Linking substance abuse treatment and public health: Identification and early intervention in STD clinics
Issue: Twenty percent of New York City (NYC) Sexually Transmitted Disease (STD) clinic patients screened positive for alcohol or other drug (AOD) abuse but less than 2% reported receiving treatment. Description: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice to identify and intervene with risky AOD users in general health-care settings. Project LINK, a Substance Abuse and Mental Health Services Administration funded program, pioneered the SBIRT model in free urban STD clinics. Between 2008-2012, Project LINK screened 151,452 patients in three NYC STD clinics: 15,706 received brief interventions, 882 received referrals to formal AOD services, and 2,146 received referrals for mental health or social service programs. Between SBIRT intake and six month follow-up, reports of AOD abstinence increased from 1.2% to 19.4%, injection drug use decreased by 35%, and unprotected sex decreased by 31%. Lessons Learned: SBIRT can be successfully implemented in STD clinics. Linking AOD early intervention with STD services elucidates the connection between substance use and risky sexual behavior that can facilitate STD transmission. Recommendations: The model has been adapted to target at-risk users in addition to dependent users, and to provide multiple intervention sessions for patients needing additional support. Project LINK's success has led to SBIRT expansion to six high-volume NYC STD clinics and to emergency departments that serve a large number of patients from the military community in Fort Drum, NY. Future research should examine whether SBIRT is associated with decreased rates of STD/HIV acquisition.
Implementation of health education strategies, interventions and programs
Public health or related organizational policy, standards, or other guidelines
Differentiate Screening, Brief Intervention, and Referral to Treatment (SBIRT) from traditional forms of substance abuse treatment.
Describe the Project LINK model used in New York City Sexually Transmitted Disease (STD) clinics
Evaluate the effectiveness of Project LINK at reducing risky behaviors, substance use, and negative health consequences of substance use among STD clinic patients
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have served as Project Evaluator of two federally funded projects delivering early intervention services in New York City STD clinics, one of which is the focus of the presentation. I have developed and delivered presentations on substance abuse and HIV/STD related issues. My interest is in the area of SBIRT and am working on a state SBIRT cooperative agreement with the goal of statewide expansion.
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.