Integrating Substance Use Disorder ( Sud ) And Healthcare Services

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Integrating substance use disorder (SUD) and healthcare services is a major target in the era of healthcare reform.1 Care integration has gained momentum with the recognition that people with SUDs often have multiple physical health problems and are at greater risk for chronic diseases (e.g., congestive heart failure).1 One practice that has been cited as important in efforts to integrate care is Screening, Brief Intervention, and Referral to Treatment (SBIRT), an evidence-based model that can be used to identify and address risky substance use in healthcare and other clinical settings.2
Screening and brief intervention models have existed for many years, are recommended by a variety of national organizations, and have empirical evidence for efficacy in certain circumstances.3 Despite this, well documented barriers encountered during implementation 4-6 have limited uptake in healthcare settings resulting in a dearth of literature describing “real world” experiences of large scale SBIRT implementation. Healthcare administrators may be unsure how to tailor SBIRT practices and procedures when considering implementation.
Implementation of behavioral interventions require careful attention to many factors as outlined by implementation science models.7,8 Such models9 highlight the importance of considering setting and patient characteristics and related research10 has found that programs in primary care practices (PCPs) with successful alcohol screening rates adjusted

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