The Times, Trenton

Use Tools Like SBIRT To Avert Drug Addiction And Its Repercussions

With 557 heroin-related deaths in 2013, New Jersey has certainly seen its share of loss to this devastating public health crisis, which has overtaken car accidents as the leading cause of accidental deaths

The Times of Trenton — Wednesday, May 5, 2015

Times of Trenton guest opinion column
Daniel J. Meara

May 7 marks Children's Mental Health Awareness Day, so designated by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) 10 years ago. Coinciding with the creation of this day dedicated to raising awareness about youth mental health was the beginnings of the nationwide surge in prescription opiate and heroin misuse, a blight the federal Centers for Disease Control and Prevention has since classified as an epidemic.

Over the past decade, adolescents and young adults have been decimated by opiate addiction and resulting overdose deaths. SAMHSA found that 31,000 teens used heroin in 2013. It is not uncommon for a person to overdose the first time he or she uses heroin. With 557 heroin-related deaths in 2013, New Jersey has certainly seen its share of loss to this devastating public health crisis, which has overtaken car accidents as the leading cause of accidental deaths.

In reaction to the mounting number of overdose fatalities in the state, policy makers have made available to police and other first responders the drug naloxone, which reverses the effects of an overdose. Naloxone has saved many lives and will continue to do so. However, everyone would likely agree that the far better course would be to interrupt an emerging drug problem early, thereby avoiding an emergency situation and removing the need to administer a life-saving drug.

It so happens that there is a screening tool that has had considerable success in identifying drug and alcohol misuse well before it reaches the life-threatening point. The full name of the model is Screening, Brief Intervention and Referral to Treatment (SBIRT). The National Council on Alcoholism and Drug Dependence-New Jersey and NJ Citizen Action are partnering to raise awareness about this model and dramatically expand its use among youth 15-22 years of age. The aim of the initiative is to open a conversation with adolescents and young adults so they don't reach the point of overdosing.

The SBIRT model takes a three-part approach to recognizing and responding to a drug problem. Its first element, screening, consists of a series of questions by a physician or counselor to identify whether a patient or student has a burgeoning drug or alcohol problem. The screening examines whether drug or alcohol use has begun to assume such a dominant role in a person's life that it causes him or her to drift away from important relationships or lose interest in activities that had been important to that individual. If the individual's responses to the screening suggest problem drug use, the next step is a brief intervention, in which the doctor or counselor initiates an exchange to explore the reasons for the misuse to help the person recognize he or she may be on the cusp of a serious problem. The third component of SBIRT, referral to treatment, is reserved for anyone whose drug use has progressed to the point of addiction.

SBIRT is very much in keeping with the shift in health care toward early diagnosis and addressing a health issue before it becomes full-blown. Early intervention saves the patient from severe health issues and enormous medical bills.

Earlier this year, NCADD-NJ and NJ Citizen Action held a forum at Thomas Edison College on the state's opiate problem and the vital role SBIRT has to play in reining in drug misuse and the health problems that arise from it. Taking part in the forum was a team from Inspira Health Network, a hospital group in southern New Jersey that has seen marked success interrupting drug use in adult patients with SBIRT and improving their overall health as a result.

The featured speaker was state Sen. Joseph Vitale, who is spearheading a package of 21 pieces of legislation that take a comprehensive approach to opiate use. To his credit, the senator took the time to learn about SBIRT and agreed to include it in one of the bills he is shepherding through the Legislature. Of the proposed screening tool, he said, "The earlier we can identify a person's drug use and prevent it from overtaking their life — or even taking their life — the better."

A personal account of drug use was provided by NCADD-NJ Advocacy Leader Joel Pomales, who told the audience at Thomas Edison about having spent years in addiction before entering recovery. He described growing up in a prosperous community with fine schools. His suburban upbringing and blue-ribbon school did not prevent addiction from consuming virtually all of his adolescence and a good part of his 20s. What just might have prevented it, he said, was SBIRT.

Daniel J. Meara is public information manager for the National Council on Alcoholism and Drug Dependence-New Jersey.

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