Posts Tagged ‘SBIRT’

Treating alcoholism in Wisconsin

January 5, 2010

I recently had a correspondence with Rep. Marlin Schneider (D-Wisconsin Rapids), the lone opponent of the most recent OWI legislation. A long with his belief that stiff penalties are in many cases unfair and vindictive, which I will explore in a later post (I’m waiting on some more feedback), Schneider called for more effective treatment of alcoholism.

I would support the ignition interlocks for repeat offenders, improving the quality of the drunk driving programs in our technical schools, and other efforts like making alcohol less available.  I attended the drunk driving program with a friend and I can tell you it is a joke.  My friend and the others in the class had to answer questions and fill out forms and literally make stuff up to satisfy the instructor.

Interestingly, the Daily Page just ran a story on a new kind of alcohol treatment philosophy that is gaining ground in the Badger State called Screening, Brief Intervention and Referral to Treatment (SBIRT).

SBIRT gives patients a questionnaire when they check in for an appointment, asking about drug and alcohol use. Professionals like Lightbourn review these responses for red flags that may indicate problems. They also check to see if there is a family history of substance abuse and any medical conditions like hypertension, high cholesterol or diabetes that might be exacerbated by drug or alcohol use.

Armed with this knowledge, Lightbourn [SBIRT doctor] initiates a discussion with the patient. She asks open-ended questions to help place the patients’ use of substances into one of four categories: low risk, at risk, harmful use and likely dependent.

Advice is given sparingly, and patients are not told what to do. As Lightbourn puts it, “The patient is driving the bus, and the decision is up to them to decide if they would like to make a change in their alcohol and drug use.”

At first glance, the technique strikes me as definitely more appropriate for certain personality types. Most adults don’t like being treated as children, and don’t like to be demeaned by being force-fed therapeutic dogma.

While plenty of people who have combatted alcoholism will likely tell you that they needed an aggressive, radical approach to get on the wagon, there are others, including many people who suffered from more mild alcoholism, that would benefit from a more frank, personalized discussion of their drinking habits. These people often resent being grouped with hardcore drug and alcohol addicts.