Substance abuse screening to become routine


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At clinics across Iowa, getting screened for substance abuse will be as common as getting blood pressure taken or having reflexes tested at a doctor's checkup — just part of the routine.

The Iowa Department of Public Health was notified on July 3 that it received a $7.5 million grant from the Substance Abuse and Mental Health Services Administration, a part of the U.S. Department of Health and Human Services. The five-year grant will fund a substance-abuse prevention and early intervention program called Screening, Brief Intervention, and Referral to Treatment.

Everyone using participating health-care centers will undergo a voluntary screening to identify those at risk for or suffering from substance dependence. Those who test positive on a preliminary screening will go through further screening and a brief counseling session to address the extent of their substance abuse.

Similar screening programs have been successfully implemented in emergency treatment centers across the country, said Michele Tilotta, a project director for the program with the Bureau of Substance Abuse and Prevention.

"[The patients] may not be seeking help with substance abuse, but if that drinking or drug use is really compromising their ability to handle health, work, or family issues, we want to catch and treat it before it becomes an addiction or even more serious problem. It will really help those who have not reached the level of diagnosis for treatment," she said. "Screening is the very first step for prevention, and it's an extremely powerful educational tool — showing people the results of the screening can help them change their behavior."

The substance-abuse screenings will first be implemented in four federally qualifying health-care centers in Cook County, Black Hawk County, Scott County, and Polk County, as well as at Iowa National Guard's Camp Dodge.

Tilotta said the program is also intended to integrate substance-abuse screening into routine medical care.

"The beauty of [the screening program] is that it makes it like everything else," she said. "It takes away the stigma of alcohol- and drug-related abuse. It's about your health. If you're at a risk for a substance-abuse disorder, we want to make monitoring and caring for that normal — to make it part of wellness."

Ron Berg, the chief executive officer of MECCA, said any effective drug-prevention program must include an array of different approaches — and the new screening program will add to Iowa's diverse measures of prevention through education in schools, community coalitions, and law enforcement.

"Just like many other medical conditions, the earlier you identify the problems, the better the outcome will be," he said. "After a substance-abuse problem gets serious, they lose some of their supports, alienate their family, employment might have suffered, and they have to address those issues as well."

Tilotta said the grant targets the 30 percent of Americans who are at low to moderate risk of developing substance dependence.

But not only does the program decrease the severity of substance abuse, it lightens the strain on the state's economy as well. Her research has revealed that every dollar spent on prevention saves between $3.81 and $5.60 in the cost of public health care.

The Iowa Department of Public Health hopes to conduct almost 8,900 screenings annually and to improve training for medical professionals. Tilotta said. After establishing the screenings in designated health centers, she said, she hopes to expand the program to other medical centers, such as primary-care providers.

Berg said the screening could help normalize substance-abuse prevention.

"People respond to screening conducted right there with a physician and tend to be more open than if they have to set up an appointment at a different treatment center," he said. "Do you go to your doctor and tell them you have a heart problem, or do you go straight to a cardiologist?"

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