1 Screening, Brief Intervention and Referral to Treatment (SBIRT) for Substance Use: A Public Health Approach Joan Dilonardo, Ph.D., R.N
2 What is SBIRT? Some definitions Screening: a preliminary systematic procedure to evaluate the likelihood that an individual has a substance use condition ( at risk of negative consequences or SA abuse/dependence). Brief Intervention: time limited effort to provide brief information or advice, increase motivation to avoid substance use, or assist the patient in learning behavior change skills Referral to Treatment: efforts to motivate and facilitate patients whose SA condition may be appropriate for specialty care.
3 Levels of Alcohol/Drug Conditions Dependence a cluster of behavioral, cognitive, and physiological symptoms that develop after repeated use ( Addicts, alcoholics) Harmful Use use causes some harm (physical/ mental/social) Hazardous Use use causes elevated risk (no harm [ yet]) 3
5 Why SBIRT? Prevalence of Alcohol and Illicit Drug Use About 9% of the US population (age 12 and older) (22.6 million) Americans - illicit drug users. (NSADUH) 2010) Slightly more than 50% drink alcohol. 23% (58.6 million)- at least one episode of binge drinking (5+ drinks on one occasion) About 7% - heavy drinking (5+drinks X 5 days last 30 days)
6 Why SBIRT? Substance Use Conditions Are Costly Total overall costs in the US including productivity, and health and crime related costs: $181 billion for illicit drugs $235 billion for alcohol Does not include family disintegration, employment loss, school failure, domestic violence or emotional impact on family.
7 Prevention Paradox Large group of patients with a (relatively) less severe problem may lead to more total harm (because there are a lot of them) in comparison to a small group of patients with severe problems. Some significant amount of harm reflected in economic estimates are from the at risk users
8 Why SBIRT? Prevalence of binge drinking in STD clinic population Adolescents and young adults (15-24) attending an STD clinic: Women Men Binge drinking: 39.6% 48% ( Cook et al, 2006) Abuse/depend 23.6% 33% Hutton et al. study in STD clinic also found high rates of binge drinking among women (30)% and men (42%); for women relationship between binge drinking, risky sexual behavior, and gonorrhea.
9 Why SBIRT? SA often treated as different than other medical conditions? Tend to think about substance abuse problems as severe addicts/alcoholics. Substance use conditions occur across a continuum of severity, just like most other medical conditions. But we often wait until problem is severe for identification and treatment. 9
10 Why SBIRT? Treatment Receipt and Perceived Need: Alcohol or Illicit Drugs, % 5% Treated Not treated/perceived need 84% Not treated/no perceived need Persons aged 12 and over needing treatment. (NSDUH, 2010)
11 Why S-BIRT? Rreach patients with a range of substance abuse conditions and provide an appropriate level of care. Unrecognized substance abuse may compromise a patient s self care ability and lead to an increase in non-compliance and poor outcomes across myriad disorders. Early recognition and brief intervention is clinically and cost effective. 11
12 Integrated Spectrum of Users and Services Prevention Intervention Treatment Non-Users and At-Risk Abuse Dependence Low Risk Users Disorder Disorder Users Assessment, Treatment, Support Brief Intervention and Boosters Education, Information (Brief Advice) and Boosters
13 Why SBIRT? Substance Use and Family Planning 25% if sexually active 9-12 th grade students reported using alcohol or drugs during their last sexual encounter: Males:31%; Females 19% Adults aged 18 to 30 there is a relationship between heavy drinking and having sex: 35% of men were drinking heavily (5-8 drinks) when having sex, and 39% of women. Substance use and unintended pregnancies often occur within the same populations. 55% of teenagers say that having sex while drinking or using drugs is often a reason for unplanned teen pregnancies. Use of illicit drugs can suppress menstruation. 13
14 Why SBIRT? Substance Use and Contraception Crack, cocaine, or injecting drug use is associated with inconsistent condom use, among women both HIV positive (27%)and negative women (35%). Female substance users may not use contraception as much as non substance abusing women.
15 Why SBIRT? Results from studies Recipients of intervention reduced their alcohol consumption an average of 13% to 34% when compared with controls. (Whitlock, 2004, USPTF) Not as many studies for effect on illicit drug use; and findings not universal, but shows promise. Positive findings for reductions after brief intervention for cocaine and heroin use (Bernstein et al, 2005) and methamphetamine (Baker et al, 2005), and cannabis (McCambridge &Strang, 1999)
16 SBI Effectiveness ACOG Committee Opinion: Dec 2008 Obstetrician-gynecologists have an ethical obligation to learn and use a protocol of universal screening questions, brief intervention, and referral to treatment in order to provide patients with medical care that is state-of-the-art, comprehensive and effective. Cost effective prevention activity endorsed by the US Preventative Services Task Force as high priority and cost effective- in the top 5 of recommended prevention activities. (as effective as flu shots for the elderly and cholesterol reduction). Also required for Level I Trauma Center Accreditation.
17 SBIRT has been implemented in Medical Care and Other Settings Primary care and Trauma centers, Emergency services, urgent care Trauma inpatient, medical surgical, other inpatient Obstetrical outpatient services, STD clinics Dental services, breast exam clinics, adolescent clinics, social service agencies, school based health 17
18 Summary Substance use problems occur along a continuum of severity. An efficient treatment system matches persons to the most appropriate and lowest level of care needed at the lowest cost. Improving identification in healthcare settings is key to creating greater efficiencies. 18
19 SBIRT Steps
21 Unhealthy Use of Alcohol/Illicit Drugs (Screen Positive) NIAAA Guidelines Pregnant women 0 drinks Illicit Drug Use: Any
22 Screening for Drugs/Alcohol in Medical Settings Asking/answering questions is normal and expected. Adding questions on alcohol drug use normalizes the conversation. Self-report screening is quick, accurate, and inexpensive. May be combined with screening for tobacco, other health risk factors. 22
23 Screening for Drugs/Alcohol in Medical Settings Many written screening tools exist; see list at end. Some one question screens. Can be done via paper/computer while waiting or orally prior to or during visit. A variety of clinic staff can participate in screening. Good screens distinguish risk levels but all SBIRT is not equal. Tolerated well by patients.
24 Screening Tool: Audit C: Questions Scoring system Your score How often do you have a drink containing alcohol? Never Monthly or less 2-4 times per month 2-3 times per week 4+ times per week How many units of alcohol do you drink on a typical day when you are drinking? How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? Never Less than monthly Monthly Weekly Daily or almost daily Score of 5+ = positive screen SCORE
25 Another Example: The CAGE
26 One Question Screens Alcohol Use How many times in the past year have you had X drinks or more in a day? X= 5 drinks for men, 4 for women. Positive screen for unhealthy alcohol use = 1 or more ( provide BI) (Barclay, Laura, 2009, Single Screening Question may accurately identify unhealthy aloohol use, J Gen Intern Med. Drug Use How many times in the past year have you used an illegal drug or used a prescription medication for non-medical reasons? Positive screen = 1 or more ( Smith PC, Schmidt SM, Allenworth-Davies D, Saitz R. 2010, A Single Question Screening Test for Drug Use in Primary care, Arch Internal Medicine 170:
27 Bring up the subject and provide screening feedback
28 Motivational Interviewing Ask patient for permission to discuss problems. Avoid arguments, and being judgmental. Help patients understand discrepancy between behavior and their goals, using personalized feedback Use empathy, reflective listening and support self-motivation. Endorsed as one approach to behavior change by ACOG Committee Opinion: Jan 2009
29 Step 1: Introduce the subject Get the patient s agreement to talk about the alcohol or drug use Can we take just a few minutes to talk about your alcohol/drug use?...or I d like to take a few minutes to talk about your [alcohol or drug] use Is that OK? Explain how understanding their alcohol/drug use is important to their getting good care. Your use of alcohol can compromise your ability to use contraception so it s important to talk about
30 Step 2: Provide Feedback From what I understand about your drinking Compare with guidelines Illicit Drugs 0
31 Provide Feedback to All Screens Healthy levels of alcohol/drug use: You are doing well with using alcohol within the healthy guidelines. Since you don t drink alcohol or use drugs, you don t have to worry about how those things will affect your choices about sexual behavior. Unhealthy levels of alcohol /drug use: Here are the guidelines for healthy use; where does yours fall?
32 Adopt and reflect the patient s view Talk about the pros and cons and context of their use/abuse What is it that alcohol does for you? What negatives might happen sometimes? Does your partner object to your use? Are you more likely to over use in particular situations? Restate and reflect what the patient says.
33 Step 2: Provide Feedback for the At-Risk User Any connection to the purpose of the visit? What connection (if any) do you see between your drinking and this visit? If the patient sees a connection: Reflect what they have just said. If the patient does not see a connection: Help make a connection with facts; use this as a teaching opportunity It s not uncommon for people to have more trouble with using protection when they are drinking or using drugs. Alcohol may lead to your making different decisions about sexual activity than you otherwise might..
34 Brief Intervention
35 Step 3: Enhance Motivation: Ask the patient to self assess: On a scale of 1-10 (1 being not ready and 10 being very ready) how ready are you to change any aspect your drinking patterns?
36 Step 3: Enhance Motivation If patient indicates he/she is ready for change: > 2 : Why did you choose that number and not a lower one? What are some reasons that you are so motivated to change. If patient indicates she is not ready for change: < 1: Have you ever done anything that you wish you hadn t while drinking?: What would make this a problem for you?. Discuss pros and cons
37 Step 3: Enhance Motivation Develop Discrepancy Explore Pros and Cons Help the patient identify the discrepancy between present behavior and important goals. Use the discrepancy as a change motivator. Let the patient name the problem and offer solutions.
38 Patient Readiness Ready patient: encourage to name own solution, choose course of action, and how to do it. Not ready for change patient: offer information, support and further contact, present feedback unless patient refuses, what would it take to consider changing? Unsure patient: don t go faster than the patient or interpret unsureness as not ready for change. Help patient identity pros and cons.
39 Step 4: Negotiate and Advise Reinforce what the patient has stated are her goals. So you would like to reduce your drinking to prevent. Negotiate the goal/elicit a response What is the next step? How can you cut down? Give advice If you can stay within the limits you just mentioned you will be more likely to stay within your sexual comfort zone.. Summarize This is what I heard you say..
40 Reinforcement Some provide patient with written contract with self to cut down use. Some schedule follow-up booster with patient; others focus patient on when they will next be seen and how they will talk then about how patient did with goal. Others provide follow-up by telephone.
41 Referral to Treatment
42 Referral to Treatment: Treatment is effective for many people; types of treatment. Suggest primary care follow up or referral may be helpful Social worker, Psychiatric services Discharge sheet of possible centers and / or programs and information Where appropriate, well developed programs may do warm hand-off, or implement other actions to improve likelihood of treatment receipt.
43 Reimbursement for SBIRT
44 SBIRT Reimbursement Medicaid codes for SBIRT* H0049 for Alcohol/Drug Screening H0050 Alcohol and/or Drug service, brief intervention, 15 minutes. Must be adopted by individual states within state plans :??? YOUR STATE??? Some States have adopted these; levels of use still unclear. * Some states use other codes: SBI in 10 States; SBIRT in
45 SBIRT Reimbursement Medicare SBIRT Codes: G0396: Alcohol and/or substance abuse structured screening and brief intervention services; 15 to 30 minutes G0397: Alcohol and or substance abuse structured screening and brief intervention services, greater than 30 minutes
46 SBIRT Reimbursement Like other medical billing, a lot of small issues emerge, especially with new codes. Same day billing for physical health and behavioral health services may be a problem in some states and settings. Issue of who performs the service??? Need to meet the requirements of the payer. See reimbursement guide reference at end.
47 Conclusion Alcohol and drug problems are common, identifiable and treatable conditions in a variety of medical settings. Knowledge and skills for screening and intervention can be learned. Reimbursement may be available. Integration of behavioral health with physical health takes on new meaning with health reform: accountable care organizations and health homes.
48 Additional Information Screening for Drug Use in General Medical Settings: Quick Reference Guide. guide.pdf Screening for Alcohol Use: ningtrainingmaterials/cme_ce.htm Screening tools: documents/appendices_b-c-d-e.pdf
49 Additional Information SAMSA-HRSA Center for Integrated Health Solutions: Implementing SBIRT in Community health and Community Behavioral Health Centers: or_integrated_health_solutions Screening adolescents: ontrainingmaterials/youthguide
50 Additional information SBIRT Billing and Reimbursement manual: dia/sbirt_manual.pdf SBIRT Training: Addiction Technology Transfer Centers: Alcohol focused: Ensuring Solutions (GW) ensuring_solutions_to_alcohol_problems.cfm
Screening, Brief Intervention, Referral, and Treatment (SBIRT) in Psychiatry Steve Martino, Ph.D. The SBIRT Training in Yale Residency Programs (SAMHSA 1U79Ti020253-01; PI: Gail D Onofrio, M.D.) At Issue
Doc 2 Doc Dial-in Discussion Series Session 3: Universal Screening for Unhealthy Alcohol and Other Drug (AOD) Use Learning Objectives: (1) Understand the concept of universal screening (2) Learn how to
Karla Ramirez, LCSW Director, Outpatient Services Laurel Ridge Treatment Center 1 in 4 Americans will have an alcohol or drug problems at some point in their lives. The number of alcohol abusers and addicts
Screening Patients for Substance Use in Your Practice Setting Learning Objectives By the end of this session, participants will Understand the rationale for universal screening. Identify potential health
SBIRT in Primary Care Settings José Esquibel SBIRT Project Director SBIRT Screening Brief Intervention and Referral to Treatment (SBIRT) is a public health approach to preventing risky substance use behavior.
Provider Training Behavioral Health Screening, Referral, and Coding Requirements Training Outline I. Behavioral Health Screening Requirements and Referrals II. Healthy Behaviors Substance and Alcohol Abuse
BRIEF SCREENING, INTERVENTION, AND REFERRAL The Problem According to the National Institute on Alcohol Abuse and Alcoholism 3 in 10 adults drink at levels that elevate their risk of physical, mental health,
Brief Screening, Intervention, and Referral for Alcohol and Opiate Disorders An Effective Three-Step Process Provider Guidelines The Problem According to the National Institute on Alcohol Abuse and Alcoholism,
Integrating Mental Health and Substance Use Services with HIV/AIDS Prevention Overview of Colorado SBIRT U.S. Conference on AIDS Orlando, Florida September 13, 2010 Presenter: Leigh Fischer, Program Manager
CAGE In the past have you ever: C tried to Cut down or Change your pattern of drinking or drug use? A been Annoyed or Angry because of others concern about your drinking or drug use? G felt Guilty about
The Need for Adolescent SBIRT in School-based Health Centers August 7, 2015 Marla Oros, RN, MS Substance Abuse: A National Public Health Problem There are over 22 million Americans who meet the medical
Tom Freese, PhD Sherry Larkins, PhD Clayton Chau, MD (Planner) - Medical Director Behavioral Services; L.A. Care Health Plan UCLA Integrated Substance Abuse Programs UCLA David Geffen School of Medicine,
Management of Substance Use in the Pregnancy Medical Home Setting Sara McEwen, MD, MPH Executive Director, Governor s Institute 1 Webinar Objectives Describe SBIRT approach to manage substance use in pregnancy
REVISED SUBSTANCE ABUSE GRANTMAKING STRATEGY The New York Community Trust April 2003 1 I. INTRODUCTION Substance Abuse is defined as the excessive use of addictive substances, especially narcotic drugs,
UTAH Adolescent Behavioral Health In Brief A Short Report from the Office of Applied Studies Adolescence (12 to 17 years) is a critical and vulnerable stage of human development, during which males and
Update December 2009 No. 2009-96 Affected Programs: BadgerCare Plus, Medicaid To: All Providers, HMOs and Other Managed Care Programs New Substance Abuse Screening and Intervention Benefit Covered by BadgerCare
Referral To Treatment for Drug & Alcohol Part I Geneva Sanford, MSW, LSW, LICDC Substance Abuse Coordinator Grant Medical Center 111 S. Grant Ave, 2nd FL. Columbus, Ohio 43213 (614) 566-9863 email@example.com
MICHIGAN Adolescent Behavioral Health In Brief A Short Report from the Office of Applied Studies Adolescence (12 to 17 years) is a critical and vulnerable stage of human development, during which males
The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures by R. Louise Floyd, DSN, RN; Brian W. Jack, MD; Robert Cefalo, MD, PhD; Hani Atrash, MD, MPH; Jeanne Mahoney, BSN,
Implementation of SBIRT onto Electronic Health Records: From Documentation to Data John R. McAteer, LCSW-R New York City Department of Health and Mental Hygiene Bureau of Alcohol and Drug Use Prevention,
"BARRIERS TO HIV PREVENTION AND CARE DUE TO CONSUMER SUBSTANCE ABUSE AND CHEMICAL DEPENDENCE PART II. BY PROFESSOR TERENCE MCPHAUL PSYCHOLOGY TELEVISION NETWORK (PSYCHTV ) Distinct Populations of Youth
The Goal of Substance Abuse Screening The goal of substance abuse screening is to identify individuals who have or are at risk for developing alcohol or drug-related problems, and within that group, identify
Impacts of an Urban Screening, Brief Intervention, and Referral to Treatment Program Kerry B. Broderick, BSN,MD Denver Health Medical Center Associate Professor of Emergency Medicine Team SBIRT Colorado
Questions asked on SBIRT TA Webinar Housekeeping Could you send out the link to download the updated SBIRT guidance document? The updated SBIRT guidance document is available online here: http://www.oregon.gov/oha/pages/cco-baseline-data.aspx
Workplace Substance Abuse Prevention What the Evidence Tells Us Rebekah K. Hersch, Ph.D. Royer F. Cook, Ph.D. ISA Associates, Inc. Focus of this Talk What is the scope of the problem of workplace substance
Substance Abuse Prevention and Intervention Programs for Adolescents Alcohol and Drug Abuse Programs December 20, 2013 School-Based Substance Abuse Services (SBSAS) Grants Awarded to 21 Supervisory Unions,
Alcohol Screening and Brief Interventions of Women Competency #2 Midwest Regional Fetal Alcohol Syndrome Training Center Competency 2: Screening and Brief Interventions This competency addresses preventing
Overview INITIATIVE New Hampshire Youth Screening, and Referral to Treatment Initiative The New Hampshire Youth Screening, and Referral to Treatment () Initiative of the New Hampshire Charitable Foundation
DrugFacts: Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please
Establishing a Programme of Screening and Brief Interventions for Alcohol in Primary Care Based on Sign 74 The Management of Harmful Drinking and Alcohol Dependence in Primary Care David M Greenwell Argyll
MVP/PREFERRED CARE GUIDELINE MVP/Preferred Care Clinical Guideline Overview Screening Adolescents for Alcohol and Substance Abuse in Primary Care MVP Health Care/ Preferred Care, as part of its continuing
Designing Clinical Addiction Research Richard Saitz MD, MPH, FACP, FASAM Professor of Medicine & Epidemiology Boston University Schools of Medicine & Public Health Director, Clinical Addiction, Research
VENTURA COUNTY ALCOHOL & DRUG PROGRAMS women s services Helping women recover (805) 981-9200 1911 Williams Drive, Oxnard, CA 93036 www.venturacountylimits.org recovery VCBH ALCOHOL & DRUG PROGRAMS WOMEN
Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use A Step-by-Step Guide for Primary Care Practices National Center on Birth Defects and Developmental Disabilities Suggested
Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas David Lakey, MD Commissioner, Department of State Health Services Lauren Lacefield Lewis Assistant Commissioner,
NC Perinatal & Maternal Substance Abuse Initiative NC Division of MH/DD/SAS Community Policy Management Best Practice Team Starleen Scott Robbins, LCSW Illicit drug use among pregnant women in the U.S.
Educating Patients on the Effects of Substance Use, Its Impact on Their Health and Linkages to Treatment LaTanya N. Townsend, LCSW-C SBIRT Program Manager Mercy Medical Center Substance Abuse a National
Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call the
C o n s u m e r Q & A 1 California Society of Addiction Medicine (CSAM) Consumer Q&As Q: Is addiction a disease? A: Addiction is a chronic disorder, like heart disease or diabetes. A chronic disorder is
OVERVIEW OF BRIEF INTERVENTION FOR RISKY SUBSTANCE USE IN PRIMARY CARE Prepared by CASAColumbia February 2014 Outline Introduction Three Key Steps Engage Motivate Plan Sample Videos 2 INTRODUCTION 3 Addiction
A NEW ANALYSIS: Recent Trends, Risk Factors and Consequences GIRLS AND DRUGS OFFICE OF NATIONAL DRUG CONTROL POLICY EXECUTIVE OFFICE OF THE PRESIDENT February 9, 2006 GIRLS BY THE NUMBERS In 2004, more
Alcohol and drug use is a medical issue. It s time we treated it like one. From asking comes answers Alcohol and drug use has been called America s number one public health concern. Drugs and alcohol directly
Name of Program/Strategy: Brief Alcohol Screening and Intervention for College Students (BASICS) Report Contents 1. Overview and description 2. Implementation considerations (if available) 3. Descriptive
Treatment Approaches for Drug Addiction NOTE: This is a fact sheet covering research findings on effective treatment approaches for drug abuse and addiction. If you are seeking treatment, please call 1-800-662-HELP(4357)
http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive
Understanding the Disease of Addiction & the Process of Recovery for Healthcare Clinicians and Staff Presented by John G. Gardin II, Ph.D., A.C.S. Chief Clinical Officer, ADAPT, Inc./SouthRiver CHC Basic
A PRELIMINARY EVALUATION OF SBIRT IMPLEMENTATION IN THE COLORADO STATE EMPLOYEE ASSISTANCE PROGRAM DECEMBER, 2010 FOR FURTHER INFORMATION, PLEASE CONTACT: MELISSA RICHMOND, PH.D. OMNI INSTITUTE 899 LOGAN
Medical College of Georgia Augusta, Georgia School of Medicine Competency based Objectives Medical Knowledge Goal Statement: Medical students are expected to master a foundation of clinical knowledge with
Vermont s Experience A Systematic Approach to Health Care Integration Barbara Cimaglio, Deputy Commissioner NASADAD 2015 Annual Meeting Background Goal of Health Care Reform Triple Aim: Better Population
Substance-Exposed Newborns State of Oklahoma 2013 Substance-Exposed Newborns State of Oklahoma 2013 Legal Background Federal guidelines in the Child Abuse Prevention and Treatment Act (CAPTA) require states
9. pg 166-169: Self-reported alcohol consumption pg 170-171: Childhood experience of living with someone who used drugs pg 172-173: Hospitalizations related to alcohol and substance abuse pg 174-179: Accidental
HEALTH MIDDLE SCHOOL ALCOHOL, TOBACCO, & OTHER DRUGS Standards & Benchmarks: 1:ALL; 2:1,2,3,4,6; 3:ALL; 6:1,3 Objective: = The students will explain the difference between responsible drug use and wrong
guideline for identification and treatment of alcohol abuse/dependence in primary care This guideline is informational in nature and is not intended to be a substitute for professional clinical judgment.
Systematic review: Alcohol screening and brief intervention in primary care: no evidence of efficacy for dependence Richard Saitz MD, MPH, FACP, FASAM Professor of Medicine & Epidemiology Boston University
Screening, Brief Intervention and Referral to Treatment Inside front cover Today, there are 23 million people in the United States who are either addicted to or abuse illegal drugs and alcohol. Over 95%
Substance Abuse The Nation s Number One Health Problem The Robert Wood Johnson Foundation A Health & Social Problem More Deaths Illnesses, and Disabilities than any other preventable health condition 1
Behavioral Health Barometer United States, 2014 Acknowledgments This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by RTI International under contract No.
Report to The Vermont Legislature Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report In Accordance with Act 179 (2014) Sec. E.306.2 (a)(1) Submitted to:
CHAPTER 2: Substance Use, Mental Disorders, and Access to Treatment Services in Household Surveys, 2002 2005 2.1 Introduction Drug misuse and abuse, and mental health disorders are major health and social
Women Entering Substance Abuse Treatment for the First Time: 10 Year Trends Prepared By: Stephan Arndt, PhD Director 2010 The University of Iowa Iowa Consortium for Substance Abuse Research and Evaluation
BREINING INSTITUTE 8894 Greenback Lane Orangevale, California USA 95662-4019 Telephone (916) 987-2007 Facsimile (916) 987-8823 On-line Continuing Education Course Material and Exam Questions Packet Course
Screening, Brief Intervention, and Referral to Treatment Core Curriculum Acknowledgments The material included in this course is based largely on the works of previously funded SAMHSA grantees. Other information
10 Colorado s winnable battles Flagship Priority: Mental Health and Substance Abuse ELEVATING HEALTH AND ENVIRONMENT Mental and emotional well-being is essential to shaping a state of health for Coloradans.
AUDIT The Alcohol Use Disorders Identification Test: Interview Version Read questions as written and record answers carefully. Begin the AUDIT by saying Now I am going to ask you some questions about your
SASKATCHEWAN NNADAP TREATMENT SERVICES APPLICATION FORM Revised June, 2009 VAN LOONVCONSULTING This application is the first step required to pre-screen applicants for adult treatment at any of the NNADAP
Preventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64 1. BMI - Documented in patients medical record on an annual basis. Screen for obesity and offer intensive counseling and behavioral
HEALTHY PEOPLE 2020 CORE INDICATORS FOR ADOLESCENT AND YOUNG ADULT HEALTH Short Title OUTCOME INDICATORS 1 SYSTEMS INDICATORS 1 HEALTH CARE Medical insurance wellness checkup Vaccine coverage among adolescents
www.cymru.gov.uk GUIDANCE ON THE CONSUMPTION OF ALCOHOL BY CHILDREN AND YOUNG PEOPLE From Dr Tony Jewell Chief Medical Officer for Wales GUIDANCE ON THE CONSUMPTION OF ALCOHOL BY CHILDREN AND YOUNG PEOPLE
Underage Drinking Underage drinking is a serious public health problem in the United States. Alcohol is the most widely used substance of abuse among America s youth, and drinking by young people poses
Substance Abuse Treatment and Child Welfare Robert Morrison, Executive Director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD) NASADAD Members Every state and territory
Maternal and Child Health Issue Brief Substance Abuse among Women of Reproductive Age in Colorado September 14 9 Why is substance abuse an issue among women of reproductive age? Substance abuse poses significant
Substance Abuse 214-215 Chapter 1: Substance Abuse 265 214-215 Health of Boston Substance Abuse Substance abuse involves the excessive use of alcohol or illicit substances (e.g., marijuana, cocaine, heroin,
Prepared by the Department of Health and Human Resources Bureau for Behavioral Health and Health Facilities OHIO COUNTY February 14 Behavioral Health Epidemiological County Profile Demographic Data Ohio
The SAOR Model for Screening and Initial Assessment The key components of the SAOR model are outlined below: Support Ask & Assess Offer Assistance Refer The support aspect of the intervention is guided
S - Screening BI Brief Intervention RT Referral to Treatment Continuum of Substance Use Severity ABSTAINERS and LOW-RISK USERS (70%) MODERATE TO HIGHER RISK 25% SEVERE and DEPENDENT (5%) Universal prevention
THE CENTER ON ALCOHOLISM, SUBSTANCE ABUSE, AND ADDICTIONS 25 years generating high quality prevention and treatment research University of New Mexico Barbara S. McCrady, Ph.D., Director CASAA exists because
SCREENING FOR INTIMATE PARTNER VIOLENCE IN THE PRIMARY CARE SETTING Partner violence can affect one third of the patients cared for in the primary care setting. The primary care setting offers an opportunity
State of Illinois Department of Human Services Division of Alcoholism and Substance Abuse OVERVIEW The Illinois Department of Human Services, Division of Alcoholism and Substance Abuse (IDHS/DASA) is the
Addressing the Needs of Patients Presenting with Substance Abuse or Suicide Risk in the Emergency Department A Toolkit for Emergency Department Staff Arizona Department of Health Services Division of Behavioral
Developing Recovery Communities: Treatment Plan Strategic Summary 2013/14 East Sussex Drug and Alcohol Action Team 1. The East Sussex Drug and Alcohol Action Team (DAAT) is the multi-agency partnership
2013 to 2002 States: United the in Use Heroin in Trends National Survey on Drug Use and Health Short Report April 23, 2015 TRENDS IN HEROIN USE IN THE UNITED STATES: 2002 TO 2013 AUTHORS Rachel N. Lipari,
Trauma Center Alcohol Screening and Intervention Michael Mello, MD, MPH Injury Prevention Center at Rhode Island Hospital /Hasbro Children s Hospital Disclosures I have no affiliations, sponsorship, financial
CASE STUDY: SPECIAL HEALTH RESOURCES OF EAST TEXAS Longview, Texas This project was funded by a grant from the Health Resources and Services Administration, U.S. Department of Health and Human Services,
Report to The Vermont Legislature Substance Abuse Treatment Services Objective and Performance Measures In Accordance with Act 179 (2014) Sec. E.306.2 Submitted to: Submitted by: Prepared by: Joint Fiscal
National Screening, Brief Intervention, and Referral to Treatment, Addiction Technology Transfer Center Presenters: Holly Hagle, PhD Director of the National SBIRT-ATTC and Eric Goplerud, PhD Senior Vice
Standardized Model for Delivery of Substance Use Services Attachment 5: Nebraska Registered Service Provider s Program Plan for the Delivery of Treatment Services Nebraska Registered Service Provider s
Pragmatic Evidence Based Review Substance Abuse in moderate to severe TBI Reviewer Emma Scheib Date Report Completed November 2011 Important Note: This report is not intended to replace clinical judgement,
Too Good for Drugs Curriculum Correlations Correlated with Oregon Health Education Standards High School, Revised Edition Lesson One: My Own Journey Demonstrate setting reachable goals (goals that are:
Barriers to treatment for alcohol dependence Sven Andréasson INEBRIA, Rome, Sep 19, 2013 Epidemiology: Alcohol problems in Sweden DSM IV based questions 5 7 dependence criteria 1,2 % 3 4 dependence criteria