The BIG Hospital SBIRT Initiative

A Learning Collaborative to Expand SBIRT into Hospitals and Other Medical Settings

Drug Control and Research


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On April 24, 2013, Deputy Director for Demand Reduction David Mineta participated in a Web-based live event on the Screening, Brief Intervention, and Referral to Treatment (SBIRT) Hospital Learning Collaborative sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) National SBIRT Addiction Technology Transfer Center (ATTC). IRETA and NORC at the University of Chicago lead this important effort to move screening and treatment of substance use conditions into mainstream medicine. The SBIRT Hospital Learning Collaborative involves all hospital stakeholders to include administrators, all hospital staff, residency programs, SBIRT grantees, professional medical association representatives and accrediting organizations. The President’s Drug Control Strategy details actions to implement the Affordable Care Act, which – for the first time in history – ends discrimination against people with substance use disorders by requiring insurance companies to cover treatment for substance use disorders as they would for any other chronic disease.  SBIRT is an approach for identifying people with substance use disorders in any health setting.

Tom McLellan, Chief Executive Officer, Treatment Research Institute, and perhaps the most internationally renowned substance use researcher, discussed three separate SBIRT-type projects that the Treatment Research Institute (TRI) has engineered to mesh with the specific cultures and workflows of health settings so that SBIRT creates value and minimizes hassles. Tom did not report randomized controlled trials, but rather a series of formative evaluations. Three scenarios described: 1) SBIRT in the breast cancer ward of a university medical center; 2) SBIRT in middle and high schools in NYC; and 3) Brief interventions (screening not necessary) for seriously addicted, repeat hospital utilizers at the time of discharge – helping to reduce rapid rehospitalizations. McLellan’s presentation was provocative, thought provoking and stimulating.
David Mineta, Deputy Director for Demand Reduction, Office of National Drug Control Policy & Tom McLellan, Chief Executive Officer, Treatment Research Institute