Implementing Substance Use Screening and Referral in Primary Care

Primary care is the first step to screening and prevention , including the identification of substance use disorder (SUD). The number of patients with SUD has increased significantly in the past 10 years. It is estimated that 65% of patients with SUD are undetected in primary care. Efforts to bring improvement to the Institute for Healthcare Improvement (IHI) triple aim initiatives of improving the health of populations , improving the patient experience and decreasing the per capita cost of patient care are enhanced by community-based screening to identify SUD in primary care. To meet the need for increased screening and prevention of SUD , a scholarly project aimed at implementing Screening , Brief Intervention and Referral to Treatment (SBIRT) was performed at a primary care practice in a rural county of North Carolina. The primary objective of the project was to increase provider adherence to the screening and referral portions of the SBIRT guideline , developed by the Colorado Clinical Guideline Collaborative. SBIRT entails the use of evidence-based screening tools to detect SUD , brief educational interventions to halt or decrease SUD , and Referral to treatment programs. Providers were educated on the evidence supporting SBIRT in primary care , including the use of a single-question screening and the Drug Abuse Screening Tool. The single-question screening helped identify patients who may be at risk for SUD and the DAST-10 was then administered to all who answered in the affirmative. Patients who scored six or greater were referred to further , specialized treatment centers