Journal of substance abuse treatment
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J Subst Abuse Treat · Jan 2016
An Examination of the Workflow Processes of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) Program in Health Care Settings.
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a public health program used to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs that has been adapted for implementation in emergency departments and ambulatory clinics nationwide. ⋯ Provisions within the Patient Protection and Affordable Care Act of 2010 call for the integration of behavioral health and medical care services. SBIRT is being adapted in different types of medical care settings, and the workflow processes are being adapted to ensure efficient delivery, illustrating the successful integration of behavioral health and medical care.
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J Subst Abuse Treat · Jan 2016
Local Implementation of Alcohol Screening and Brief Intervention at Five Veterans Health Administration Primary Care Clinics: Perspectives of Clinical and Administrative Staff.
Population-based alcohol screening, followed by brief intervention for patients who screen positive for unhealthy alcohol use, is widely recommended for primary care settings and considered a top prevention priority, but is challenging to implement. However, new policy initiatives in the U.S., including the Affordable Care Act, may help launch widespread implementation. While the nationwide Veterans Health Administration (VA) has achieved high rates of documented alcohol screening and brief intervention, research has identified quality problems with both. We conducted a qualitative key informant study to describe local implementation of alcohol screening and brief intervention from the perspectives of frontline adopters in VA primary care in order to understand the process of implementation and factors underlying quality problems. ⋯ Findings suggest that the local process of implementing alcohol screening and brief intervention may have inadequately addressed important adopter needs and thus may have ultimately undermined, instead of capitalized on, staff and providers' belief in the importance of addressing alcohol use as part of primary care. Additional implementation strategies, such as training or academic detailing, may address some unmet needs and help improve the quality of both screening and brief intervention. However, these strategies may be resource-intensive and insufficient for comprehensively addressing implementation barriers.
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J Subst Abuse Treat · Jan 2016
Implementation of a Brief Treatment Counseling Toolkit in Federally Qualified Healthcare Centers: Patient and Clinician Utilization and Satisfaction.
The need to integrate behavioral health care within medical settings is widely recognized, and integrative care approaches are associated with improved outcomes for a range of disorders. As substance use treatment integration efforts expand within primary care settings, training behavioral health providers in evidence-based brief treatment models that are cost-effective and easily fit within the medical flow is essential. ⋯ This work is significant because it provides support to clinicians in delivering evidence-based brief interventions and has been formatted into presentation styles that can be presented flexibly depending on patient need.
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J Subst Abuse Treat · Nov 2015
The characteristics of a cohort who tamper with prescribed and diverted opioid medications.
To describe the methods and baseline characteristics of a cohort of people who tamper with pharmaceutical opioids, formed to examine changes in opioid use following introduction of Reformulated OxyContin®. ⋯ Findings highlight the heterogeneity in the patterns and clinical correlates of opioid use among people who tamper with pharmaceutical opioids. Targeted health interventions are essential to reduce the associated harms.
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J Subst Abuse Treat · Nov 2015
Assessing Change Readiness and Treatment Eagerness among Psychoactive Substance Users in Northern Nigeria.
Studies on psychoactive substance use in Nigeria had focused on prevalence and rarely on treatment implication(s) of large rates reported. Further challenge was to find suitable instruments to monitor change readiness as well as predict treatment outcomes along motivation continuum and according to resilience characteristics. Such ability will not only help to match treatment strategy with stage of change but also come with a more satisfactory outcome. ⋯ ANOVA of these five profiles based on SOCRATES' 3 subscales was significant. The study demonstrates utility of SOCRATES-8 to assess change readiness and treatment eagerness of psychoactive substance abusers according to stages of change and their resilience characteristics. This will aid treatment planning and can also measure treatment outcome.