April 16, 2013

Intervention Program Helps More Than 100 Substance Users

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An intervention program intended to curb substance use among at-risk substance users has helped more than 100 patients — including Cornell students — at Cayuga Medical Center since January, according to a Cayuga Addiction Recovery Services report released in March.

Known as Screening, Brief Intervention and Referral to Treatment, the program launched on Jan. 26, according to the report.

In the first step, “screening,” a trained health promotion advocate asks a patient a series of questions to assess the severity of his or her substance use. In the next stage, “brief intervention,”the advocate has a conversation with the patient to increase the patient’s awareness about substance use. The final stage, “referral to treatment,” provides those identified as needing more extensive treatment with access to specialty care, which may entail further contact with Cayuga Addiction Recovery Services or trips to Gannett Health Services.

In SBIRT’s first eight weeks, 143 patients were seen by a Cayuga Addiction Recovery Services health promotion advocate. 126 of those patients went onto screening, 100 went onto brief intervention, 66 received referral to treatment and 33 were connected to services, according to the report.

According to the Cayuga Addiction Recovery Services report, Cayuga Medical health promotion advocates said that, so far, the program has seemed to have a positive effect on participants.

“I’ve received a lot of positive feedback from college students I’ve met with in the [emergency room],” one advocate said in the report. “Some have reached out to me for follow-up support because their experience in the hospital was a real ‘wake-up call.’ They’ve been very thankful for the chance to talk with someone about what happened and learn what steps they can take to avoid future problems.”

The follow-up and referral aspect of the program makes an especially big difference, according to another advocate.

“One of the [nurses] helped me connect to a patient who had been in earlier in the night and had left before I arrived. With her help, I was able to contact him, and he is now in treatment. I thought it was also a great example of what a powerful partnership this can be,” the advocate said in the report.

The three steps involved in the program are fairly simple, but have also been supported by a significant body of literature, according to Tim Marchell, director of mental health initiatives at Gannett.

“[The program] has been shown to be effective in identifying people with alcohol problems and reducing further problems after the intervention,” Marchell said. Unlike broad, educational-based approaches like Alcohol-Wise, an online course required for all first-year students, the program uses a patient-by-patient approach, or “a targeted strategy to help individual students,” according to Marchell.

Before January, medical staff would have conversations with patients, typically shortly before the patients were discharged, but did not begin the intervention process with the same level of screening or follow-up with referrals directly after discharge, according to Marchell.

“What CARS proposed was that they could enhance the existing supports by having health promotion advocates in the emergency room on weekend nights,” Marchell said. “Having them available to provide some focused attention to individuals who are recovering from severe intoxication allows the emergency department staff to attend to other patients.”

“[Gannett is] very encouraged by the SBIRT program,” Marchell said. “We’re looking forward to reviewing with CARS and Cayuga Medical Center how the implementation is going.”

Original Author: Noah Rankin