In Alaska: Screening Is Part of Routine Care
By Rebecca A. Clay
To Shannon R. Sommer, Director of Recovery Services for the
Cook Inlet Tribal Council, Inc., one reason for SBIRT’s
success is its strategy of making drug and alcohol screening
just as routine as screening for heart problems or diabetes.
That approach helps battle stigma, she said.
The Council received a 5-year SBIRT
grant in 2003 to offer SBIRT to Alaska
Natives and others in Anchorage.
“If you incorporate the screening
into regular appointments, people don’t
think, ‘Oh, my goodness, they
must know that I use or think I have
a problem,’ ” said Ms.
Sommer.
The process typically begins when
a patient comes to the council’s
partner organization, the Southcentral
Foundation, for primary health care.
A medical assistant asks a few questions
to assess the patient’s risk
level, then passes the results on to
a behavioral health consultant.
Patients
who need brief interventions receive
two to five 15-minute sessions. Others
receive brief therapy, which consists
of about half a dozen weekly sessions.
Those with the most serious problems
receive referrals to substance abuse
treatment.
The goal of brief interventions and
brief therapy is to motivate the person
to change.
“As in many other cultures,
direct confrontation doesn’t
work very well with this population,” said
Ms. Sommer. “It tends to shut
people down.” As a result, the
interventions emphasize motivational
interviewing and negotiation.
The results have been “almost
unbelievable,” said Ms. Sommer,
noting that 25 percent of those screened
have alcohol or drug problems.
Between intake and a 6-month followup,
the percentage of individuals with
no past-month substance use more than
doubled—from almost 26 percent
to 57 percent.
The percentage of patients reporting
no or reduced consequences from alcohol
or illegal drug use jumped from almost
77 percent to almost 94 percent. Improvements
also included the percentages of individuals
who had stable housing, who had jobs
or were in school, and who had no involvement
in the legal system.
“Just this one basic screening
has a phenomenal impact,” said
Ms. Sommer. 
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