Know what SBIRT is? Eventually, it might be part of your dental or physical checkup.
SBIRT is Screening, Brief Intervention and Referral to Treatment for alcohol and drug use. The University of Missouri-Kansas City School of Nursing and Health Studies won an $859,979 federal grant to incorporate SBIRT training into its curriculum for health professional students at the School of Dentistry and School of Medicine and its internal medicine and emergency medicine residency programs.
The project will result in a better-trained workforce that is prepared to respond to substance use as a health issue and implement SBIRT, increasing access to appropriate care for underserved patients and decreasing the prevalence of substance use disorders.
The Substance Abuse and Mental Health Services Administration, funder of the grant, wants to increase SBIRT throughout the healthcare system. SBIRT is a brief standardized screening for alcohol and drug use, and a 5- to 15-minute discussion to help patients who use substances at risky levels to reduce their use, or referral to treatment for patients who may have a substance use disorder.
“We are excited to bring this training to UMKC medical students, medical residents and dental students. Up to 20 percent of Americans use alcohol or drugs at risky or harmful levels,” said Heather Gotham, principal investigator of the grant and associate research professor in the Collaborative for Excellence in Behavioral Health Research and Practice at the UMKC School of Nursing and Health Studies. “They do not have a substance use disorder and need formal treatment, but probably do not know that their level of substance use can cause new, or worsen existing, health problems, including diabetes or hypertension.”
What is considered risky use? According to the National Institute on Alcohol Abuse and Alcoholism, risky drinking is healthy men consuming more than 4 drinks in one day or more than 14 drinks per week and healthy women consuming more than 3 drinks in one day or more than 7 drinks per week. Risky drug use is any use of illegal drugs or using prescription drugs other than how they were described.
SBIRT has been shown to decrease alcohol use, and lead to better health outcomes. However, most health professionals do not receive training and education on how to intervene with patients who are using alcohol or drugs. Currently, primary-care physicians, given the little time they can spend with patients, don’t practice SBIRT often. So the goal is to have health care professionals perform SBIRT during annual primary care checkups, emergency department or other specialty care medical visits, and mental or behavioral health care appointments.
“SBIRT is a perfect example of why it is so important for all health professionals to work as a team,” said Steven L. Kanter, dean of the UMKC School of Medicine. “The benefit to patients and the entire community is clear.”
The new grant, which begins in September, will train 145 faculty and 87 field supervisors on SBIRT. Then those supervisors would train about 327 dental students, 360 medical students, 78 internal medicine residents and 55 emergency medicine residents. The ultimate goal is to implement strategies that allow for SBIRT to continue after the three-year funding period ends, giving training to local and regional health systems.
“The SBIRT grant that UMKC has received will be helpful in multiple ways to our health professions students and the patients they serve,” said Marsha Pyle, dean of the UMKC School of Dentistry. “The project will help health sciences students work together to learn evidence-based ways to identify and help patients who have risky substance use. Brief intervention and referral strategies can then be utilized. By implementing curricula on this topic, the importance of early intervention to prevent negative health effects of substance use can be given priority.”
UMKC won a $934,223 grant in 2013, its first for SBIRT. In the past three years, more than 500 UMKC nursing and social work students received training. It also developed a free online course that has trained another 800 health and behavioral health professionals and students.
“The pioneering SBIRT curriculum developed at the UMKC School of Nursing and Health Studies will now be taught to our colleagues in the schools of Medicine and Dentistry. The impact of educating interprofessional teams in their environments, based on this evidence-based practice, will improve the patient experiences and outcomes in our urban health systems,” said Ann Cary, dean of the UMKC School of Nursing and Health.
The UMKC grant team includes Gotham, Pat Kelly, Sarah Knopf-Amelung, Araba Kuofie, Sharon Colbert, Kendra Barker and Doris Rogers at the School of Nursing and Health Studies; Michael McCunniff and Catherine Saylor-Boles at the School of Dentistry; and Caroline Dawson, Amy Stubbs, Jen McBride and Jared Keeler at the School of Medicine.