255217 SBIRT for “risky” stimulant use in a Skid Row community health center

Wednesday, October 31, 2012

Lillian Gelberg, MD, MSPH , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Ronald M. Andersen, PhD , Department of Health Services, UCLA School of Public Health, Los Angeles, CA
Steve Shoptaw, PhD , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Lisa Arangua, MPP , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Yohana Barth-Rogers, MD , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Mani Vahidi , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Kyle Singleton , Medical Imaging Informatics (MII) Group, UCLA, Los Angeles, CA
Corey Arnold, PhD , Medical Imaging Informatics (MII) Group, UCLA, Los Angeles, CA
Alex Bui, PhD , Medical Imaging Informatics (MII) Group, UCLA, Los Angeles, CA
Barbara Leake, PhD , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
AIMS. NIDA/UCLA Quit Using Drugs Intervention Trial (QUIT) conducted an RCT of a very brief intervention for reducing risky drug use and harm in low-income, diverse primary care patients in FQHCs. The design emphasizes screening, very brief clinician advice (2-3 minutes), and two telephone drug-use health education sessions vs usual care control (240 per condition).We present findings on recruitment in a Skid Row FQHC. METHODS. Pre-visit screening of adults was conducted using a touchscreen Tablet PC. At-risk drug use was defined as casual, frequent, or binge use without dependence (ASSIST score 4-26). RESULTS. In 2011, 1060 adults were approached: 86% 40+ yo; 70% male; 64% Black, 21% Latino, 13% white; 70% homeless. 80% were excluded prior to the ASSIST. Among the 210 who completed the ASSIST, 23% were dependent on drugs or alcohol. ASSIST scores were (no/low risk, moderate risk, dependence, respectively): tobacco (24, 48, 28), alcohol (28, 46, 26), cannabis (43, 36, 21), cocaine (42, 34, 24), opioids (60, 26, 14), sedatives (66, 22, 12), methamphetamine/ amphetamine type stimulants (69, 20, 11), hallucinogens (81, 14, 5), inhalants (86, 10, 4). Excluding low risk- or dependent users, 56 patients (5.3% of those observed in waiting room) met study criteria of past 3 mo “risky” stimulant use. CONCLUSIONS. Integrating SBIRT into FQHCs is feasible. In Skid Row, only 5% of patients qualified for the study based on rates of risky stimulant use, as eligible patients were generally low- or dependent users. Stimulant rates observed are higher than in general populations (NSDUH).

Learning Areas:
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
To describe rates of substance use among patients of a Skid Row Community Health Center.

Keywords: Homelessness, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Professor of Family Medicine and Public Health at UCLA, and PI of the NIDA QUIT study upon which this abstract was based.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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