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Research Summary

Alcohol and Other Drug Use Decreased During a Statewide Screening and Brief Intervention Program

As part of New Mexico’s SAMHSA*-funded initiative to provide screening, brief intervention, and referral to treatment (SBIRT), >55,000 adult patients statewide were screened for alcohol and past-year illicit or nonmedical prescription drug use. Behavioral health counselors assessed patients with AUDIT† scores >8 or with affirmative answers to questions regarding illicit or nonmedical prescription drug use, then conducted either brief intervention (BI) or a more intensive service (brief treatment [BT] or referral to treatment [RT]). Of the randomly selected 1290 adult patients who received services, 834 (69%) were available for 6-month follow-up. Pre-/post-analyses were adjusted for confounders and baseline substance use.

  • Overall, mean days of past-month substance use decreased regardless of service received (alcohol use from 7.2 to 4.3 days, alcohol intoxication from 5.5 to 3.1 days, and illicit drug use from 6.4 to 2.9 days).
  • Past-month alcohol use decreased by 32% in the BI group and 47% in the BT/RT group; past-month drinking to intoxication decreased by 30% in the BI group and 47% in the BT/RT group; and past-month use of illicit drugs decreased by 52% in the BI group and 60% in the BT/RT group.

*SAMHSA=Substance Abuse and Mental Health Services Administration.
†AUDIT=Alcohol Use Disorders Identification Test.

Comments:

Although the aim of this study was to compare the impact of BI versus BT/RT, to me the most important finding was that SBIRT could be implemented in health centers across an entire state and across a range of severity of alcohol and drug use problems. And, it appeared to be effective. This is a promising real-world, primary-care–based model for implementing SBIRT as long as well-trained behavioral health counselors are available. On the other hand, since the effects of BI in high-quality randomized trials are much smaller than the dramatic decreases observed here, caution should be used in interpreting the findings. Hillary Kunins, MD, MPH, MS

Reference:

Gryczynski J, Mitchell SG, Peterson TR, et al. The relationship between services delivered and substance use outcomes in New Mexico's Screening, Brief Intervention, Referral and Treatment (SBIRT) Initiative. Drug Alcohol Depend. 2011;118(2-3):152–157.

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