Yale University

Yale University is currently in the second year of a five-year NIH funded grant to evaluate the effectiveness of screening and brief intervention for hazardous and harmful drinkers in the emergency department. This randomized control study is expected to have a total enrollment of 900 patients and is scheduled to run through February 2010. Patients over age 18 who present to the Yale-New Haven Hospital are screened for hazardous at-risk drinking using NIAAA criteria.

Patients who screen positive receive a brief negotiated interview (BNI) performed in the ED with referral to a primary care provider, followed by a telephone booster intervention with a trained nurse one month after the ED visit. This intervention is being compared to BNI without booster, standard care with assessments, and standard care without assessments. Follow-up assessments, at 6 and 12-months, will be obtained via interactive voice response (IVR). 

IRETA

The Commonwealth of Pennsylvania is currently working in cooperation with SAMHSA on a project to encourage health care providers to screen and provide counseling to their patients who misuse alcohol or other drugs. The goal is to moderate risky behavior patterns and reduce exposure to the negative consequences of misuse. This initiative is also designed to improve the linkages between general community health care and specialized substance use treatment providers to facilitate access to care.

Pennsylvania’s Screening, Brief Intervention, Referral and Treatment (SBIRT) project consists of multiple components. These include a continuum of screening, intervention and referral to treatment throughout Pennsylvania. Additionally, the SBIRT program includes education, identification of barriers to identify persons with substance use in the community, best practices in service delivery and specialized training to medical providers. 

Project ASSERT

Project ASSERT is a Screening and Brief Intervention program that was originally implemented at Boston Medical Center in 1993. The objective of Project ASSERT is to use the Emergency Department visit to improve the quality of care for patients who use alcohol, tobacco and other substances, as well as for patients without access to primary and preventive care services.

Project ASSERT uses Health Promotion Advocates (HPAs), hired from the community, to work with ED staff to screen, provide brief interventions and referrals to those who screen positive for hazardous substance use. Since 1994 over 50,000 patients have received services. Between 1999 and 2005, Project ASSERT has provided various services to over 27,000 patients. Currently, the Massachusetts Department of Public Health, Bureau of Substance Abuse has funded the BNI-ART Institute to disseminate the Project ASSERT model and train providers in six ED’s throughout the state.