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Publié par | ictea0 |
Nombre de lectures | 19 |
Langue | English |
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Screening, Brief Intervention &
Referral to Treatment (SBIRT)
An Overview
Bonnie McRee, PhD, MPH
Department of Community Medicine & Health Care
University of Connecticut School of Medicine
mcree@up.uchc.eduz
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University of Connecticut
Health Center Partners
Provide training and program evaluation for the
CT SBIRT initiative
Over 25 years of conducting screening and brief
intervention clinical trials, implementation
programs and evaluation efforts
Participate in WHO working groups to develop
screening instruments and brief intervention
protocols for at-risk substance usez
z
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Program Rationale
Use of tobacco, alcohol and other drugs is a
leading cause of preventable death in the
U.S.
Most affected individuals receive no
treatment
Early identification and intervention works
The CT SBIRT Program is putting early
intervention into practicez
z
Actual Causes of Death in the
Actual
United States
Modifiable risk factors are the leading causes of
mortality in the U.S.
– Tobacco use (18%)
– Poor diet and physical inactivity (17%)
– Alcohol consumption (3.5%)
Other actual causes: microbial agents, toxic agents, motor
vehicle crashes, firearms incidents, sexual behaviors and
illicit use of drugs.
Mokdad, Marks, Stroup & Gerberding. (2004);
JAMA, 291, 1238-1245.z
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National Survey on Drug Use
and Health (NSDUH, 2010)
Current use
– Cigarettes: 58 million (23%)
– Binge drinking: 58 million (23%)
– Marijuana: 17 million (7%)
– Prescription drugs (non-medical): 7 million (3%)
Abuse or dependence: 22 million (9%)
– Received treatment: 2 million Alcohol Use and Related Problems
Dependent
At Risk
Lower Risk
AbstainersAt-Risk Drinking-
Per Occasion Per Week
Men >4 drinks >14 drinks
Women >3 drinks >7 drinksSubstance Abuse - DSM IV-
Maladaptive pattern of use leading to impairment
as manifested by at least one:
– Recurrent use resulting in failure to fulfill role obligations at
work, school or home
– Recurrent use in physically hazardous situations
– Recurrent substance-related legal problems
– Continued use despite having persistent or recurrent social or
interpersonal problems caused or exacerbated by the effects
And does not meet criteria for DEPENDENCESubstance Dependence - DSM IV-
Maladaptive pattern of use leading to impairment
as manifested by three or more:
– Tolerance
– Withdrawal
– Using more and/or using for longer times
– A desire or repeated attempts to cut down
– Lots of time using or recovering
– Reduced activities: social, work, recreation
– Recurrent use despite physical and psychological problemsz
What is SBIRT?
Screening is method for identifying
someone at risk for a condition
– Validated assessments include ASSIST,
AUDIT, DAST, FTND
– Screening score provides an assessment of
patients’ risk levels (lower, moderate, high)
– Health Educator conducts screening in general
medical, dental or other departments