SBIRT is used to screen for and reduce alcohol and other drug use problems among people. It also links people with addiction support and treatment services. Usually SBIRT is provided in primary care settings.
This study, published in the journal Addiction, looked at how SBIRT for alcohol and other drug use problems works with patients already undergoing treatment for mental health conditions. The study is important because people with mental health conditions are at substantially greater risk for alcohol and other drug use problems. Additionally, substance use can interfere with the course of mental health treatment.
The study addresses important questions about the implementation and effectiveness of SBIRT among underserved patients with co-occurring psychiatric disorders.
The study included 718 patients who were 18 years of age or older, with a current psychiatric disorder diagnosis and had an alcohol or other drug use problem.
Researchers used block randomization method to group participants. They were first grouped according to primary psychiatric disorder, primary substance of use (alcohol vs. cannabis or stimulants), and gender. Then randomized into the SBIRT group or the control group which was Health Education.
The study sites were two mental health treatment settings in Ventura (community-based outpatient clinics) and Los Angeles counties (university-based healthcare settings), California.
In the SBIRT group, the clinicians used the WHO ASSIST measure to screen alcohol, cannabis, and stimulant use severity. Those who scored in the moderate or high-risk range received brief intervention. Those who scored in the high-risk range also received a referral to specialty substance use treatment.
The Health Education group participants received health education focused on health and wellness, and was not specific to substance use.
Researchers gathered data at baseline, three, six, and 12 months to evaluate changes in alcohol, cannabis, and stimulant use, and rates of referral to treatment.
Alcohol use reduced with SBIRT
The study found that compared to the control group those who underwent SBIRT reduced their alcohol and stimulant drug use by three months. The improvements were sustained at six months and 12 months.
The study did not find a reduction for cannabis use after SBIRT. Neither did it find any results indicating greater engagement with substance use treatment. The researchers suggest further investigation to explore the reasons.
The positive findings coupled with the brevity and ease of implementation of SBIRT show promise regarding the efficacy of SBIRT.
These findings are specifically important considering the significant unmet mental health and substance use treatment need among patients with co-occurring substance use and other psychiatric disorders.
The study findings have four fold implications:
- SBIRT can be helpful for individuals and families seeking recovery to achieve lasting reductions in their alcohol and other substance use.
- SBIRT is important for treatment professionals and treatment systems when designing interventions for people who have co-occurring mental health and substance use problems.
- The findings also add to the research base showing efficacy of SBIRT.
- The study proves that ongoing investment in SBIRT initiatives in psychiatric clinics is worthwhile given its potential to reach patients who might not otherwise receive substance use intervention, or know about recommended treatment options.