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SBIRT: A Timely Response to Ohio’s Explosive Addiction Problem

Congratulations to the Center for Community Solutions and the Mental Health and Addiction Advocacy Coalition for issuing a much needed report By the Numbers 3: Developing a Common Understanding of the Future of Behavioral Healthcare, Analysis of Alcohol and Other Drug Treatment in Ohio (7/27/15). The report analyzes data from the 2013 National Survey on Drug Use and Health (NSDUH) and documents publicly funded expenditures on treatment for alcohol and drug addiction.  There was one particular fact in the report that really got my attention. Based on the NSDUH less than ten percent of people who are misusing or dependent on illicit drugs are receiving treatment, and just over five percent of people misusing or dependent on alcohol are being treated. (Report, page 1).

And here is the unfortunate dilemma. People with addiction are waiting in line in the public system for treatment. We must significantly ramp up the availability of treatment to ensure people are getting the care they need. At the same time, we have to redouble our efforts to prevent addiction.  It’s time to set aside the perennial struggle between “treatment” and “prevention” for scarce substance use dollars and start looking at the whole person and the whole society. 

The brain science is clear, addiction is a disease.  Like other chronic diseases, early detection is more cost effect than waiting for a problem to escalate, allows for more successful treatment and can save lives. Screening, Brief Intervention and Referral to Treatment (SBIRT) is a set of tools that can help adults and youth eliminate or reduce problem drinking and drug use, before they even get to the stage of addiction. 

A few simple, age appropriate questions by trained professionals such as a school nurse, doctor or counselor can open the door to a conversation – a conversation about drugs, alcohol or both.  There are good tools available that help professionals ask teens or adults about their substance use, such as the CRAFFT, NIDA Quick Screen, and the Drug Abuse Screening Test (DAST). A professional may use a counseling technique called motivational interviewing to help a person strategize how they can reduce or eliminate substance use.  If a serious problem exists, the professional would refer to a provider specializing in addition treatment.  

UHCAN Ohio is currently approaching school districts about considering the introduction of SBIRT into their high and middle schools.  Ohio Mental Health and Addiction Services (OMHAS) with a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) continues to reach out to medical practices to introduce SBIRT.  Hospitals are using SBIRT in the emergency room, and at least one juvenile court in Ohio is using SBIRT.  There’s so much more that can be done to help young people in Ohio avoid addiction and choose healthy paths.  As long as we put aside the false prevention/treatment dichotomy and roll up our sleeves.

Kathleen Gmeiner

Project Director, Somebody Finally Asked Me!

kgmeiner@uhcanohio.org

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