1. Overview of WASBIRT October 2004 WA State Screening, Brief Intervention, Referral and Treatment Five-year project: Oct. 2003 – Sept. 2008

2. INTRODUCTION TO WASBIRT Traumatic injury inflicts enormous medical and psychosocial harm on its victims. The greatest underlying cause of injury is the misuse of alcohol and drugs. A wide range of effective treatments have been developed for mild, moderate, and severe drug and alcohol problems.

3. INTRODUCTION (CONT.) Prior studies have shown that interventions, when delivered to injured patients in hospital emergency departments (ED) and on inpatient units of hospitals, can: –Reduce alcohol and drug consumption. –Prevent re-injury. –Help patients with more severe problems access intensive, community-based chemical dependency treatment.

4. The Goals of WASBIRT are … 1.Identify ED patients Substance Use, Abuse, and Dependency Disorder 2.Provide Screening and Brief Interventions in the EDs 3.Provide Brief Therapy on an outpatient basis

5. The Goals of WASBIRT are … 4.Increase referrals of patients with substance dependency disorder 5.Create Systems Change 6.Reduce Subsequent ED visits Future injuries Medical costs Criminal justice costs Death

6. How will WASBIRT do this? Six of the busiest trauma hospitals will host Chemical Dependency Professionals (CDPs) in their ED: Harborview … 5 CDPs – Initiated services 4/12/04 Tacoma General … 3 CDPs – Initiated services 4/26/04 SW Medical Center Vancouver… 3 CDPs – Initiated services 5/5/05 Providence Everett … 3 CDPs – Initiated services 7/5/04 Yakima Regional and Toppenish … 4 CDPs – Anticipate services will be available on 10/28/04

7. What will the CDPs do? Screen trauma and other medical emergency patients to determine their level of abuse or dependence on alcohol or drugs. Based on screening results, patients will be: –screened out or –provided a brief intervention or –referred for assessment and brief therapy or –referred for assessment and full CD treatment. Since April 12, 2004, WASBIRT CDPs have provided services to 4,300 patients whom have received screening, brief interventions, and referral for brief therapy, or chemical dependency treatment.

9. What system needs will be met in Washington State? Building the “I” into PITA Prevention – Intervention - Treatment – Aftercare New Collaborative Substance abuse treatment community and health care system

10. What system needs will be met in Washington State? TX as a prevention strategy Cost Offset Study Brief Interventions for those with a substance use or abuse disorder Demonstrate cost effectiveness of WASBIRT

11. How will we evaluate outcomes? Compare baseline and follow-up data on drug and alcohol use Examine costs offsets for Medicaid clients Measure hospital savings from reduced ED visits

12. Screenings, Brief Interventions and Referrals to Brief Therapy or CD Treatment April 12 – October 2, 2004

13. Type of Participation by Hospital

14. Number of Participants Approached by Hospital

15. Technical Notes: HOSPITAL START DATES Harborview Medical Center began interviewing patients on April 12, 2004. Tacoma General Hospital began interviewing patients on April 26, 2004. Southwest Washington Medical Center started interviewing on May 5, 2004. Providence Everett Medical Center began interviewing on July 5, 2004. INTERVENTIONS DESCRIPTION Screening Only – Patient Screened for alcohol /drug use, brief intervention not given. Brief Intervention – Patients received a Screen for alcohol /drug use and received a Brief Intervention in the Hospital. Brief Therapy – Patient received a Brief Intervention by the CDP plus Brief Therapy sessions. CD Treatment – Patient received a Brief Intervention by the CDP plus chemical dependency treatment. Held for Referral – Patient received a Brief Intervention by the CDP and was referred for further assessment and treatment. Patient records are held up to 28 days for resolution.