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Active duty military personnel exhibit higher rates of problem alcohol use than their civilian counterparts. This project explored the efficacy of Screening, Brief Intervention, and Referral to Treatment (SBIRT) as an avenue for serving this hard-to-reach population. SBIRT was implemented in 7 civilian medical settings in New York near Fort Drum between February 2012 and January 2015 to assess service access, utilization, and rates of alcohol and drug use. Approximately 15% of patients were active duty military, with 7.7% screening positive for alcohol or drug misuse and almost 200 receiving project services. Findings highlight specific strategies for improving the model. [ABSTRACT FROM AUTHOR]

Aims: Research has reported a lack of practice of early intervention for substance use disorders among primary healthcare professionals, and only a fraction of patients were asked about their substance use when visiting a primary healthcare office. This study examines conditions that may influence the adoption of early intervention [i.e., screening, brief intervention and referral to treatment (SBIRT)] among primary healthcare professionals. Methods: A pilot survey was emailed to primary care physicians, nurse practitioners, and physician assistants in New York State, and 248 recipients responded to the survey. Findings: Three areas appear to be associated with the adoption of SBIRT: percentage of respondents' patients using marijuana (β = 0.14; p < 0.05); perceived ability to perform intervention (β = 0.32; p < 0.05); and perception of early intervention as a responsibility of primary care professionals (β = 0.29; p < 0.05). Conclusions: Training and education to promote SBIRT for primary care workers should focus on increasing their favourable attitudes towards the intervention as a strategy of preventive medicine and include the knowledge of the infrastructure of services for substance use disorders, especially for medical providers who see large numbers of patients at a high risk for alcohol and drug misuse. [ABSTRACT FROM AUTHOR]

Objective: This article reports the integration and outcomes of implementing intervention services for substance use disorder (SUD) in three New York City public sexually transmitted disease (STD) clinics.Methods: The screening, brief intervention, and referral to treatment (SBIRT) service model was implemented in the STD clinics in 2008. A relational database was developed, which included screening results, service dispositions, face-to-face interviews with 6-month follow-ups, and treatment information.Results: From February 2008 to the end of September 2012, 146,657 STD clinic patients 18 years or older were screened for current or past substance use disorders; 15,687 received a brief intervention; 954 received referrals to formal substance abuse treatment; 2082 were referred to substance abuse support services such as Alcoholics Anonymous (AA), and 690 were referred to mental health, social or HIV awareness services. Intervention services delivered through SBIRT resulted in improvements in multiple outcomes at 6 month follow-up. Patients who received interventions had reduced SUD risks, fewer mental health problems, and fewer unprotected sexual contacts.Conclusion: Delivery of SUD services in a public health setting represents a significant policy and practice change and benefits many individuals whose SUDs might otherwise be overlooked. Intervention services for substance use disorder were integrated and highly utilized in the STD setting. Further research needs to focus on the long-term impact of SUD interventions in the STD setting, their cost effectiveness, and the extent they are financially sustainable under the new healthcare law. [ABSTRACT FROM AUTHOR]

Based on an administrative data base of 410,000 substance abuse treatment clients in New York State, Asians are a small minority who differ significantly from other racial-ethnic groups on income, primary language, treatment setting, substance of abuse, referral source, and discharge status. In particular, relative to other race-ethnicity groups such as whites, blacks, and Hispanics, significantly greater percentages of Asians are referred from drinking-driving programs and completed treatment. However, most of the significant differences between Asians and other groups are found among clients with a first admission, and tended to attenuate among clients with a second or third admission. [ABSTRACT FROM AUTHOR]

Background and significance: According to New York statewide substance abuse treatment and discharge data, Asians are a small minority who differ significantly from other racial-ethnic groups on income, primary language, treatment setting, substance abuse, referral source, and discharge status. Objectives: The present study further compares alcohol and substance abuse service utilization patterns of Asians with those of Whites, Blacks, and Hispanics in New York State. Methods: Cox regressions were employed to examine the differences in treatment admission patterns among Asians and other ethnic groups, while controlling a number of demographic, treatment-related, and non-treatment-related factors. A sample of 408,158 clients was selected from the Client Data System of the New York State Office of Alcoholism and Substance Abuse Services for the analysis. Results: While Asians in general are less likely to use treatment services and to have multiple treatment admissions compared with other groups, those Asians with multiple admissions tend to show utilization patterns - the period of greatest risk for readmission, the rate at which readmissions occur, and the likelihood of readmission - similar to the other groups at each subsequent admission. Conclusion: These findings suggest both similarities and differences in treatment readmission patterns between Asians and other clients of substance abuse treatment services. Future research on the cultural and linguistic factors related to Asians' recovery and service utilization patterns after the initial treatment experience may be particularly important for systems of care seeking to be responsive to Asians' needs. [ABSTRACT FROM AUTHOR]

Abstract: This article addresses the issue of underutilization of treatment services by Asian Americans. Although Asian Americans continue to be the fastest growing ethnic minority in New York City, they are reported to underutilize substance abuse treatment services. However, much of the underutilization may be attributed to cultural and language barriers hindering them from seeking help and support. Past literature indicates that when culturally appropriate services are available, service utilization tends to increase among Asian Americans. This study tested strategies to enhance the continuum of care in the Asian community by adapting a well-documented generic early intervention model in a culture-specific setting. The results of this study indicate that these models may be successfully adapted to culturally specific settings such as Asian American communities. When culturally competent services combined with case management and motivational interviewing are provided, there tends to be an increase in Asian clients'' chance of accomplishing treatment goals. [Copyright &y& Elsevier]

Background: Unhealthy substance use is associated with increased rates of sexually transmitted diseases (STDs), including HIV. The screening, brief intervention, and referral to treatment strategy is effective at reducing substance use over time. We investigated whether STD clinic patients who received a brief intervention (BI) had lower rates of STD/HIV acquisition over time than those who did not.Methods: A retrospective sample of 7665 patients who screened positive for substance abuse or dependence between May 1, 2008, and December 31, 2010, was matched with STD and HIV surveillance registries for a 1-year follow-up period to determine incidence of STD and HIV infection.Results: Overall, 44.6% (n = 3420) received BI; 7.0% of this population acquired a bacterial STD compared with 8.8% of persons who did not receive BI (P < 0.005). In multivariate analysis, BI had a protective effect against STD infection for men (odds ratio, 0.774; 95% confidence interval [CI], 0.63-0.96), after controlling for age, race/ethnicity, and sex of partner. There were 61 new HIV infections over the follow-up period; however, we found no significant association between BI and subsequent HIV diagnosis.Conclusions: Brief intervention is associated with a reduction in STD incidence among men who screen positive for substance abuse and should be considered as an STD prevention strategy. Further study is needed to identify mechanisms through which BI may impact STD outcomes. [ABSTRACT FROM AUTHOR]