Effect of SBIRT services provided in hospital emergency departments in Washington State on admission to chemical dependency treatment following screening

National survey data indicate that about 12% of the people who need substance abuse (SA) treatment in any given year actually receive it. In an effort to strengthen the capacity of organizations and communities to offer SA prevention and treatment services, the Substance Abuse and Mental Health Services Administration (SAMHSA) started the screening, brief intervention and referral to treatment (SBIRT) national initiative. Washington State was awarded one of the early SBIRT grants to develop a SBIRT program in 9 hospital emergency departments (ED). As part of a larger evaluation of the Washington SBIRT program, we evaluated the effect of the program on admissions to chemical dependency treatment in the 90-day period following screening. The treatment group (n = 7,097) consisted of 3 groups of welfare clients on Medicaid or a state-sponsored medical program. Using 1 to 1 propensity score matching procedures, we constructed a comparison group consisting of 7,097 clients who did not receive screening. We used multivariable logistic regression techniques to assess the effect of the program on 90-day readmission rates, controlling for demographic factors, treatment need, and health risk factors. Individuals receiving SBIRT services were 2.6 to 3.2 times more likely (p <.01) to be admitted to treatment. The SBIRT effect was greater for clients who had not received treatment during the year prior to screening (OR 3.0 to 3.8, p < .001). Our findings suggest SBIRT programs operating in ED settings can promote timely admission to treatment for individuals with drug or alcohol misuse problems.