Screening, Brief Intervention, and Referral to Treatment Plus (SBIRT-Plus): A Novel Interprofessional Training for Rehabilitation Science Professional Students.

IMPORTANCE: With the increasing amount of substance use-related health conditions in the United States, it is important for rehabilitation science professionals to receive screening and prevention training. OBJECTIVE: To describe and examine the preliminary effectiveness of a novel educational program, Screening, Brief Intervention, and Referral to Treatment Plus (SBIRT-Plus), that combines traditional SBIRT training with new modules for cannabis, stimulant, and opioid use. DESIGN: Prospective, cohort design. SETTING: Academic institution. PARTICIPANTS: One hundred eighty-one rehabilitation science graduate students. INTERVENTION: SBIRT-Plus curriculum. OUTCOMES AND MEASURES: Outcomes included satisfaction with training, perception of interprofessional training, attitudes, knowledge, and stigma, as assessed with the Readiness for Interprofessional Learning Scale, Alcohol and Alcohol Problems Perception Questionnaire, Drug and Drug Problems Perception Questionnaire, Knowledge Screening Scale, and two stigma instruments. RESULTS: Most students (>80%) expressed satisfaction with their training, would recommend the training to a colleague, and believed that the training would influence and change the way they practiced with patients at risk for substance use disorders. Students' attitudes and knowledge increased from pre- to post-training, and stigma perceptions were significantly reduced. CONCLUSIONS AND RELEVANCE: SBIRT-Plus is an evidence-based interprofessional training that is feasible to implement in graduate-level education programs. Integrating SBIRT-Plus into professional graduate programs may be an optimal and low-cost model for training rehabilitation health care professionals. Plain-Language Summary: Screening, Brief Intervention, and Referral to Treatment Plus (SBIRT-Plus) is an evidence-based interprofessional training that can be easily adopted in curricula to train professional students about the importance of screening for substance use disorders.

Executive Summary of the American Society of Addiction Medicine (ASAM) Clinical Practice Guideline on Alcohol Withdrawal Management.

: The American Society of Addiction Medicine (ASAM) Clinical Practice Guideline on Alcohol Withdrawal Management provides guidance on the identification and management of alcohol withdrawal in adults with varying degrees of syndrome severity. The guideline addresses both ambulatory and inpatient care and considers special patient populations. The Guideline was primarily developed following the RAND/UCLA Appropriateness Method (RAM), a process to determine the appropriateness of a set of clinical procedures. This process included a review of gray and empirical literature published between January 2012 and October 2017. Nineteen existing guidelines, 112 reviews, and 150 research studies were used to develop draft guideline statements that were assessed by a panel of physicians experienced in withdrawal management and representing a diverse range of settings and patient populations. Recommendations were included in the Guideline where consensus on appropriate clinical practice was identified by the panel. Areas where additional research would provide valuable information for determining best practices were highlighted.

Screening, brief intervention, and referral to treatment (SBIRT) education of residential care nursing staff: Impact on staff and residents.

Approximately 40% of older adults drink alcohol. Older adults living in community care residences are a vulnerable population at risk for alcohol use related problems especially for those age 65 years and older who are taking medications, have health problems, and have risky alcohol consumption. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach for individuals at risk for alcohol use disorders. A quality improvement project evaluated SBIRT education effects on nursing staff knowledge and attitudes related to alcohol use, and resident alcohol use. The staffs' SBIRT knowledge and alcohol related attitudes increased significantly. The staff documented SBIRT intervention 231 times in three months' post training.

Exploring medical students' conceptions of substance use: A follow-up evaluation.

BACKGROUND: Despite the devastating impact of alcohol and other drug involvement and misuse within society, medical students still receive very limited exposure to these issues. The Scaife Advanced Medical Student Fellowship in Alcohol and Other Drug Dependency, offered by the Institute for Research, Education and Training in Addictions for over 10 years, offers a unique, 3-week intensive educational experience, including didactic, observation, and experiential learning in these topics to first-year medical students. The goal of this project was to evaluate the impact of the Scaife Fellowship on medical students' attitudes toward patients with alcohol and other drug involvement 1 to 5 years after completion of the experience. METHODS: Past Scaife students and individuals who applied but did not attend were located and recruited to participate in an online attitude survey. RESULTS: Results indicated that Scaife Fellowship students largely retain their sense of role security around working with patients with alcohol and other drug involvement at the follow-up time point. Although therapeutic commitment or the motivation to work with these patients decreased for drug use, the decrease was smaller than that typically noted in the literature. The group of comparison students showed lower scores on both subscales at the evaluation time point compared with Scaife students. CONCLUSIONS: A three-week experiential program significantly improved medical students' Role Security and Therapeutic Commitment toward working with patients with substance use disorders. Moreover, the positive effects gained from the program were sustained over time.

Educating Emergency Department Registered Nurses (EDRNs) in screening, brief intervention, and referral to treatment (SBIRT): Changes in attitudes and knowledge over time.

Alcohol and other drug (AOD) diagnoses in the ED co-occur with injury-related presenting conditions including: falls, motor vehicle accidents, poisonings, and both intentional and unintentional injuries. Clinical attention to ED admissions resulting from hazardous AOD use can significantly improve patient care and reduce high cost utilization of ED visits and treatment. The EDRN-SBIRT project is designed to improve the knowledge and attitudes of ED nurses working in a large academic medical center to identify and address risky AOD use as it relates to an ED visit. ED nurses' knowledge and attitudes toward patients with AOD use can be improved through SBIRT education. SBIRT education can establish an evidence-based standard of nursing practice to improve healthcare outcomes, but it must be reinforced with ongoing ED review and supportive educational sessions until practice is firmly established.