Brandeis Evaluates $14 Million Project

Schneider Institutes researchers partnering with Massachusetts Department of Public Health to evaluate its $14 million substance abuse screening, brief intervention, referral and treatment project

Researchers at Brandeis University’s Heller School will evaluate the newly funded Massachusetts Screening, Brief Intervention, Referral and Treatment (MASBIRT) project. The Massachusetts Department of Public Health (MA DPH), Bureau of Substance Abuse Services, in collaboration with Boston Medical Center (BMC), recently received a $14 million, five-year grant from the Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) to implement the MASBIRT project. MASBIRT will increase drug and alcohol screening in general health care settings and enhance the state’s substance abuse treatment service systems.

“This grant will allow us to broaden the continuum of substance abuse services to more readily identify people in the earlier stages of their disease. Historically, we have waited for people with substance use disorders to progress to the point where they need more acute services rather than picking them up sooner, particularly in primary care settings,” said grant recipient Michael Botticelli, assistant commissioner for Substance Abuse Services at the MA DPH.

According to Daniel Alford, MD, medical director of MASBIRT, the demand for substance abuse treatment continues to rise in Massachusetts. In 2004, there were 102,226 admissions to licensed substance abuse treatment services throughout the state, with almost 20% of those from the city of Boston.

To address this need, MASBIRT will be implemented in several BMC primary care clinical sites, inpatient services and emergency and urgent care sites, as well as three Boston HealthNet Community Health Centers.

The award will also allow MASBIRT to expand in several other capacities, including:

• Implementing a computerized medical information and data documentation system, which will allow MASBIRT to facilitate primary care provider involvement in alcohol and drug abuse screening and brief interventions as well as facilitate linkages with the substance abuse treatment system.
• Providing a full-time health promotion advocate at clinical sites who will assist patients with drug and alcohol screening and assessment and offer brief intervention and referral to substance abuse treatment for those patients in need.
• Providing substance abuse brief treatment by addiction counselors at generalist medical settings.
• Offering patients the option of updating their general health information and completing drug and alcohol screening at home via an automated telephone system prior to their primary care appointment.

“Patients diagnosed with alcohol or drug problems will be offered treatment at their primary care site or referrals to brief or long-term substance abuse treatment depending on the severity of their problem,” explained Alford. “Our goal is to increase and enhance the services currently offered to Massachusetts residents through the development of an effective, sustainable and replicable model of substance abuse screening, brief intervention, referral and treatment in generalist medical settings.” The evaluation, led by Christopher Tompkins and Mary Brolin of the Institute for Behavioral Health in the Schneider Institutes for Health Policy at Brandeis’ Heller School, will assess how well MASBIRT meets this goal.

In addition to evaluating the outcomes of the project, Brandeis’ evaluation will assess costs relative to savings in other areas of the healthcare system. “This approach will allow us to make the business case for MASBIRT,” says Christopher Tompkins. “The current initiative will allow Massachusetts to build the needed infrastructure for SBIRT and promote widespread support. The evaluation will help policymakers determine if the investment is worth the gain.”