Integrating Substance Use Disorder Services with Primary Care: The Experience in California

Abstract

Integrating substance use disorder (SUD) services with primary care (PC) can improve access to SUD services for the 20.9 million Americans who need SUD treatment but do not receive it, and help prevent the onset of SUDs among the 68 million Americans who use psychoactive substances in a risky manner. We lay out the reasons for integrating SUD and PC services and then explore the models used and the experiences of providers as they have begun SUD/PC integration in California.

A time and motion study of Screening, Brief Intervention, and Referral to Treatment implementation in health‐care settings

“…Because many people who engage in harmful substance use receive care in general health-care settings [1], there is an opportunity to identify patients engaging in risky use and to provide them with the appropriate level of care. Major bodies that guide medical decision-making in the United States have promoted implementing screening and brief intervention (SBI) in medical settings.…”

An Examination of the Workflow Processes of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) Program in Health Care Settings

“…Since its initiation, almost 1.6 million patients have been screened as part of the SBIRT program (SAIS, 2014). To date, SBIRT programs have been implemented in emergency departments (EDs) (Bernstein et al, 2009;Désy & Perhats, 2008;Higgins-Biddle, Hungerford, & Cates-Wessel, 2009;Mello et al, 2009;Parker, Libart, Fanning, Higgs, & Dirickson, 2012), inpatient clinics (Cruz, 2013;Groves et al, 2010), ambulatory clinics (Fleming, 2004;Padwa et al, 2012), and school-based settings in urban and rural areas (Gonzalez et al, 2012;Gryczynski et al, 2011).…”

The Cost-effectiveness of Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Emergency and Outpatient Medical Settings

“…The U.S. Preventive Services Task Force recommends that clinicians provide alcohol screening and brief intervention (SBI) to adult patients (Moyer, 2013). The Institute of Medicine, the Office of National Drug Control Policy, and the National Prevention Council have called for the integration of services designed to address substance misuse into primary care (Padwa et al, 2012). The American College of Surgeons Committee on Trauma requires that level I and II trauma centers screen for alcohol misuse, and level I trauma centers provide brief interventions (American College of Surgeons Committee on Trauma, 2007).…”