6-month follow-up, in a sample of a randomly selected population
(10%) that screened positive at baseline.
Of 459,599 patients screened, 22.7% screened positive for a spectrum of use (risky/problematic,
abuse/addiction). The majority were recommended for a brief intervention (15.9%),
with a smaller percentage recommended for brief treatment (3.2%) or referral to specialty
treatment (3.7%). Among those reporting baseline illicit drug use, rates of drug use
at 6-month follow-up (4 of 6 sites), were 67.7% lower (p<0.001) and heavy alcohol
use was 38.6% lower (p<0.001), with comparable findings across sites, gender, race/ethnic,
age subgroups. Among persons recommended for brief treatment or referral to specialty
treatment, self-reported improvements in general health (p<0.001), mental health (p<0.001),
employment (p<0.001), housing status (p<0.001), and criminal behavior (p<0.001) were
found.
SBIRT was feasible to implement and the self-reported patient status at 6 months indicated
significant improvements over baseline, for illicit drug use and heavy alcohol use,
with functional domains improved, across a range of health care settings and a range
of patients.