**Massachusetts Department of Public Health**

**Program Description**

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT), has awarded the Massachusetts Department of Public Health, Bureau of Substance Abuse Services, $2.8 million per year for 5 years to expand and enhance the continuum of accessible substance abuse treatment services by institutionalizing screening and brief interventions in general health care settings—including medical inpatient services and outpatient primary care, family medicine and adolescent clinics, and emergency departments—through the Massachusetts Screening, Brief Intervention, and Referral to Treatment (MASBIRT).

**Program Model**

**Screening**

Screening is administered by a Health Promotion Advocate or via a telephone or Web-based instrument, using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for adults and the Car, Relax, Alone, Forget, Family, Friends, Trouble (CRAFFT) for adolescents.

**Brief Intervention**

Brief interventions are conducted using motivational interviewing and the Brief Negotiated Interview (BNI) model. Brief interventions are conducted in-person or via telephone or Web-based technology and consist of one to four sessions. 

**Brief Treatment**

Brief treatment begins with an assessment of addiction severity, using the Addiction Severity Index (ASI). After discussion with patients about options for treatment modality and location, up to 12 sessions of motivational enhancement therapy and cognitive behavioral therapy are conducted by master's-level brief treatment specialists.

**Referral**

A Community Referral Coordinator coordinates referrals for brief and long-term specialty treatment. The Bureau of Substance Abuse Services and the Boston Public Health Commission maintain a list of programs and services to facilitate access to treatment.

**Service Features**

· All staff are trained in cultural competence and culturally specific services include specialty programs for adolescent, elder, women, gay/lesbian and transgender, African American, Latino, and Asian populations. 

· The use of a Tablet computer by the health promotion advocates allows for electronic links with the patient electronic medical record, and for MASBIRT data to be electronically entered into the MASBIRT DataMart. 

**MASBIRT Collaborative Partners**

· Boston Medical Center Section of General Internal Medicine, Clinical Addiction Research and Education Unit 

· Boston Medical Center Management Information Systems Unit 

· Boston Public Health Commission Substance Abuse Prevention and Treatment Services Counseling and Central Intake Unit 

· Boston University BNI-ART Institute 

· Boston University Data Coordinating Center 

· Brandeis University Substance Abuse Center of the Schneider Institute for Health Policy 

· Boston Treatment Development Training Center 

**MASBIRT Services Integrated in Boston**

· Boston Medical Center: General Internal Medicine, Family Medicine and Adolescent Clinics, Inpatient Units, and Emergency Rooms 

· Dorchester House MultiService Center 

· South Boston Community Health Center 

· Codman Square Health Center 

**Program Effectiveness**

As of July 3, 2008, a total of 22,552 patients have received services through this project. Of these, 14.0 percent (3,159) screened positive and receved an intervention and/or additional services for substance use.

MA SBIRT services as of July 3, 2008: 

· Screened 18,690 patients

· Provided brief intervention to 3,159 patients

· Provided brief treatment to 263 patients

· Referred 440 patients to treatment

**Contact Information**

Michael Botticelli, Project DirectorDepartment of Public HealthBureau of Substance Abuse Services250 Washington StreetBoston, MA 02108(617) 624-5151michael.botticelli@state.ma.us