Results of the Georgia BASICS SBIRT Initiative

Gabriel P. Kuperminc, Ph.DGeorgia State University22 October 2015, Atlanta, GA

Georgia BASICS

• SBIRT Demonstration Project– Routine screening in Emergency Departments– Motivational Interviewing (15-30 minutes)– Availability of therapy, referral to treatment

• Settings– Grady Health System (Atlanta)– Medical Center of Central Georgia (Macon)

Urban Emergency Patients

• Risk– Poverty, housing instability– Lack consistent health care, unmet needs– Behaviors (e.g., alcohol, drug use) linked with

health concerns

• ED visit as “Teachable Moment”– Opportunity to help patients make the connection– Change from blame for poor choices to increased

motivation for positive choices

3 Question Prescreen: 25% Pos.

Patient Enters ED

7% High Risk

BI + BT

54% Low- Moderate Risk

BI

Positve Prescreens

receive ASSIST Full Screen

7% Very High Risk

BI+ RT

BI = Brief InterventionBT = Brief TherapyRT = Referral to Treatment

10% Sample enrolled For 6 month Follow Up

Nurse

Health Educators 32% Screening Feedback

Georgia BASICS: Services Provided

Services Provided

Screening/Feedback 154,429

Brief Intervention (BI) 21,193

BI + Brief Therapy (BT) 2,790

BI + Referral to Tx (RT) 3,176

Total 181,588

Evaluation

Screening:Identify Pts. Eligible for

Services

Brief InterventionBrief Therapy

Referral to Treatment

6-Month Follow Up

INTERVENTION GROUPx x

xCONTROL GROUP

x 0x

Study SampleControl Group

(N = 1737) SBIRT Group

( N =1170)

Years of Education 11.77 11.80

Average Age 42 42

Female 34% 29%

African-American 74% 74%

Employed Full or Part Time 33% 33%

Unstably housed/Homeless 49% 48%

Average Monthly Wage $807 $571

Notes: (1) SBIRT pts enrolled in study via random selection from those receiving services.(2) Control pts received screening/assessment but no services.(3) 6-month follow-ups completed w/ 50% of Controland 65% of SBIRT pts.

SBIRT Patients Decreased Substance Use Baseline to 6-mo Follow-up

Alcohol Any Drugs Marijuana Cocaine0

2

4

6

8

10

12

Baseline Follow-Up

Greater Decreases in Binge Drinking for SBIRT vs. Control Patients

SBIRT Control0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

92%

74%

58% 58%

Mental Health Improvements in Quality of Life

SBIRT Comparison3032343638404244464850

Baseline 6-Month

Conclusions

• REDUCED Alcohol and other Drug use– Similar to findings in other SBIRT studies– Tend to be Larger for SBIRT vs. Controls– Better Evidence for Effectiveness with Alcohol

than other Drugs

• MORE THAN SUBSTANCE USE– Improved Mental Health may mark greater

sense of control, help individuals choose to reduce use of substances

Thanks toSAMHSA, #TI019545 GA Div. Behavioral Health & Developmental

DisabilitiesGSU Colleagues and StudentsGrady Health System & Medical Center of

Central Georgia

For more information, contact:Gabriel KupermincDept of PsychologyGeorgia State UniversityP.O. Box 5010Atlanta, GA 30302gkuperminc@gsu.edu