Screening and brief intervention (SBI): has it hit the tipping point?

Excerpt

In 1961, Chafetz [1] reported the results of a randomized trial of brief advice by a psychiatrist to patients with alcoholism in the Massachusetts General Hospital (MGH) emergency department (ED); 42% of patients in the advice arm reported to an alcohol clinic versus only 1% in the control group. Fifty years later, in the Liberty Hotel, the same space as the former Charles Street Jail in Boston where there was a “drunk tank” and across from that same MGH ED, over 200 researchers and clinicians gathered to present over 100 abstracts and plenary sessions on screening and brief intervention (SBI). In those 50 years, thousands of patients participated in randomized trials of SBI; the US Institute of Medicine (in 1990) encouraged identification and intervention for unhealthy alcohol use for people across the spectrum from risky use through dependence; the World Health Organization validated assessment tools and showed SBI’s effectiveness in primary care settings; and the US Substance Abuse and Mental Health Services Administration allocated substantial funding for SBI for both alcohol and other drugs across many general health settings. …