National Academy of Medicine establishes model for confronting substance use

National Academy of Medicine establishes model for confronting substance use
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The National Academy of Medicine recently established a model for primary care physicians for addressing substance use disorder, including opioid use disorder (OUD).

The approach is identified as a screening, brief intervention, and referral to treatment (SBIRT) model and was developed in response to rising overdose deaths in 2020. Physicians based their treatment on the initial assessment.

SBIRT traditionally has been used for alcohol misuse. Studies indicate it may be effective in reducing the misuse of other substances.

According to the new model, during the screening step, a clinician uses a questionnaire to assess the possible severity of patient substance use. During the brief intervention step, the clinician provides patients with feedback, discusses risks, encourages change, and discusses individualized goals. Patients needing more intensive care are referred to specialty treatment.

Some studies suggest there is no difference in outcomes for some who received SBIRT, whereas other peer-reviewed research indicates SBIRT may be effective in reducing drug misuse.

A study of 11 programs serving more than 1 million people in 2017 discovered an 80 percent reduction in self-reported illicit substance use following an intervention.

In 2005, a randomized controlled trial found that both heroin and cocaine use fell 29 percent following SBIRT interventions.

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