Prescription Drug Abuse Prevention & -Early Intervention (SBIRT)

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1 Prescription Drug Abuse Prevention & -Early Intervention (SBIRT) Barry R. Donovan, Ph.D. NYS OASAS Bureau of Prevention Services Research Application Unit

2 Substance Abuse Prevention What do Heroin, Rx Opiates, Alcohol, Marijuana and Cocaine all have in common? All effect the pleasure center of the brain: the walnut-shaped nucleus accumbens.

3 Rx Painkillers The body of research on risk and protective factors that specifically predict Rx Painkiller abuse is relatively meager (SAMHSA, NE CAPT, 2014 webinar). We do know that as the addictive disease process progresses, addicts will use heroin, Rx opiates, alcohol, benzodiazepines, whatever mitigates withdrawl symptoms and stimulates the brain s pleasure center.

4 NYS Youth Survey More Risk and Less Protection Predicts Greater Prevalence of Marijuana Use Distribution of Risk Factors in Population Recent Youth Marijuana Population Use 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 42% Drop in Use 14% Number of Risk Factors Number of Protective Factors NYS OASAS, Youth Survey, 7-12th grade students, n = 41,540. Recent Use = Past 30 days.

5 Institute of Medicine Pop. Continuum

6 Environmental Strategies 1. Develop/Improve Laws, Regulations & Policies to Reduce Availability 2. Improve Enforcement of Laws & Regulations to Reduce Availability 3. Social Norm Change (media campaigns) 6

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15 What is SBIRT? SBIRT is a universal, selective, and indicated prevention and treatment strategy designed to intervene based on patient need and prevent/treat substance use problems at various levels. 15

16 Primary Goal The primary goal of SBIRT is to identify those who are at moderate or high risk for psycho-social or health care problems related to their substance use choices. The primary goal of SBIRT is not to identify those who are dependent and need higher levels of care. 16

17 Other Goals of SBIRT? (continued) Improve linkages among Healthcare and SUD providers Improve identification of substance misuse Decreased cost related to substance abuse problems Enhance treatment access within the recommended levels of care 17

18 SBIRT Breakdown SAMHSA s SBIRT Grants reported over for 459,000 patients screened: o 23% Screened Positive 16% Received Brief Intervention 3% Brief Treatment/Intensive Interventions 4% Referred to Treatment 18

19 Patient Outcomes Follow Up at 6 months: 50% hadn t had a drink in 30 days. More than 50% of those using illicit drugs had stopped that behavior. 74% of high-risk individuals reported lowering their drug or alcohol consumption after one or more BI or BT sessions. 19

20 SBIRT Saves Money Researchers found that every dollar invested in SBIRT saved $4.30 in future health care costs. Texas report revealed SBIRT saved more than: o o o $4 million in the year after the patients received services. Emergency room usage dropped. Shift from inpatient to outpatient treatment Washington State program reported savings in Medicaid of approximately $2,000,000 for each 1000 Medicaid patients with a significant portion attributable to reductions in re-hospitalizations 20

21 Evidence Based Alcohol and Substance Use Screening Instruments Evidence Based Screening Instruments AUDIT- 10 Questions Focuses on Alcohol Use DAST - 10 Questions Focuses on Drug Use ASSIST- 8 Questions Focuses on both AOD CRAFFT 6 Questions Focuses on both AOD Adolescent Screen OASAS SBIRT website:

22 Teen Intervene Teen Intervene is an evidence-based program (EBP) for adolescents (twelve to nineteen years old) experiencing mild to moderate problems associated with alcohol or other drug use. The program may also include the participation of teens parents or guardians. Can be administered in 2-6 sessions. Designed for trained professionals, including teachers, school counselors, social workers, etc. Helping professionals do not have to be trained counselors for the intervention to be effective.

23 Teen Intervene (cont ) Forms and worksheets guide interaction between the adolescent and staff member. Teen Intervene has been shown to: o o o o o Reduce Number of days of use of alcohol and marijuana; Reduce Number of alcohol abuse and alcohol dependence symptoms; Reduce Number of cannabis abuse and dependence symptoms; and Reduce Consequences related to alcohol and drug use. Increase abstinence rates for both alcohol and marijuana. The results were more positive if the parents/guardian were involved.

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