Screening, Brief Intervention & Referral to Treatment in a Rural Ryan White Part C HIV Clinic

About 24% of people living with HIV nationally are identified as needing treatment for alcohol or illicit drug use. Screening, Brief Intervention, and Referral to Treatment (SBIRT) has evolved as a strategy to assess and intervene with substance abuse behaviors in various clinical settings. However, less is known about the processes and outcomes of using the SBIRT intervention in outpatient HIV clinics. 

This paper presents a descriptive analysis of de-identified existing SBIRT results data from an outpatient HIV clinic located in western Colorado. From 2008 to 2013, a total of 1616 SBIRT evaluations were done, which included duplicate patients because some individual patients were screened more than once in a given year. 

Over this time period, 

• 37-49% of encounters per year were notable for tobacco use, 
• 8-21% for alcohol use, 
• 6-16% for marijuana use, 
• 3-9% for amphetamine use, and 
• 0-2% for illicit opioid use. 

Unique, unduplicated patient data from 2013 revealed 40% of patients used tobacco, 16% used alcohol, and 11% used methamphetamine. Analyses highlighted that the majority of our patient population (58% in 2013) used and/or abused tobacco, alcohol, and/or illicit substances. An alarming finding was the increase in methamphetamine use over time with more than 50-fold prevalence of use in our population compared to national rates.

Purchase full article at:   http://goo.gl/SFA5E4

By:  Graham LJ1,2, Davis AL2, Cook PF1, Weber M1.

• 1 College of Nursing , University of Colorado , Aurora , CO , USA.
• 2 St. Mary's Hospital and Medical Center , Grand Junction , CO , USA. 
• AIDS Care. 2016 Apr;28(4):508-12. doi: 10.1080/09540121.2015.1110235. Epub 2015 Nov 7.

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                                                                                  HIV-infected H9 T Cell RF

mHealth Tool for Alcohol Use Disorders among Latinos in Emergency Department

Latino drinkers experience a disparate number of negative health and social consequences. Emergency Department Alcohol Screening Brief Intervention and Referral to Treatment (ED-SBIRT) is viable and effective at reducing harmful and hazardous drinking. However, barriers (e.g. readily available language translators, provider time burden, resources) to broad implementation remain and account for a major lag in adherence to national guidelines. We describe our approach to the design of a patient-centered bilingual Web-based mobile health ED-SBIRT App that could be integrated into a clinically complex ED environment and used regularly to provide ED-SBIRT for Spanish speaking patients.

Below:  AB-CASI Language Selection Screen

Below:  AB-CASI Frequency of Drinks Screen

Below:  Architecture of ED-SBIRT Mobile App Bilingual Text-to-Speech Generation

Below:  AB-CASI Ruler Screen

Full article at:   http://goo.gl/3r2GIa

By:  Fuad Abujarad and Federico E. Vaca

Department of Emergency Medicine Yale University, School of Medicine New Haven, Connecticut

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Integrating Intervention for Substance Use Disorder in a Healthcare Setting: Practice & Outcomes in New York City STD Clinics

OBJECTIVE:

This article reports the integration and outcomes of implementing intervention services for substance use disorder (SUD) in three New York City public sexually transmitted disease (STD) clinics.

METHODS:

The screening, brief intervention, and referral to treatment (SBIRT) service model was implemented in the STD clinics in 2008. A relational database was developed, which included screening results, service dispositions, face-to-face interviews with 6-month follow-ups, and treatment information.

RESULTS:

From February 2008 to the end of September 2012, 146 657 STD clinic patients 18 years or older were screened for current or past substance use disorders; 15 687 received a brief intervention; 954 received referrals to formal substance abuse treatment; 2082 were referred to substance abuse support services such as Alcoholics Anonymous (AA), and 690 were referred to mental health, social or HIV awareness services. Intervention services delivered through SBIRT resulted in improvements in multiple outcomes at 6 month follow-up. Patients who received interventions had reduced SUD risks, fewer mental health problems, and fewer unprotected sexual contacts.

CONCLUSION:

Delivery of SUD services in a public health setting represents a significant policy and practice change and benefits many individuals whose SUDs might otherwise be overlooked. Intervention services for substance use disorder were integrated and highly utilized in the STD setting. Further research needs to focus on the long-term impact of SUD interventions in the STD setting, their cost effectiveness, and the extent they are financially sustainable under the new healthcare law.

Purchase full article at:  http://goo.gl/jVWwX6

By:  Yu J1, Appel P2, Rogers M3, Blank S3, Davis C4, Warren B5, Freeman A4, Harris B2, Hussain S2.

• 1 School of Social Welfare , University at Albany, State University of New York, Albany , New York , NY , USA.
• 2 New York State Office of Alcoholism and Substance Abuse Services, Albany , New York , NY , USA.
• 3 New York City Department of Health and Mental Hygiene , Bureau of STD Control, Long Island City , New York , NY , USA.
• 4 The Lesbian, Gay, Bisexual & Transgender Community Center , New York , NY , USA.
• 5 Mount Sinai Health System , Office of Diversity and Inclusion , New York , NY , USA.

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